IBS and hypokalemia

Tokyo007

Well-Known Member
Hey doctor and everyone..old school member here. Got a question when you get a chance if you could respond.

This is really a sad story but i've been sick and nauseated for 3+ years. 2 weeks before my CFI checkride in 2005 under heavy stress I got some sort of infection, was given months of antibiotics for a UTI that never cultured out. Never recovered. I grounded myself, and never talked to an AME/FAA about my situation because I didn't know what it was. Been a lab rat for 3 years basically testing for everything (scopes, blood tests, ct scans mri's you name it). Had my gallbladder removed in 2007 due to low ejection rate of 12% and I thought that was the answer to my problems but it wasn't. Anxiety, nausea, sweaty palms, major IBS issues...I knew something was really wrong and now can't work. To stay in aviation I taught as an instructor using my AGI/IGI certificates trying to stay current.

Everytime i've been to the ER room over the years (5 or 6 times with abdominal pain and severe nausea) the Dr.'s would just shrug and say "you're dehydrated and you have low potassium blood levels..but we can't find anything wrong with you so.. must be classical IBS. Here take a potassium pill and follow up with your doctor."

After years and years of trial and error; me and my GI doctor put two and two together and noticed my potassium blood levels were all low over the years and suspected hypokalemia (1-5 in scale it was around 3) and he put me on potassium chloride pills for 30 days.


Happy to report my nausea levels have gone waaay down..to minor and i'm really excited and starting a food diary on offending foods with fiber supplements but my abdominal pains/IBS-C issues are still there. Been doing fiber and exercising trying to reduce stress and prepare for my AME (if I can ever get better) if I can just get the dumb IBS issues under control. Little bit of anxiety issues but if you didn't fly for 3 years you'd be the same I think. Starting fiber slowly and increasing is what i've heard i'm supposed to do. Drinking plenty of water now.

Anyway question:

I searched for IBS via this site/FAA AME guide... and I know many pilots just "deal with it" and fly with it, and the FAA is ok as long as symptoms are under control and not taking meds for it. But right now mines a little crazy to the point where i can't fly, but hopefully I can get my IBC-C muscle spasms/cramps under control..but I can't find any info on hypokelemia on the AME guide. I'm just guessing but i'll probably need a letter from the doctor about it? We're planning on retesting to make sure my blood levels are normal after the 30 days. I was probably dehydrated/hypokelmic for 3 years which resulted in major IBS levels left over i'm dealing with now. Any other suggestions I need to get back up? I figured i'd ask, wouldn't hurt.

Thanks! (i'm just excited to be *maybe* coming back again..hopefully I can...over the years I thought it was chron's to intersistal cystisis...thank goodness it's nothing more than that!)
 
btw the I should say the only firm diagnosis i've been given is IBS/spastic colon *shrugs* but I haven't been formally diagnosed with hypokelmia.

Thanks :)
 
I feel your pain - almost the exact same thing happened to me when I was in college. Similar symptoms - similar lack of a diagnosis. I suffered for about five years but the effects still seem to linger - although to a much, much smaller extent.

I was on Accutane for two weeks prior to getting sick, so I always though that that's what it was. Now based on what I've read in some places, I'm starting to think that it might have been toxic shock from the blonde hair dye I used to use. The symptoms also started not long after I started using it. I told every one of my docs but none believed there to be any connection. I started getting a lot better about the time time I stopped using it.

Hope you get it resolved - I can certainly relate to how frustrating it is.
 
Thanks Murdoughnut :S yeah it's been... a nightmare. It's weird how it started too, I was given flagyl as an antibiotic and the doctors *think* I had an allergic reaction to it. I ended up in the ER room with severe dehydration and that was the start of the downfall. Not sure if I ever want to touch antibiotics ever again after that.

Glad you're better..this is the first time i've started feeling a *little* better. Before just driving a car was a challenge with the nausea I was dealing with *crosses fingers* hopefully it'll all resolve and i'm trying to stay on natural products as much as possible.

Thanks.
 
Thanks Murdoughnut :S yeah it's been... a nightmare. It's weird how it started too, I was given flagyl as an antibiotic and the doctors *think* I had an allergic reaction to it. I ended up in the ER room with severe dehydration and that was the start of the downfall. Not sure if I ever want to touch antibiotics ever again after that.

Glad you're better..this is the first time i've started feeling a *little* better. Before just driving a car was a challenge with the nausea I was dealing with *crosses fingers* hopefully it'll all resolve and i'm trying to stay on natural products as much as possible.

Thanks.

Yeah, I took Flagyl at one point too - god there were so many meds. The only one that really helped me was Hyoscyamine - it's an anti-spasmotic that helped with some of my stomach and intestinal pains. That and cranberry juice (100% all natural stuff) seemed to help a bit too.
 
yeah i've taken some antispasmotics like hysocamine (dry mouth feeling) and librax.. they seem to help me sleep but I know they're a total FAA nono.

Hopefully the fiber will help. I know with hypokelmia the symptoms are constipation and nausea do to lack of potassium to smooth muslces so hopefully I can fly again *crosses fingers* are you flying at the airlines now? You're near my age. You all better now? I"ll try your cranberry juice idea.
 
yeah i've taken some antispasmotics like hysocamine (dry mouth feeling) and librax.. they seem to help me sleep but I know they're a total FAA nono.

Hopefully the fiber will help. I know with hypokelmia the symptoms are constipation and nausea do to lack of potassium to smooth muslces so hopefully I can fly again *crosses fingers* are you flying at the airlines now? You're near my age. You all better now? I"ll try your cranberry juice idea.

Yeah, I got the dry mouth from it too - actually the reason I went off of hyoscyamine was because when I finally went to finish my PPL, the FAA pulled my medical. I had to go off of it for 6-months and submit a doctor's note before I could fly again.

Nah, I just fly private - co-own a 172, about to finish my instrument ticket. I don't have any plants of flying commercially. I would say that I'm 85% better now - still have some stomach issues, but since giving up fatty and hard to digest foods, they've gotten a lot better. The most important thing is that now it doesn't get in the way of my day to day life. For a long time there I was really wondering what I was going to do with myself.

Try the cranberry juice idea, though - couldn't hurt. Good luck! :)
 
That's awesome you're back up flying again, because right now the only thing that is really holding me back is the pains on my left upper left and the hint of nausea but the doctors tell me fiber should help that out. I just want to be close to 100% if I can before I deal with the AME/FAA.

I'll try cranberry (heck i'll try anything!) I haven't been able to work these last 6 months so just going on potassium has been a big change. I still hope and dream on the airline pilot job...right now I don't know but i'm glad to hear someone else is doing well enough to fly again :)

Thanks for the info!
 
if the docs say you need more fiber, I'd suggest trying the Fiber One granola bars. The strawberries and almond one in particular I really like and it has 35% of your daily fiber intake in it (and doesn't taste nasty and dry like most fiber products)
 
1) You will need to submit copies of ALL of your records to the FAA for a decision..

2) I would go to either the Mayo Clinic in Minnesota for an evaluation or to the University of Utah in Salt Lake City. I had a friend recently who had seen multiple physicians and been diagnosed with several different GI illnesses until she finally was seen at the Mayo Clinic where they made the correct diagnosis.

3) I don't think regular IBS causes hypokalemia. You need to see the expert at the bottom of the funnel for a good evaluation.
 
1) You will need to submit copies of ALL of your records to the FAA for a decision..

2) I would go to either the Mayo Clinic in Minnesota for an evaluation or to the University of Utah in Salt Lake City. I had a friend recently who had seen multiple physicians and been diagnosed with several different GI illnesses until she finally was seen at the Mayo Clinic where they made the correct diagnosis.

3) I don't think regular IBS causes hypokalemia. You need to see the expert at the bottom of the funnel for a good evaluation.


Thanks doctor, that's what I figured on the records part. You know after months and months of antibiotics treating a UTI that never cultured out...maybe this is some sort of yeast overgrowth/SIBO causing spastic colon on my left side? I've had negative stool studies but i've read that they are mostly undetected as far as yeast and bacteria overgrowth. I've done the fiber routine many times before and I do feel a *little better* on potassium (not as nauseated) but I still feel like there is a cause for this. Maybe i'll ask my GI specialist about trying that, probiotics with antifungal therapy or something with fiber..i'm just thinking off the top of my head but I've never gotten a firm diagnosis except IBS and it's really frustrating being in pain and nausea like I am.

I do have one request though (Sorry!) you wouldn't happen to have the name of someone or the group to talk to or contact info at the University of Utah? I live like 20 min. away from the U of U. I'm desperate..can't work, and no insurance this whole time (broke living with the parents) i'm on my 3rd GI specialist..but talking to the pros would be worth a try

Thanks for the reply!


**Theshortone: yeah I've been doing citrucel/benefiber but I will try that too..i've heard those fiber bars are pretty good actually. Thanks :)
 
Thanks doctor, that's what I figured on the records part. You know after months and months of antibiotics treating a UTI that never cultured out...maybe this is some sort of yeast overgrowth/SIBO causing spastic colon on my left side? I've had negative stool studies but i've read that they are mostly undetected as far as yeast and bacteria overgrowth. I've done the fiber routine many times before and I do feel a *little better* on potassium (not as nauseated) but I still feel like there is a cause for this. Maybe i'll ask my GI specialist about trying that, probiotics with antifungal therapy or something with fiber..i'm just thinking off the top of my head but I've never gotten a firm diagnosis except IBS and it's really frustrating being in pain and nausea like I am.

I do have one request though (Sorry!) you wouldn't happen to have the name of someone or the group to talk to or contact info at the University of Utah? I live like 20 min. away from the U of U. I'm desperate..can't work, and no insurance this whole time (broke living with the parents) i'm on my 3rd GI specialist..but talking to the pros would be worth a try

Thanks for the reply!


**Theshortone: yeah I've been doing citrucel/benefiber but I will try that too..i've heard those fiber bars are pretty good actually. Thanks :)



Were you on Clindamycin by any chance?
 
Were you on Clindamycin by any chance?

You know.. it's been awhile I might have..it was 2+ months of straight powerful antibiotics. I remember the doctors were frustrated and reaching for every antibiotic they had.. do you know the generic name of it? I don't remember that one off hand so probably not..I do remember flagyl/cipro/avelox/tequin.

I'm actually thinking of asking my gi specialist about SIBO (small intestine bacterial overgrowth) and candida (even though my stool studies were negative) because my nausea is just insane..even if..not to get gross but even when i'm completely empty which makes me wonder and question this whole IBS diagnosis.
 
I am in no way a doctor, but some of the symptoms you describe are similiar to what my wife had. It took over a year before one doctor had a light bulb moment....

Have you ever been checked for Crohn's Disease? It's an auto-immune disease with numerous, reoccuring symptoms until it is under control (Not always easy to get the right treatment since every patient responds differently)


good luck.
 
thanks for the post pilotbob34,

Yeah i've had 2 conoloscopies and 2 endoscopes plus multiple CT scans and one MRI looking for anything (including a barium upper GI drinking elmers clue like stuff x-ray) so they've eliminated that as well. I thought it was chron's disease years ago actually.

Well the sad news.. and good news is.. to update my situation is I asked my doctor to test for SIBO (small bacterial overgrowth) because that's one test i've never done before.. and I noticed it's also used to test for lactose intolerance. I've gone on no dairy before but I didn't realize how lactose is in some breads..cereals ect..the sad part is we couldn't find a place that does testing for the breath test so they told me to go lactose free and see how I feel.

Anyway, I've gone lactose free for about a week now and my nausea waves are WAAAY down!! Like i'm no longer tied to a bathroom or home.. :) i'm still dealing with a spastic colon pains on my left side so i'm doing fiber now trying to get rid of that with lots of water. Trying to avoid anti-spasmotics since they just put your colon to sleep basically but hopefully my spastic colon will go away and i'll get it under control and hopefully i'll be flying soon (i'm exercising trying to eliminate anxiety as well...I was really messed up on dairy it turns out..)

Anyone have advice how to beat anxiety/spastic colon from a lactose intolerance/dairy allergy?? let me know thanks..trying to get back to working asap and flying.... Hopefully i'll be flying soon!

Thanks!
 
I was diagnosed with hypokalemia too but I think it was more based on my poor diet. I've been eating a lot of cantalope and honey dew melons, bananas, etc now.
 
yeah i'm eating bannanas every other day now, bleh.. but gotta do it.

Also I think I have a hunch i'm celiac (or very least wheat intolerant). I was tested 3 times over the years all negative blood tests but i've eliminated dairy/wheat from my diet and i'm feeling quite a bit better so hopefully *crosses fingers* I think I might just have some lousy food allergy of some sorts.. most likely wheat.
 
I hear ya. I lived with stomach problems for years while flying and it was no fun. I too played the guessing game with the docs and was just as frustrated until one Doc changed my antibiotic to Levaquin and suggested no dairy. I have been nearly normal ever since.

Hang in there and don't give up. Keep asking the docs questions and take Dr. Forred's advice. Go see the best of the best docs.

Good Luck!
 
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