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Hi there I am 25. I have had ongoing health issues for over a year and no doctors I have seen (and there have been many) seem to be interested in helping me.

For the entire time I have had loose bowel movements, sometimes diarrhea, frequent stomach pains, flatulence and nausea- all of which have severely impacted on my work and personal lives.

I am always tired and often feel faint.

I also often get numbness in my hands but that is probably unrelated.

There were no changes to my diet and it is pretty balanced - I eat plenty of red meat, I had a gastroscopy in August which came back ok but I am not sure what exactly was being looked for.

I was told in February that I had a b12 deficiency (158 pmol/L) which has been treated with injections, though there does not seem to be a cause and all three doctors I have discussed it with have done blood tests for pernicious anemia and then shrugged about it.

I have also noticed on print outs I have requested that my bilirubin level has been above the range at 21 and 24 umol/L for the two tests I have had done on it, though I am not sure if this is significant as none of the aforementioned doctors said anything about it.

I have been referred to a different gastroenterologist in February, I am not sure exactly why or what they will be doing though. I would really like any suggestions of what it could be or what I can do to feel better.
Thank you



Dear Anon,

Irritable bowel syndrome (IBS) tends to take one of three different types: diarrhea predominant, constipation predominant and alternating diarrhea and constipation.

Most people diagnosed with IBS have diarrhea predominant form.

Trigger foods are different for every person that has IBS, but red meat is one of them.

While red meat is a great source of vitamin B12 and other nutrients, it is hard to digest.

The diagnosis of IBS is performed using a diagnostic algorithm. Well-known algorithms include the Manning Criteria, the obsolete Rome I and II criteria, the Kruis Criteria, and studies have compared their reliability.The more recent Rome III Process was published in 2006.

Physicians may choose to use one of these guidelines, or may simply choose to rely on their own anecdotal experience with past patients. The algorithm may include additional tests to guard against mis-diagnosis of other diseases as IBS. Such "red flag" symptoms may include weight loss, GI bleeding, anemia, or nocturnal symptoms.

B12 deficiency can cause anemia.

In the condition called Gilbert's disease, which occurs in 5% of the population, there is an isolated increase in bilirubin. The disease does not progress.

There is a connection between Gilbert's Syndrome and Irritable Bowel Syndrome most likely due to gastroparesis, which has been found to be connected with GS.

Gilbert's disease is a common disorder passed down through families. It affects the way bilirubin is processed by the liver, and causes jaundice. Fatigue is the first symptom and Jaundice typically appears during times of exertion, stress, not eating, and infection.

IBS or Irritable bowel syndrome can also cause fatigue

Anemia may cause high bilirubin values.

Fainting is one symptom of Irritable bowel syndrome in extreme cases.

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