Hello, Given this, a leading suspicion would be autoimmune gastritis / pernicious anemia (or a related autoimmune process affecting stomach lining and intrinsic factor) causing insufficient absorption of vitamin B12 (and possibly other nutrients). This can then lead to neurologic damage, gastrointestinal disturbances, and systemic symptoms.
And which specialist you should see; Find a specialized GI center or academic hospital where they handle complex malabsorption / autoimmune GI cases and please request for a multi specialist evaluation.
Tests to consider; Upper GI endoscopy plus gastruc biopsies Complete blood panel Serologic tests Neurologic test Autoimmune screen
Feel free to talk Thank you
You appear to have a multi-system autoimmune and malabsorption disorder centered on pernicious anemia (Biermer’s disease), with secondary intestinal inflammation and nutrient malabsorption. Your current picture (persistent gut issues despite normal colonoscopy and corrected labs) suggests microscopic inflammation or dysbiosis rather than psychological or purely functional disease.
This condition can improve significantly, but it requires: Lifelong B12 maintenance Gut microbiome restoration Balanced diet (not overly restrictive) Regular autoimmune monitoring
Your complex case suggests a multi-layered issue that has been difficult to pin down. Despite multiple diagnoses and treatments, several symptoms persist, indicating the need to revisit or broaden the diagnostic perspective. With chronic diarrhea, mucus, blood in stools, and instances of vitamin deficiencies, inflammatory conditions like celiac disease, inflammatory bowel disease (IBD), or irritable bowel syndrome (IBS) with atypical presentation could be considered. Even though celiac tests were negative and initial colonoscopies didn’t confirm IBD, it’s worth exploring these further.
The presence of macrocytosis, high ESR, and vitamin B9 deficiency suggest absorption issues or chronic inflammation. The repeated finding of vitamin B9 deficiency despite treatment points to possible malabsorption or dietary insufficiency that hasn’t been fully addressed. The anti-intrinsic factor antibodies also hint at a possible autoimmune issue like Pernicious anemia, affecting vitamin B12 absorption, though your B12 levels are currently adequate due to supplementation.
The recurrent episodes of neurological symptoms combined with gastrointestinal issues can sometimes be part of a broader condition like small intestinal bacterial overgrowth (SIBO) or less commonly, a condition like mast cell activation disorder which can overlap with symptoms of allergic responses you’ve experienced.
At this point, given the complicated nature of your symptoms and test results, it’s crucial to re-evaluate your case with a multidisciplinary approach. I would recommend seeing a gastroenterologist or an internal medicine specialist who has expertise in complex cases. They might consider ordering more comprehensive stool studies, genetic tests for rare autoimmune disorders, or specialized breath tests for carbohydrate malabsorption and bacterial overgrowth. Moreover, re-evaluation by a nutritionist to ensure proper absorption and dietary adherence can also be beneficial. Further, a rheumatologist or an immunologist consultation could rule out any systemic inflammatory or autoimmune conditions.
Your dietary management, though strict, should continue being monitored, especially if certain food groups seem to trigger or worsen symptoms. Since your symptoms don’t notably align with stress, ensuring there’s an ongoing assessment to update your symptom log might reveal patterns that haven’t been seen yet.
In situations like severe or sudden exacerbations characterized by high fever, unremitting rectal bleeding, prolonged severe abdominal pain, or significant weight loss, promptly seeking emergency medical attention is important to rule out acute complications.
Hello Lylia On the basis of whole given scenario of your medical condition
Advice / Plan (Short) • Likely problem: Chronic autoimmune/inflammatory gut disorder with nutrient deficiencies. • See: Gastroenterologist, hematologist, neurologist. • Diet: Balanced, avoid extreme restrictions. • Supplements: Continue folate, iron, vitamin D as advised. • Emergency: Severe pain, vomiting, blood in stool, fainting → go to hospital. • No new meds until evaluated by specialists.
Your long-standing digestive issues with chronic diarrhea, mucus and occasional blood in stools, rapid transit, and persistent abdominal pain despite normal imaging and labs suggest a complex gastrointestinal or malabsorption disorder, possibly functional or autoimmune-related. Given your history of vitamin deficiencies, positive anti-intrinsic factor antibodies, and ongoing systemic symptoms, a comprehensive evaluation by a gastroenterologist, ideally with a focus on malabsorption syndromes and autoimmune enteropathies, is strongly recommended. Additionally, a nutritionist and possibly an immunologist should be involved to address dietary optimization and underlying immune or inflammatory contributions.
