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Eosinophilia and digestive issues
Hello All,

Thank you for taking the time to read this. To start, I am an otherwise healthy, 39 year old female and around December 6 had some health issues crop up, most of which haven't resolved. Basically, the first thing that happened is I sustained a back injury in the first week of December. Pretty much immediately afterwards, I had loose stools or full on diarrhea that has persisted to this day. I have normal bowel movements as well, but 99% of the time I will have loose or watery stools the same day. I've lost about 5 pounds in 2.5 months, but I am pooping a lot! I have mild to moderate diarrhea unless there is a rare occasion I have no bowel movements. The back pain I had cleared in a week and a half; however, the bowel issues did not. When wiping one time, there was pink on the tp. I was also dealing with stomach pains that seemed to coincide with the loose stools or diarrhea. I got in touch with my doctor after about 1.5 weeks, and he suggested gastritis, but I immediately had a sneaking suspicion it was not that. Fast forward to Boxing Day, and I had upper middle stomach pain that was so bad it left me bed ridden all day! I got in touch with the doctor for the second or third time, did a stupid Covid test which came back negative, and finally got my first round of blood work ordered and taken. I did stool samples but worried I may have contaminated them and they came back negative for parasites. I would like to do them again. Everything was great in my blood work, except I had Eosinophilia. When I next talked to the doctor, he had talked with a specialist who suggested taking me of an ant acid pill I was on to see if my issue with my bowels resolved. She also said we wouldn't have to redo the stool samples. I knew my issues wouldn't clear with the removal of the medication, as I had recently started taking them, after all of my bowel issues started. As an aside, I have, for the past 3-5 years had suspected reflux and confirmed swallowing issues. On a couple of occasions, I had food impacted and it was painful! Food still gets stuck in my esophagus from time to time, and I am logging these incidents now. I think this is all connected and have read up on EOE if you're familiar. Suffice it to say, I was to repeat the blood work after being on a new pill for my swallowing/reflux issues, and I still have diarrhea and loose stools to this day. The Eosinophilia is still present with the same number as a month prior (1.5, usually less than 1). The stomach pain seems to have mostly resolved though. And no more sightings of blood at all. I am currently waiting to hear from a specialist. This is starting to impact my sleeping and I am dreaming about my current diagnosis. I know Eosinophilia can mean something less severe or more severe. Any insight for me? Thank you so much in advance!
22 Replies
ACH2015
1903 Posts
seasons_fade

I am on an RX antacid due to acid reflux myself. During the work up after discovering Unknown Primary cancer, a gastroscope revealed I have Barrett's esophagus which is monitored with annual gastroscopes to keep an eye on - as it can lead to cancer itself.

You mention having stool samples taken.Was a FIT test done? FIT screening for colorectal cancer in Ontario is one less invasive way to rule out cancer in the colon, next step would be a colonoscopy to have a look. Recent Canadian studies indicate we should be tested at younger ages for colon and other cancers toward early detection and early intervention. Sometimes we are not looked at for screening due to our age factor working against us in the charts and thinking of some doctors. Symptoms should be investigated based on severity - not age. I'd suggest getting a FIT test done, ask for your blood work to be redone and keep an eye and get some further investigation done on your esophagus issues as the symptoms you mention are some of those I was told to advise my doctor about (difficulty swallowing is a red flag) for further investigation toward early intervention and better control of the condition. I don't want to scare you here - but your doctor sounds like the type that always goes through the lesser testing methods that take too long to determine the issues at hand - given your history and current symptoms.

One last thing I'll pass onto you - always trust your instincts and advocate for yourself.

Hope this helps.

ACH2015
ACH2015

Thank you so much for your reply. I don't think I have had the FIT test done, and I'm in Alberta, if that makes a difference. The stool kit I received was directly from the clinic and I didn't pick up a FIT test kit from the lab. There is also no information about a FIT test on my patient portal account with my results. I will call tomorrow and make an appointment to ask about it. Can he also order a colonoscopy?
When My doctor talked with the specialist on the phone, he relayed that she said he has ordered all the right tests for the time being...? At least that is what he told me. My MIL thinks I need a new doctor. Maybe I can ask the specialist about a recommendation for a new primary care doctor. I'm really glad I'm being referred to a specialist at this point. The appointment(s) can't come fast enough. I'm going to document the time line and ALL of my issues to bring up at the appointment.
ACH2015
1903 Posts
Hi seasons_fade

I suggested the colonoscopy for several reasons. If there is bleeding / blood in the stool it may be a hemorrhoid, or other intestinal issue - not always cancer. The FIT test is a fecal test to determine if a person has colon cancer. The same test should be available in Albert, the Ontario test was the first one I came across, when I sent the info, It is a less invasive tool for cancer screening, and is the precursor to an colonoscopy. In light of your acid reflux I am surprised you've not had a gastro scope to date to investigate the esophagus and see what's going on there. I ignored my acid reflux for years and ended up with Barrett's Esophagus - a precancerous condition that needs to be monitored. Fortunately, a change in eating habits and the RX meds are keeping the condition under control, and my last gastro scope revealed improvement. You mentioned a specialist, but not what type. Is it a gastroenterologist you are waiting to see? I understand its not always necessary to jump right to a colonoscopy, but make sure the specialist you see has your complete history of events, conditions when they started and also mention the esophagus history and issues as well. Mught as well get yourself assessed from stem to stern so to speak.

I hope you get into see the specialist asap, and get the answers and interventions you seek

Keep us in the loop - and keep safe.

ACH2015
ACH2015

I'm not even certain which specialist I am seeing, silly me didn't ask for clarification when I last spoke to my doctor on Thursday. I will ask for confirmation when I talk with him this week. I'm going to be demanding the FIT test, and if not, seeing a new doctor as soon as I can. My swallowing issues have been brushed off by him for the most part it seems, though I've had two doctors say they wouldn't recommend the scope as of now; as my swallowing issue hasn't gotten worse or more frequent. My doctor even said he wouldn't refer for a scope as I don't meet the criteria, such as vomitting blood! He has diagnosed me with Dyspepsia GERD and put me on an antacid pill and told me to log the stuck incidents. Makes me wonder how much of an issue he figures is acceptable in terms of food getting stuck. Should I lie to get further testing? Like really! He also didn't want to suggest the barium swallow test as it "has a lot of radiation." I talked with health link here in Alberta and the nurse suggested a swallow test as a great first step.Thank you so much for your thorough replies. I will document everything and bring it to the attention of the specialist I am seeing. Thank you again!
ACH2015
1903 Posts
Hi seasons_fade

I really don't understand the hesitancy on your doctors part to do some investigation on your behalf. The attitude of waiting until you are vomiting blood is horrid, and perhaps he/she does not understand what the warning signs (increased difficulty in swallowing for example) mean in relation to a worsening condition. Its your life and your esophagus and your health that need to me managed. I say this believing that you are following all preventative measures and doing your part toward the management of your condition. I am not saying you aren't , but just suggesting you reinforce this with any specialist you see, as to not being a patient that was suggested treatments you may have chosen not to follow. Patients that don't follow recommended treatments can kind of sink themselves when issues get worse - and based on what you've told us in your posts, you certainly sound like someone that wants a solution and has been following recommendations. I am more inclined to suggest you get a new GP as they are not all created equal, and I myself have terminated one oncologist during my treatments. Just make sure you have another GP to switch to first.

I always suggest to everyone to trust your instincts, and to advocate for yourself when needed.

Keep safe and keep us in the loop with what you discover please.

ACH2015
ACH2015

Thank you, and I agree. He has never investigated my esophagus issues. My swallowing issues have not worsened over time, I would say they have been fairly consistent and mostly only slightly bothersome since they started 3-5 years ago. It happens on occasion; I think last week it happened twice. I've only ever had two painful stuck incidents, years ago. I have never modified what I ate in terms of textures or solids or anything. I did have one incident of pain in my upper middle abdomen that was severe, about a 1-1.5 years ago. It was starting to affect my breathing at the time; my breath was shaky. It was like some sort of attack, as it subsided after 20-30 minutes. If it didn't, I was heading to emerg as per health link suggestion at the time.

Then I had upper middle stomach pain on Boxing Day that left me bed ridden all day. This was about 3 weeks after all of my current issues began. I've talked to 2 doctors now who said they wouldn't recommend the scope at this time, as my swallowing has not increased in frequency or the foods I have difficulty swallowing. Perhaps I need a third doctor to weigh in on the situation. I wish I could do the barium swallow as well as the scope!

Aside from an antacid pill to manage reflux, my doctor has only told me to avoid dairy, so I am doing that the best I can. I've gotten more suggestions from someone else to eliminate the 4 main allergy culprits: egg, dairy, wheat and corn; so I will try to do that as best as I can to see if it helps my condition until I see the specialist. I'm finding myself a bit lost in terms of eating at the moment! It seems like these items are in so many foods! Oh well, salads, fruits, rice, meat and veggies are my main stays at the moment. Maybe some vegan treats too!

I will look into the possibility of finding a new GP. It seems like a bit of a daunting task. I will ask around for suggestions. My instincts say I don't have cancer, but I know it's best that all of my symptoms are fully investigated for confirmation about what is wrong with me. Thank you for your replies. It truly means a lot. :)
ACH2015
1903 Posts
Hi seasons_fade

I meant to get back to you much earlier - but one issue after another today.

Re the first post Feb. 22

I read the Alberta health criteria you sent (thank you) is minimum age of 40 for a FIT test, but certainly your doctor could do a similar test just to rule this out - right? They do have the power to override the system, They have to look at symptoms first - not age related only. as a prerequisite.

And the second post Feb 22:

Again, I just don't understand the reluctance to investigate the GURD and your esophagus. I went several years with the condition - never went to a doctor about it and it was only after my cancer diagnosis that the full work up trying to determine the origin of my unknown primary cancer revealed the Barrett's Esophagus (a pre cancerous condition) and only then was I given RX meds and now undergoing annual scopes to keep an eye on things. I was told upfront that if my swallowing issues got worse or pain or increased acid refulx - I was to advise that specialist asap.

Food types are only one side of the coin here. I also modified the amount I eat at any one time. Several smaller meals seemed to help as well. Sometimes I know we all overeat at one sitting - especially with favorite dishes and treats. I also make a habit of not eating several hours before bed time and stay sitting in a chair (reclining) vs lying down that tends to help stop a problem before it starts. Lots of tricks and things to try, and its too bad not all doctors are created equal.

I'm happy to help - especially since your condition sounded so familiar to me and not having investigations sooner than later. Keep an eye on things, and see what your specialist has to say about the concerns you've raised here and have for yourself.

Keep us in the loop.

ACH2015
ACH2015

Thank you. I've been referred to an Internal Medicine clinic. Is this an adequate referral?
ACH2015
1903 Posts
Hey seasons_fade

It sounds like a good step in the right direction. Being referred gives you a chance to discuss your issues. The internal medicine clinic will give you that third opinion you mentioned and direction in moving forward - so I think so.

keep us in the loop.

ACH2015
Boby1511
303 Posts
seasons_fade
Did you get a CT?
I have had radiation which has caused a lot of diarrhea.
I had stomach/cramping, most notably after eating.
My CT revealed bowel inflammation. No cure just more fluids.
My doc also suggested imodium. Said diarrhea is not something you should let play out.
It's not a way your body is fighting an infection, its a reaction and should be treated.
But my diarrhea has been extreme. Diarrhea will also bring fatigue.
Wishing you well.
Boby1511
303 Posts
seasons_fade
Did you ask why you couldn't have the scope anyway?
I've had this throat scope, it is not fun, but quick. And no harm getting one.
(Mine they were looking for bowel obstruction, I have a colostomy).
Maybe get a nurse practitioner, they too can order these things. Although likely a wait time unless you marked urgent.
Boby1511

I haven't had a CT scan. I've only had blood work and stool samples. And I've been going to see my doctor and having phone consults for 2.5 months now. He didn't recommend treating the diarrhea with anything! I've counted, and I've already had diarrhea 39 times this month! I would say on average it is classed as "moderate" day to day. I've asked for the scope but been denied by both doctors.

Is the radiation what caused your symptoms? That's scary. Thanks for replying to me. :)
Boby1511
303 Posts
seasons_fade
Radiation caused my diarrhea. But mine is extreme. It is all water.
You can get over the counter imodium. I think it is fairly innocuous. Ask the pharmacist.
I do find the imodium helps a bit.
The CT scan can show if there is something wrong with your bowels.
I have inflammation. It hurts. Kinda like they twist and turn and seize up.

If you have a flareup you can go to emerge. Likely they would CT you with your symptoms.
But it could be anything, Diverticulitis, crohn's, irritable bowel syndrome,.. doesn't have to be cancer.
You could even have a glucose intolerance. Notice worse pain after eating white bread?
Your internal medicine referral is probably the place to get the CT/scope referral. You know when you appointment is?

I would think constant ongoing diarrhea should be some concern for follow-up. Along with your swallowing issues.
But don't overthink it. It could be anything at this stage.

Boby1511

From my understanding, it's probably not IBS as I have also had two incidents of nocturnal diarrhea since all of this started. But I'm trying to keep a positive mindset as you said, because I have no current answers. I am still having pretty regular normal bowel movements alongside diarrhea and mushy stools. As of this morning, I've lost 5-8 pounds. I don't notice change in stomach pain with food honestly. I'm trying to eliminate some high trigger foods to see if it helps, but that has just started.

I'm probably waiting a couple of weeks to hear from the specialist clinic as this is the very beginning and I don't yet have an appointment. If I don't hear from them, I'm to phone my doctor and let him know.

Thank you!
Boby1511
303 Posts
seasons_fade
If you have another flare up go to the emergency. Don't suffer at home.
Hopefully the internal medicine gets you in soon.
Wishing you all the best.
Boby1511
ACH2015

I have a phone consult Friday morning with my doctor to inquire if my stool has been tested for blood and if not, why not, and then requesting it to be done. I'm also going to ask if I can take anything for the diarrhea. We will see what the doctor has to say. I don't see anything on my patient portal account about testing for blood. Still patiently waiting to hear from internal medicine. I should hear back between March 4th and 11th at the latest. I will definitely go to emergency if I have another stomach flare up. Thank you both so very much. Your help means a lot.
ACH2015
1903 Posts
Hi seasons_fade

That's good to have the consult this Friday. At least your prepared questions can be answered.

So looking back, your blood work - it was tested and was negative for parasites. That's one potential cause other's are: "an increase in the number of eosinophils in the blood, occurring in response to some allergens, drugs, and parasites, and in some types of leukemia". Mayo clinic Eosinophilia link shares and gives more information about the condition and potential causes. To share some experience with rectal bleeding, my cancer is unknown primary, and I have been scoped and scanned and prodded to death - almost. Some years ago - early in the diagnosis phase - I noted blood after defecating as well. I had a follow up colonoscopy and it was a hemorrhoid. So, its not always the worst case scenario. I know others had mentioned in their posts in this thread that it could be many reasons and causes for the diarrhea, abdominal pain, bleeding and all associated concerns. The key is continuing on with the required testing to figure this out. If bloodwork showed eosinophilia, anf its not from parasites - further testing need be done to discover the cause - right? So that next step has to be established by either your GP or the internist you are waiting to see.

Andy you are right to seek discovery for the stool sample that was taken to determine if there are reasons for concern and their root causes.

Thank you for the update, and keep us in the loop with your discoveries.

***One other thing I meant to mention. I was concerned about by gut bacteria after all the chemo / immuno / anti biotic and the host of all other drugs could affect my natural bacteria and flora related to digestion of foods and ability to properly absorb nutrients and break down and process foods. I was concerned I should be taking a probiotic supplement. The oncology dietician I spoke with said if people have been on sustained anti biotics or like drugs - there natural bacteria count could be down, and may need a boost - but not regular taking of probiotic supplements, because like the old saying goes "too much of a good thing - is no good" rings true with gut bacteria. Overstimulation is just as bad as not enough - so something else I wanted to mention to you. Anyway, let us know what you discover.

Keep safe.

ACH2015
ACH2015

My blood work showed the Eosinophilia; my stool showed that there are no parasites. But I'm worried I may have contaminated the stool sample and would like to re-do it just to be certain. I will ask about that on Friday as well.

I'm not currently taking any probiotics. I'm basically not doing anything unless the doctor suggests it, aside from a bit of an elimination diet. So far that is going well; no diarrhea yesterday or today so far.

Thank you for telling me about your personal situation, as like you said, bleeding can be from so many things. With primary cancer, they cannot tell where it originated? That sounds like a lot to deal with. So thank you for taking the time to help others on this site.

The rectal bleeding only happened ever so mildly, and only visually once. I do want them to test for microscopic blood though, I think that's important. And I'm on the cusp of 40 (in August). I like what you said in an earlier post about investigating based on the severity or chronic nature of symptoms rather than being exclusionary based only on age. A person of any age can get cancer, after all. And colon or rectal cancers are on the rise for younger people.

I will update when I talk with the doctor on Friday.
ACH2015
1903 Posts
Hi seasons_fade

Hope you are well. Discussing what is going on in our own situations is the best way to learn and also feel less alone with our issues right? Sometimes we can believe and feel like these things are only happening to us - and in truth, many of us are in the same boat. I'm happy to share with you.

Let us know what you discover from the testing.

Keep safe

ACH2015
ACH2015

Hello again! I am doing okay. How are you doing?

I went to emergency on Sunday and received blood work and urine samples only, no CT scan. I guess my pain was not enough to warrant the CT scan. My blood work showed the eosinophilia as resolved (at the moment anyways). However, my loose stools persist. I'm on a restricted diet and have now lost 10 pounds. I cut wheat, eggs, corn and most dairy. I had 3.5 days of only normal bowel movements last week and thought I was onto something with the new diet. I ate something a little different for me and then my loose stools ramped up on the 4th day. So I won't be eating that anymore to see if it helps. It was a gluten, dairy and egg free cupcake that may have had corn ingredients in it.

The good news is I have an initial phone consult booked with a General Internal Medicine Doctor on March 12. So making progress. I'm going to type up a point form document that lists all of my issues from start to finish to refer to during the initial phone consult.

Hope you're doing well. Thanks for checking in!
ACH2015
1903 Posts
Hi seasons_fade

The good news is that you've got some recent results to share with the GIM doctor on March 12th. The imbalance in your system has to get identified to determine what is causing these flux's in your bowel movements. An excellent idea to do a point form sharing for the consult, and be as descriptive as possible with when you first noted these issues and mention all issues including the GURD because there could be links to things we don't see.

Since having all of my interventions, I have more frequent mood swings, less energy and fatigue is a constant. More recently - never ending headaches. I have had CT's blood work, etc... and after years so much has been ruled out - but no cause found to date. These are frustrating and at times debilitating issues to live with in both our cases. I am sure there will be some need for the GIM doctor to do some additional research, perhaps testing and hopefully get to the bottom of this. And as always seek out any referral he or she may suggest in the quest for the cause if they are stumped.

Thanks for the update - and keep moving forward.

ACH2015
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