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Suggest Treatment For Severe Stomach Pain, Cramps And Diarrhea
Question: Hi Doctor,
About 2 months ago I was filling ill with stomach pain, cramps, diarrhea, coughing. Finally, I went to see a doctor. She gave me a Z-pack for the cough and sent me for a blood test. My Absolute EOS were extremely high at 7.4 and WBC 15.7. She sent me for stool test to see if I don’t have any parasites. Negative. Another blood work, WBC went down to 11.6 and Absolute EOS were bit lower 6.9. Another stool test. Negative. Finally, she send me to see infectious disease doctor. Blood test still the same, stool #3 negative. My stomach symptoms are gone for almost a month but blood is still showing abnormal results. I am scheduled for endo and colonoscopy next week. Since I don’t have any more stomach symptoms I am afraid that something else is causing my abnormal blood tests. I will still do the endo and colonoscopy but should I see hematologist at this point? I don’t want to waist more time if this is something serious and it’s been almost 2 months since my first abnormal blood work. I would greatly appreciate your input.
About 2 months ago I was filling ill with stomach pain, cramps, diarrhea, coughing. Finally, I went to see a doctor. She gave me a Z-pack for the cough and sent me for a blood test. My Absolute EOS were extremely high at 7.4 and WBC 15.7. She sent me for stool test to see if I don’t have any parasites. Negative. Another blood work, WBC went down to 11.6 and Absolute EOS were bit lower 6.9. Another stool test. Negative. Finally, she send me to see infectious disease doctor. Blood test still the same, stool #3 negative. My stomach symptoms are gone for almost a month but blood is still showing abnormal results. I am scheduled for endo and colonoscopy next week. Since I don’t have any more stomach symptoms I am afraid that something else is causing my abnormal blood tests. I will still do the endo and colonoscopy but should I see hematologist at this point? I don’t want to waist more time if this is something serious and it’s been almost 2 months since my first abnormal blood work. I would greatly appreciate your input.
Brief Answer:
Clinical features & investigations suggestive of hypereosinophilic syndrome
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
An absolute increase in eosinophil count over 1500 / microlitre is of concern.
You have mentioned that the high eosinophil count is persisting over 2 months.
First of all allergies and parasitic infections need to be ruled out.
Your history suggests that repeated stool tests have come negative for parasites- ova and cyst.
There i no evidence of allergy in your history.
A clinical assessment is required to look for any organomegaly. This is to rule out any blood related disorder like malignancy.
However, your blood picture does not show any immature cells, thus, ruling out possibility of any blood malignancy.
Now we are left with the possibility of hypereosinophilic syndrome.
Hyper-eosinophilic syndrome is characterized by elevated eosinophil count, cause of which cannot be found out.
The condition leads to infiltration of eosinophils into organs like gastrointestinal tract, nerves, lung tissue etc.
Accompanying diarrhea, cramps, coughing etc support the possibility of hyper-eosinophilic syndrome.
Thus, I suggest you to go for endoscopy and colonoscopy and for biopsy from respective sites.
The syndrome can be confirmed by histopathological examination of biopsies.
Treatment of this syndrome is symptomatic.
Thanks and take care
Dr Shailja Puri
Clinical features & investigations suggestive of hypereosinophilic syndrome
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
An absolute increase in eosinophil count over 1500 / microlitre is of concern.
You have mentioned that the high eosinophil count is persisting over 2 months.
First of all allergies and parasitic infections need to be ruled out.
Your history suggests that repeated stool tests have come negative for parasites- ova and cyst.
There i no evidence of allergy in your history.
A clinical assessment is required to look for any organomegaly. This is to rule out any blood related disorder like malignancy.
However, your blood picture does not show any immature cells, thus, ruling out possibility of any blood malignancy.
Now we are left with the possibility of hypereosinophilic syndrome.
Hyper-eosinophilic syndrome is characterized by elevated eosinophil count, cause of which cannot be found out.
The condition leads to infiltration of eosinophils into organs like gastrointestinal tract, nerves, lung tissue etc.
Accompanying diarrhea, cramps, coughing etc support the possibility of hyper-eosinophilic syndrome.
Thus, I suggest you to go for endoscopy and colonoscopy and for biopsy from respective sites.
The syndrome can be confirmed by histopathological examination of biopsies.
Treatment of this syndrome is symptomatic.
Thanks and take care
Dr Shailja Puri
Above answer was peer-reviewed by :
Dr. Prasad
Thank you very much for your response.
Just assuming that my colonoscopy and endoscopy test with biopsies are normal what would you suggest as a next step? My infectious doctor is suggesting to see allergy doctor as a next step but I don’t have any symptoms of any kind of allergy. You’ve mentioned “A clinical assessment is required to look for any organomegaly”. Besides my GI track tests and referral to see an allergy doctor nothing was suggested at this point. What organs do you have in mind that should be checked? And how soon should I repeat my blood work in case my EOS?
Thanks again
Just assuming that my colonoscopy and endoscopy test with biopsies are normal what would you suggest as a next step? My infectious doctor is suggesting to see allergy doctor as a next step but I don’t have any symptoms of any kind of allergy. You’ve mentioned “A clinical assessment is required to look for any organomegaly”. Besides my GI track tests and referral to see an allergy doctor nothing was suggested at this point. What organs do you have in mind that should be checked? And how soon should I repeat my blood work in case my EOS?
Thanks again
Brief Answer:
In case biopsy is negative, you need to consult an allergy specialist.
Detailed Answer:
Hello and welcome again,
Based on your clinical features- pain, cramps and diarrhea, it is likely that there is infiltration of the eosinophils in the intestinal mucosa and other parts of gastrointestinal tract. The condition is called gastroenteritis.
Thus, you need to wait for the biopsy report.
In case the biopsy is negative the you need to consult an allergy specialist and watch your eosinophil count.
Ideally it should be repeated every month.
Thanks and take care
Dr Shailja Puri
In case biopsy is negative, you need to consult an allergy specialist.
Detailed Answer:
Hello and welcome again,
Based on your clinical features- pain, cramps and diarrhea, it is likely that there is infiltration of the eosinophils in the intestinal mucosa and other parts of gastrointestinal tract. The condition is called gastroenteritis.
Thus, you need to wait for the biopsy report.
In case the biopsy is negative the you need to consult an allergy specialist and watch your eosinophil count.
Ideally it should be repeated every month.
Thanks and take care
Dr Shailja Puri
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. REMY KOSHY
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