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She’d seen seven specialists in 18 months, but no one could explain her Lyme disease abdominal pain. The tests were normal. The pain was not.
Her doctors never considered that Lyme disease abdominal pain often begins long before anything shows up on imaging.
Ultrasound: normal. CT scan: normal. Endoscopy: normal. Colonoscopy: normal.
The final GI note read: “Likely functional. Consider stress management.”
That’s when she asked about Lyme disease.
“Normal GI tests don’t rule out real pain — they just mean we haven’t asked the right question yet.”
Why Lyme Disease Abdominal Pain Gets Missed
Abdominal pain rarely points to one diagnosis, so she was sent through every standard test to rule out ulcers, gallbladder disease, IBD, or cancer. When all of it came back normal, her pain was quietly placed in the “functional” category — a medical way of saying, “We don’t know.”
And that’s where the investigation usually stops.
But her story didn’t fit the pattern of a functional disorder. The timing felt wrong. The symptoms too sudden. The rest of her body was clearly involved.
How Lyme Disease Abdominal Pain Starts
Lyme disease doesn’t just affect joints or the brain — it can disrupt the autonomic fibers of the vagus nerve, the main signaling path between the gut and the rest of the nervous system. When those neural pathways misfire, digestion slows, sensitivity heightens, and the gut loses its rhythm.
Many patients also develop constipation that seems to appear out of nowhere — a sign of slowed motility from vagal dysfunction rather than a primary GI disorder.
And for some, the disruption goes even further.
Lyme-related GI issues don’t look the same in every patient. Certain individuals develop sudden-onset gastroparesis — food sitting in the stomach for hours, early fullness after small meals, or nausea that feels out of proportion. Others experience functional dyspepsia, bloating, or the sense that their stomach simply “won’t empty.” These aren’t separate diseases; they’re different expressions of the same autonomic problem.
By the time patients reach me, they’ve often completed every GI test imaginable. What they haven’t been evaluated for is nerve-driven gut dysfunction — the kind that doesn’t show up on imaging but is felt deeply in daily life.
She put it this way: “It feels like my stomach just stopped working.”
Why Lyme Disease Abdominal Pain Doesn’t Show Up on Imaging
Traditional GI tests look for visible problems — blockages, inflammation, structural changes.
But Lyme disease abdominal pain is driven by disrupted signaling, not damage you can see on a scan.
That’s why the pattern feels so confusing:
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Migrating cramping
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Bloating that worsens throughout the day
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Nausea in waves
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Pain that intensifies with POTS or standing
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Test after test returning normal
It’s not IBS developed slowly over time. It’s abrupt autonomic disruption.
Co-Infections Complicate the Picture
Co-infections don’t just add symptoms — they amplify autonomic instability, making Lyme disease abdominal pain more intense and more unpredictable.
When It Actually IS IBS or Gastritis
Not all abdominal pain points to Lyme disease. True IBS tends to unfold gradually, with predictable bowel patterns and clear dietary triggers. Gastritis often improves with acid suppression or avoiding irritants.
Her case didn’t match either.
Her pain was sudden, migrating, systemic — and stubbornly unresponsive to typical GI treatments.
That mismatch matters.
Treating Lyme Disease Abdominal Pain: What Actually Helps
Her story took a turn when she recalled a tick bite six months before her symptoms began. Around that time, she also developed joint pain, dizziness, night sweats, and a racing heart when standing — clues pointing away from GI disease and toward infection-driven autonomic dysfunction.
So we treated Lyme and Babesia together.
Within three weeks, the nausea began to ease.
By six weeks, the cramping episodes were fewer and less severe.
At three months, she told me: “I can finally eat a normal meal again.”
Her pain had always been real.
The cause had simply been missed.
The Bottom Line
For many patients, Lyme disease abdominal pain is a neurologic symptom — not a GI mystery. Recognizing that difference opens the door to answers instead of more dead ends.
Share Your Story
Have you had abdominal pain dismissed despite normal testing?
Did your symptoms begin after a tick bite or along with dizziness, palpitations, or fatigue?
Share your story below — your voice may help someone else finally be heard.
Resources
- Case Rep Orthop. Abdominal pain as first manifestation of lyme neuroborreliosis in children, case report and review of literature
- CDC. The many manifestations of a single disease: neuroborreliosis
- Dr. Daniel Cameron: Lyme Science Blog. Sep 11 Abdominal pain, ileus and constipation due to Lyme disease
- Dr. Daniel Cameron: Lyme Science Blog. Lyme disease leads to muscle weakness of the leg and constipation
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I had violent abdominal pain, something like burning pain. Gabapentin came with an improvement in this, so it was a kind of neuropathic pain.
I am glad you found a solution. I have urged my patients to include a Lyme disease evaluation in my patients with unresolved GI issues
What treatment did you use that helped the person in this article.
Thank you
My daughter who is 8 now tested positive for Lyme at 5 years old. She was perfectly healthy before Lyme got to her. She had a limp, headache, extreme fatigue, red bullseye rashes all over, irritated eyes, a fever of 104 that wouldn’t go away for days. Her nurse practitioner for whatever reason didn’t think it was lyme. So for 3 weeks she had these symptoms before I finally brought her to urgent care. They immediately diagnosed her with Lyme and sent her home with 3 weeks of doxycycline and two weeks of amoxicillin. That seemed to kick the limping, fever and excessive fatigue. She has been struggling with poor digestion and big stools and urinary urgency ever since. She now can’t digest milk products and she doesn’t eat big meals anymore. She always feels full. Her teeth don’t look healthy even though she brushes every day. Her hair is thin as well. I feel like she is not absorbing enough nutrients. I don’t know who to take her to see because her nurse practitioner denies that she had it even though she tested positive for it. She even called me and told me she tested positive for it but says it was most likely a false positive. I just want to see my daughter thrive. We need help from a real doctor who won’t gaslight us. We do not have lots of money to bring her to get tested everywhere. This article really sounds like what she has been dealing with. If you have any suggestions I am all ears! Thank you for your time
One of my first Lyme symptoms over 30 years ago was stomach pain and then POTS. Treated on and off for many years and generally much better except for the stomach issues listed above. Two years ago My heart eould race everytime I swallowed and only lasted maybe 15 seconds. Stayed in hospital two nights and everything was pretty normal…. All tests. I told the docs it was probably my vagus nerve and they thought it plausible. Recently bloating and what felt like gastroparesis led me to get tested at IGENEX and test came back with IGM positive for babesia and indeterminant for TBRF. So im waiting for atovaquone and arithromycin to come. Ive read that babesia can also cause these symptoms so we will see. Its kind of a relief to hear that it could be lyme/coinfection related
Thanks for sharing. I have patients with POTS and GI issues from autonomic Lyme
Pareil pour moi piqûre avec érythème migrant rester sans traitement pendant un mois mon généraliste ne voyait pas ce que j’avais je me suis présenté aux urgences et là un interne m’a dit faut faire une sérologie et bien sûr j’étais positive plus plus et depuis j’ai reçu deux fois un mois amoxicilline et rien d’autre mais toujours pas soigner j’ai toujours des symptômes qui migre mais les médecins ne nous écoute pas voilà
I am sorry to hear that you are still ill. You are welcome to call my office with your question.
Thank you for posting this. This was my experience exactly! Sudden issues with constipation that didn’t follow normal advice (drink more water, eat more fiber, etc). Tests all came back normal. I had a hard time getting providers to listen to me or take me seriously. The gastrointestinal symptoms were preceded by noticeable psychiatric changes for about a year (big increase in anxiety, less feeling of being grounded, more negative self-talk). No bullseye rash or acute illness. It took me 23 years to get diagnosed. Treating now and finally getting some relief.
Interesting article. I contracted some form of lyme and babesia and other coinfections. First in Germany in 1995 and some probably later. Regardless of where I lived my life changed 100% as even the Mayo clinic, pain clinics, Univ…. long story short, GI has always been a problem. Try every option i learn of. In 2019 i went to a clinic in Germany and finally learned the truth. Read and followed lyme dr’s and read Buhner and others recommendations.
Takes work to try to be healthy but more so to deal with humans who don’t believe nor understand. Best is to read, try, love animals, exercise, and eat carefully. Bikram hot yoga! Any GI advice welcomed. Even good food can leave one feeling miserable.