Stomach pain can be a symptom of Lyme disease

woman with stomach pain from lyme disease

“Although abdominal pain is generally not considered a sign of LD [Lyme disease], in this case report we describe a patient with unexplained severe abdominal pain that eventually turned out to be LD due to radiculopathy,” explains Stolk from the Haga Teaching Hospital in the Netherlands. [1]

The 71-year-old woman underwent an exhaustive evaluation to determine the cause of her abdominal pain. Tests included: CT scan of the chest and abdomen; whole body emission tomography-CT scan (PET-CT); colonoscopy; gastroscopy, and an MRI of the small intestines. Initially, doctors did not consider testing for Lyme disease as a cause of the patient’s stomach pain.

The woman was admitted to the hospital for pain management and other diagnostic workups.

READ MORE: Lyme disease manifests as abdominal pain in a young child

Approximately 8 weeks prior to her hospitalization, she experienced temporary lower back pain, myalgia, fever, burning sensations and tenderness on her head and upper legs and moderate stomach pain. Several weeks later, her abdominal pain worsened.

“Going over the history again, she emphasized that she had stayed in a high endemic area for ticks and had suffered a possible tick bite without any sign of erythema migrans,” writes Stolk and colleagues.

Lyme disease associated with stomach pain

Serologic testing and a spinal tap were consistent with Neurologic Lyme disease. The spinal tap revealed an elevated IgM antibody to Borrelia burgdorferi (Bb), a lymphocytic pleocytosis, markedly elevated IgM antibody index to Bb, and markedly elevated IgG antibody to Bb.

[bctt tweet=”Case report: When abdominal pain is the main manifestation of neuroborreliosis.” username=”DrDanielCameron”]The authors point out that “Since the incidence of LD is rising it is important to realize that severe abdominal pain could be the first clinical manifestation of early neuroborreliosis.

After a 2-week course of intravenous ceftriaxone to treat Lyme disease, the woman’s symptoms, including stomach pain, resolved completely.

This case demonstrates the importance of re-examining a patient’s history when symptoms cannot be explained, the authors point out.

“Instead of doing extensive diagnostic tests, it is important to scrutinize the patient’s medical history in the presence of unexplained clinical signs.”

The authors note: Abdominal pain in the presence of facial paralysis has been described in Europe as Bannwarth Syndrome.

Editor’s note: I often see Lyme disease patients in my practice who present with stomach pain severe enough to warrant extensive diagnostic testing before Lyme disease is suspected.

UPDATED: May 28, 2021

  1. Stolk JM, van Nieuwkoop C, van der Voorn M, van Erp S, van Burgel ND. Ticking off diagnoses of abdominal pain: early neuroborreliosis with radiculopathy. Neth J Med. 2018;76(7):336-338.

33 Replies to "Stomach pain can be a symptom of Lyme disease"

  • delilah
    05/27/2020 (3:27 am)

    My daughter is 18 years old and has been sick for 8 months with severe abdominal pain, nausea/vomiting and blood in stool. She originally went to the ER and was said to have a kidney infection, a month later she had her appendix removed. She has had several ultrasounds, 2 ct scans, a colonoscopy, gastroscopy and is awaiting a cystoscopy and a MRI of the small intestine. Do you think there is any chance this could be Lyme disease. She was camping for about a month 3 weeks before she got sick and there was ticks around, although she does not remember getting a bite.

    • Dr. Daniel Cameron
      05/27/2020 (2:23 pm)

      I have seen children and young adults with GI problems. The problem relates to autonomic issues when the immune system responds to the tick-borne infection.

      The stomach problems clear if Lyme disease is treated. Call my office at 914 666 4665 if you have questions

  • Melissa Vacek
    08/16/2019 (8:53 pm)

    Can gastric ulcers be caused by Lyme? My 17 year old daughter has had lots of issues over the past few years with stomach pain being the main complaint. She has been diagnosed with PANS and a few weeks ago we got a positive Lyme test. She did not respond well to IVIG treatment for the severe PANS symptoms. IVIG seemed to make it worse. Any advice you have would be much appreciated. I hate to see my daughter suffering so badly!!

    • Dr. Daniel Cameron
      08/16/2019 (10:49 pm)

      It is hard to tell if gastric ulcers are connected. I would look again at whether antibiotics might be helpful.

  • Audrey Vernick
    08/02/2019 (3:23 am)

    My son (13) has had intense, constant central abdominal pain for 11 months and other GI issues (diarrhea, constipation, gastroparesis, SIBO, etc.) plus terrible insomnia. His LLND and LLMD are not 100% certain that his Lyme and co-infections are the cause of this pain, or how to treat. He had a positive PCR (DNA of borrelia in the blood) on an Igenex test; AND he had 6 IND or positive bands, just not on one test: IND: 18, 31, 41 IGG (IgeneX); IND: 39, 41 IGM (IgeneX); POS: 41, 93 (LabCorp, 11/18); POS: 41, 58, 93 (LabCorp, 4/19). For Bartonella he had 1:128 on Galaxy Bartonella for IGG only, and a weak positive on Armin. (Armin did not show Lyme at all.) He also had mycoplasma. We are struggling with treatment since his gut is the main issue. We have tried oral antibiotics and IV Rocephin with no improvement at all… We’ve ruled out all other GI possibilities. Thoughts? Ideas? Help! He missed the entire school year last year and is miserable. Thank you.

    • Dr. Daniel Cameron
      08/03/2019 (12:51 am)

      It is hard to know what to do at this point without evaluating your son.

    • Rhonda
      01/29/2024 (6:03 pm)

      Is your son still sick? I know someone in similar situation. I am very interested in if this has improved for him over these years and what helped if so.

  • Mary Rybarczyk
    07/26/2019 (5:20 am)

    I have severe debilitating back pain of the thoracic spine, unexplained weight loss and stomach issues. Could this be caused by lyme disease?

    • Dr. Daniel Cameron
      07/26/2019 (10:20 pm)

      There are so many causes to consider. You would need an organized evaluation until you get an answer.

  • Julie
    06/19/2019 (2:42 pm)

    Since my Lyme diagnosis I have had debilitating stomach pain. Lost 45 lbs, limited to ensure shakes, broth, and very, very little food outside of chicken and potatoes. I have had so many CT’s, ultrasounds, an MRI, end more blood work than I can count. The pain is crippling and every physician, specialist, etc. has given up on a possible answer. In the year and a half since my positive Lyme test I have gone from a fully functional adult to a barely functioning human and the medical community treating me as if I am crazy. I finally managed to get an appointment with an infectious disease specialist who specializes in Lyme. It’s truly my last hope. Anyone who states that Lyme isn’t real has clearly never been affected by it. PS: This is my second time with Lyme, only this time it’s actively trying to kill me.

    • Dr. Daniel Cameron
      06/19/2019 (6:24 pm)

      I have often seen stomach problems from Lyme disease even if not treated with antibiotics. The stomach problems may improve if Lyme disease resolves.

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