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"

  • Tracey Fagan
    03/23/2022 (2:58 am)

    I have been treated for RA for the last 3 years. Which has only ever given me a stiff wrist.
    I now have GI issues, a creaky neck and twitching muscles.
    I was bitten whilst on holiday in Costa Rica but don’t know what by. This was a few months before symptoms started.
    I feel like I have so many new symptoms and they do not regularly test for Lymes in the UK.
    Do you think I should insist on Lymes test?


    • Dr. Daniel Cameron
      03/23/2022 (6:52 am)

      I have included a Lyme disease test in my evaluation of patients with rheumatoid arthritis. I have had patients who had GI issues with their Lyme disease. They appear to be ill with the autonomic symptoms related to Lyme disease.

  • Bobbi
    08/23/2021 (10:27 pm)

    My 15 yr old daughter was bitten a few years ago and I asked for antibiotics but was told no. The only symptom that she had was slight swelling in neck lymph nodes. She has slowly changed and has what appears to be gastroparesis. I now think it may be from Lyme and or co infection. She also seems to have low serotonin. The life has been sucked out of her. The 1st thing that I need is to get her tested for Lyme before she’s put on adderol which would be a band aid for 1 of her problems! What is the newest most accurate test for both Lyme AND co infections?? Thank you

    • Dr. Daniel Cameron
      08/24/2021 (8:39 am)

      It must be difficult to see your daughter ill. The tests are not as accurate as I would like. I advise my patients with similar problems to work with a doctor familiar with Lyme disease to make sure she is not ill with neuropsychiatric manifestations of Lyme disease even if the tests are negative.

  • Kris Bonts
    07/06/2021 (5:10 am)

    It can be transmitted sexually they say thats why its showing up everywhere. Im currently trying to decide to get test as I heard it only tests for one strain. The Igenex tests for most all I guess. But really bad stomach pain in night and morning, joint muscle and tendon pain, weoird creaks in neck like rice krispies. Heard its in 15 percent of blood supply they found.

    • Dr. Daniel Cameron
      07/06/2021 (2:54 pm)

      We still do not have a good sexually transmitted study. I have not seen a good test that is strain specific. The studies on the the blood supply have been frustrating in the absence of good testing. I advise my patients with the same presentation to add a doctor familiar with Lyme disease to their list of specialists.

  • avis pepin
    12/07/2020 (11:25 am)

    I had a tick bite back in 2000 with bulls eye. It took me 10 yrs to find a doctor that sent my blood to Igenex on the west coast. It came back chronic by then. I was having all kind of weird symptom that i never had before yet nobody could figure it out. I ended up in a car accident about that time and hit my head on steering wheel that change my life forever. Now it is more complicated withwhat is cuncussion and what is lyme. Doctors here give the run around and i keep getting no such thing as lyme even with proof. If i hear another doctor say that i am going to lose it for sure. A naturapath in northampton mass. did the tests and gave me test results being lyme. I think i believe them more than regular doctors. This one at least takes insurance which helps but the iv’s cost thousands of dollars which i don’t have. I see that they do more intense workups than regular doctors. I try to enjoy life now at 72 the best i can but it is nowhere near my previous life. I have gone from a sumwhat inteligent person to a idiot. I even contacted the CDC and they sent me a suicide link. Believe me at times i do feel like ending it since i am so miserable. They even label me a name i can’t remember but on same idea as a hypercondriac which i don’t think i am but this is making feel like i am loosing it for sure

    • Dr. Daniel Cameron
      12/07/2020 (12:32 pm)

      I have patients in my practice with similar stories despite multiple evaluations by multiple doctors. I have patients who did not know they had Lyme disease until they developed a concussion. I find oral antibiotics helpful and more affordable than IV for many of these patients.

    • Zdena
      01/11/2022 (2:22 am)

      I have Chronic Lyme over 5 years. Doctors gave me the run around and eventually I was labeled. I felt helpless as doctors in Canada don’t treat Chronic Lyme. I did lot of research on Lyme myself, and came across a women who lives in Manitoba Canada , website: Spirit of Boriel. She is the one that is helping me, when the doctors gave up on me. I am in 7month treatment, work part time, headache is gone, heart rate is better, I can move my arms and lift up to 5lb lot of improvement. My issue is Lyme weight gain as Lyme is messing with metabolic system and my stomach is bloated and sore, digestive issues. I feel this will get resolved with time also. I had to avoid any kind of sugar and carbs, take good supplements, probiotics, drink lot water, (all kind tea,) eating food on small plate, more cooked veggies trying to avoid stress, and develop positive attitude and working on spiritual, high power connection. I know this is going to be long haul.

  • Lisa
    11/09/2020 (12:45 pm)

    Hi! I think I was bit by something while ago- I was in the deep woods doing a photography shoot with flip flops on! Dummy me- that night I came home and the top of my foot felt funny! I had no rash. 2 days later my foot swelled, I took Benadryl and it went away, 2 days after I woke up to my entire left leg tingling. My leg has felt achy ever since. My left hand feels stiff, aching in my joints as well. My left eye has been twitching and recently I’m dealing with indigestion. I have had multiple blood tests- but they still haven’t checked me for Lyme’s Disease- are these symptoms I’m experiencing? Help!

    • Dr. Daniel Cameron
      11/09/2020 (4:12 pm)

      I have a few patients in my practice who have had similar presentations. I would typically include a Lyme disease evaluation.

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