Stomach pain can be a symptom of 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
Related Articles:
Long-term problems for some Lyme neuroborreliosis patients
What happens to the brain during acute Lyme neuroborreliosis?
Atypical symptoms of Lyme disease: numbness, paresthesia and abdominal wall weakness
References:
- 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.
Karen
04/20/2022 (10:40 pm)
My grandson was the 17th person in Colorado to be tested and proven to have contracted Lyme disease in this state. Initially his doctors did not even suggest testing for Lym, but my NP daughter (his mother) insisted on that test being done, and it came back positive with the values indicating very recent infection.
He was treated with a short course of antibiotics after losing 40 pounds in two months due to stomach pain and other Lyme-related symptoms, and they temporarily resolved.
He is now going through a renewed period of “knife-like pain” in his stomach, and in addition has a very slightly enlarged liver, swollen lymph nodes, mid-upper-back pain, and (as of just today, prompting my online search), a severely twitching eye together with facial pain, and the manifestation of MS-like muscle effects including ‘intentional tremor’ (we have a video of him trying to lightly toss a ball to his dog, resulting in a severe contraction of his upper arm / dropping the ball). He has lost over SIXTY POUNDS in 2-1/2 months. Every time he tries to eat, he becomes nauseous, often throws up, and develops that ‘knife-like’ pain both before and even after having cut EVERYTHING out of his diet except the cans of tuna to which he has been reduced.
He has already had a PET scan, MRI scan (for the mid-back spine pain), endoscopy (which showed gastritis of unknown origin), and colonoscopy (nothing wrong). His GI doc gave up, saying it was beyond his purview, and provided a referral for him back to his infectious disease specialist — who then canceled his appointment claiming that “GI problems have nothing to do with Lyme disease.” BUNK!!
Worse, there is a WHOLESALE ABROGATION OF RESPONSIBILITY AND DIAGNOSTIC EFFORT. Neither doctor will take responsibility for referring him to some OTHER doctor who might diagnose his symptoms as anything ELSE other than Lyme, though they have no idea themselves what the underlying cause might be. Neither has opted to delve into it diagnostically with further testing to even TRY to find the problem (perhaps other known pathogens that cause severe gastritis?). He happens to be biracial, and I bristle at the fact that they have intimated that he is a drug-seeker (he’s absolutely not … he went two months without any pain meds because he REFUSED them, not wanting pain meds to deal with his deeply painful stomach problems). One even initially posited ‘cannabis-related hyperemesis’ until my daughter pointed out that his symptoms did NOT at all meet that diagnosis and that he did not excessively use/abuse our locally-legal use of cannabis, which helps him deal with the depression all this has brought upon him. He is now severely disabled by all this, with no treatment in sight.
Here in Colorado, Lyme disease-literate doctors are not to be found; are we going to have to send him to the East Coast to even get a doctor to listen to him? Are you able to refer us to a ‘Lyme-Literate doctor’ anywhere in the Denver metropolitan area? Especially one able to differentiate potential MS-related signs from ‘long Lyme disaease?’
Dr. Daniel Cameron
04/21/2022 (9:37 am)
I have patients who identified names through Global Lyme Alliance, LymeDisease.org, LymeDiseaseAssociation, and ILADS. I have patients who have used Dr. Daniel A. Kinderlehrer in your area. I am on the East Coast. Call my office at 914 666 4665 if you are on the east coast.
Dawn
09/04/2022 (2:35 pm)
Feel free to message me. I’m an east coast resident (45 minutes west of Boston). My 15 year old is battling Lyme. I want to share some things with you.