GI Lyme Disease

jmayk8 · Post by **jmayk8** » Wed Mar 28, 2012 1:29 pm

has anyone ever heard of this? I friend of mine contacted me today saying her friend's daughter was suffering with a lot of gut symptoms (even got dx as crohns..) Had a ton of food allergies/sensitivites and had a lot of problems with swallowing a lot like lesley's problems and was just dx with Lyme disease primarily in her gut...I just googled it and found a ton of info, but never heard anything about it before?

Zizzle · Post by **Zizzle** » Wed Mar 28, 2012 1:49 pm

I never heard of it, but I am not at all surprised. I think many people in the Northeast who deal with unknown, strange autoimmune issues are dealing with untreated Lyme disease (or other potential tick-borne infections like Ehrlichiosis or Babesiosis). I think peopl at risk should be tested at least every couple of years. Of course Lyme testing is not 100% accurate, so many infections get missed (especially in the early stages when you need treatment, but aren't producing enough antibodies to get diagnosed). It's truly alarming.

Which has me wondering, why the heck haven't I aked for a Lyme test for myself? I saved my husband from Rocky Mountain Spotted Fever when no docs considered it. With global warming, Lyme is spreading north into Canada too.

Zizzle · Post by **Zizzle** » Wed Mar 28, 2012 2:08 pm

I found these abstracts helpful. It seems liver involvement is common.

THE SPECTRUM OF GASTROINTESTINAL MANIFESTATIONS IN LYME DISEASE
Fried, Martin D.; Abel, M; Pietruccha, D.; Bal, A.

Department of Pediatrics Jersey Shore Medical Center, Neptune, New Jersey

Abstract 24

Purpose: To describe the GI manifestations of Lyme

Methods: Twenty two consecutive patients between the ages of 8 and 20 years presented with a history of chronic gastrointestinal symptoms coupled with multiple organ system complaints. A clinical diagnosis of Lyme disease was made. Endoscopic evaluation was performed to assess the gastrointestinal mucosa and to obtain biopsies for polymerase chain reaction (PCR) to the outer surface protein A (Osp A) of Borrelia burgdorferi. As controls, ten patients with biopsy proven Crohn's disease were also tested by PCR. The laboratory performing the PCR analysis was blinded to the diagnosis of all specimens they received.

Results: The presence of Lyme disease in the gastrointestinal tract was confirmed by PCR for B. burgdorferi DNA in 14 of 20 patients with the diagnosis of Lyme and in two of the control subjects with Crohn's disease. Biopsy evidence of gastritis, duodenitis and colitis was found in Lyme patients and associated with the detection of B. burgdorferi in the GI tract.

Conclusion: In patients living in an endemic area for Lyme disease who present with abdominal pain, acid reflux, chronic diarrhea or blood in the stool, Lyme should be considered as part of the differential diagnosis. In the absence of an erythema migrans rash or blood test confirmation of Lyme, diagnosis can be provided by PCR analysis of gastrointestinal biopsies.

Lyme Disease and the GI Tract

Lyme disease generally does not affect the GI tract alone, according to Martin D. Fried, MD,[9] of the Jersey Shore Medical Center, Neptune, New Jersey. Rather, GI disease is typically only one component of a systemic disease. Patients with Lyme disease can present with a variety of GI symptoms, including abdominal pain, chronic diarrhea, acid reflux, or blood in the stool. Children may develop encopresis -- the loss of bowel training -- which may indicate a neurologic effect of the spirochete.
Evaluation of patients suspected of having Lyme disease includes the ever-important history, physical examination, CBC, liver function tests, and endoscopic examination. The Lyme WB is generally not helpful, but PCR testing of biopsy specimens for B burgdorferi OspA can be useful. Silver staining of biopsy specimens can reveal spirochetes. For those who test positive by PCR, RNA polymerase testing of the biopsy sample can indicate whether the spirochetes are actively multiplying.

The differential diagnosis includes the majority of gastrointestinal diseases, such as pancreatitis, stool infections, peptic ulcer, Crohn's disease, and inflammatory bowel disease. Skin tags are an indication that the patient has Crohn's rather than a complication of Lyme disease. Crohn's patients have a malabsorption syndrome and are therefore generally underweight. By contrast, those with GI Lyme disease often also have fatigue or arthritis, and the inactivity may make them overweight.

Treatment involves antibiotics, but regular follow-up is important to detect recurrences and lack of response. Dr. Fried has seen B burgdorferi persist in the GI tract despite multiple rounds of antibiotics over many years.

I wonder if Joe in NH has been tested for Lyme Disease?

jmayk8 · Post by **jmayk8** » Wed Mar 28, 2012 2:26 pm

Interesting...I'm definitely going to bring this up at my appt on Friday.

Joefnh · Post by **Joefnh** » Wed Mar 28, 2012 2:32 pm

Zizzle no I have not been tested, at least not recently. This is an interesting article and I will be having a followup appt with my GI doc to go over the results from yesterday in a couple of weeks, I will bring a copy of this with me.

Jenny thanks for posting this.

jmayk8 · Post by **jmayk8** » Wed Mar 28, 2012 2:35 pm

Joe,
Whenever I go back home to my moms in CT. Her two goldens always have a tic or two or three! I'm sure Nestlé gets a bunch too!

jmayk8 · Post by **jmayk8** » Wed Mar 28, 2012 2:39 pm

http://www.lymediseaseblog.com/lyme-disease-symptoms/

Joefnh · Post by **Joefnh** » Wed Mar 28, 2012 3:13 pm

Yep there are plenty of ticks up here Jenny. Both Nestlé and Skittles, Nestles 'brother', a Maine coon cat have to be treated monthly in the warmer weather because of the ticks.

During one road trip several years ago when Nestlé was just a year old, we stopped on a old back road so she could do her 'business'. Somehow she got her nose into a nest of ticks and had at least a hundred baby ticks crawling on her in seconds. Fortunately we were near a farm house and the lady there immediate brought out a garden hose, a dog comb and some flea and tick shampoo. Nestle was very fortunate as she did not get any bites. I still send the couple that owned that farm a Christmas card each year.

"Brother & Sister"

Kari · Post by **Kari** » Wed Mar 28, 2012 3:51 pm

You made my day with that picture Joe - thanks - never knew you had a cat :).

Love,
Kari

Lesley · Post by **Lesley** » Wed Mar 28, 2012 5:59 pm

Wonderful picture Joe.

jmayk8 · Post by **jmayk8** » Wed Mar 28, 2012 7:49 pm

so cute!

carolm · Post by **carolm** » Sat Mar 31, 2012 8:41 am

Cute even when slightly annoyed.

Polly · Post by **Polly** » Sat Mar 31, 2012 10:50 am

Very interesting about Lyme. It is a disease that masquerades as numerous serious health problems and is a real nuisance here in the east. One year, several years ago, 10% of the homes in my neighborhood had someone with diagnosed Lyme disease!

I didn't know about the GI effects, though, and don't believe I've ever seen it mentioned here. Something else to be considered in the differential diagnosis of MC. Thanks for sharing.

Love,

Polly

Post by **tex** » Sat Mar 31, 2012 12:05 pm

Polly wrote:One year, several years ago, 10% of the homes in my neighborhood had someone with diagnosed Lyme disease!

Love,
Tex

starfire · Post by **starfire** » Sat Mar 31, 2012 12:52 pm

WONDERFUL picture!!! Of both of them. I know someone who used to "show" a Maine Coon (I believe he was a champion of some sort). He is so beautiful.

I had to chuckle when I read: "Skin tags are an indication that the patient has Crohn's rather than a complication of Lyme disease."

My first thought was about my own skin tags, then I wondered if you had any, Joe. I'm not really asking. Just laughing at the way my mind works.

Love, Shirley