# Hideously embarrassing itching!!!



## Guest (Oct 26, 2004)

I've had IBS (mainly C) for about 7/8 years and hobble on OK for most of the time - and manage to keep some of the symptoms at bay with reasonable diet management. However - about 6 months ago, maybe more started itching around the pubic area - not internally but in the hair and up onto my abdomen. It really gets quite intense and I have to absolutely scrape away (how foul I know!) at it. Its particularly prevalent at night and after a shower or bath, also worse in the heat. This is NOT the ideal situation as my job involves dealing with clients. I manage the condition with an oil based cream. The Doc thinks its eczma of some kind but I'm 42 and have never suffered with any type of skin problem before. I'm in reasonable health but I wondered if this could be linked with the IBS - perhaps another manifestation of my wheat/gluten intolerance. Any ideas warmly welcomed.
Sue, Rainy Manchester, UK


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## Rosanna Thomas (Oct 13, 2004)

Food reactions can create more than just an upset stomach, so the connection between wheat/gluten could be causing a reaction. Have you been tested for Celiac? This is a blood test to see if you should avoid wheat and gluten? Although mine came back negative I still minimalize the gluten in my diet as it can cause a reaction in some IBS suffers. It sounds more like a skin reaction (especially with your comment that it worsens with moisture and heat). You might want to see if it is exyma (sorry about the spelling on that one!). Are you on any new meds (something within the last month)? I had a rash on the side of my neck after I started taking Nortriptaline to help me get to sleep. Once I stopped taking it the rash went away. You may want to check into a possible drug reaction.


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## Guest (Oct 27, 2004)

Thanks for that rthomas. No, I'm not on any drugs. Here in the UK, its basically grin and bear it with IBS but what you say about Celiac sounds worth thinking about. How are you tested for this? Sounds thick I know but the GPs here have never made ANY connection between gluten and the IBS, basically if it isn't cancer you get on with it. Sorry that sounds very cynical but I've been managing my condition for years. Its was only a food intolerance bod that has made any sence to me at all.Sue


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## editor (Jun 20, 2004)

Hi,sounds like a truly awful problem! (Yes I know, like IBS isn't







)You said it seems worse after a shower/bath? Could you be having a reaction to any soaps / shaving foams / talcum powders? Could there be something on your towel or flannel (fabric conditioner or soap powder) that's irritating you? I know that if it was something like a soap powder, you might get a reaction elsewhere on your body...but...who can say? That is quite a delicate area afterall







Also, you said it's worse in heat: and the dr. has given you a diagnosis, but, does it also feel like a prickly heat rash you are having? Perhaps a lukewarm bath / shower for at least a week will help?I'm sure you do this already: but, do you wear cotton knickers? If not, it might be worth doing so for a while. Also, do you wear trousers / jeans a lot? Maybe going into skirts will help? Try to avoid tights too - if you need them for work, then maybe hold ups might be an idea?Perhaps a cooling cream like aloe vera will soothe things down a little bit? Can't think of anything else practical that might help? The intolerance thing is definitely an interesting idea and is worth looking into.


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## Guest (Nov 1, 2004)

God bless editor. Thanks for the help. I certainly try some of these and will try others though it would be a pretty cold day in hell before I wear a skirt!!! Actually I work in a very casual environment so tend to wear trousers though nothing too tight (I am 42 and have had 3 kids so try to leave something to the imagination if you know what I mean!!). Will deffo try the aloe vera cream, I have to go to the health food shop and see what they suggest too. They are excellent and the probiotic I'm on has made me feel a whole ton better. Just gotta sort out the itching! But I really do appreaciate your help.All the best from rain-soaked Manchester.Sue


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## editor (Jun 20, 2004)

heh...no worries!Just had a thought about trousers: are they cotton? If not, it might be an idea to try and get hold of some (heh, I know, *impossible* in Winter.) Some of these new fangled materials could cause undue heat, hence setting off an itch cycle maybe? Also: what kind of fastening do your trousers have and where is it positioned? If it's a zip front-fly affair then it's not beyond the realms of possibility that something in the fastener is causing a reaction?And, maybe a sprinkle of non perfumed talc may help? Tesco's do a great, non-stinky, sensitive baby powder?


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## Guest (Nov 2, 2004)

You read my mind. Tried that today with surprisingly effective results. Long live Tesco!!Sue


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## kschultz (Jul 8, 2004)

Found this info on testing ... rather long winded but you have to sign up to access so I thought people wouldn't mind if I posted the whole thing.THE TESTS Body fluids Serum carotene Description Carotene is released from dietary proteins in the stomach. It then joins lipid micelles and bile salts in the small bowel for absorption. Serum carotene is therefore a marker for fat absorption. In cases of steatorrhea, serum carotene will be low.Advantages/Disadvantages Advantages:Rapid method to diagnose malabsorption because quantitative fecal fat is a cumbersome test to perform. It presumes that patients are on a normal diet, and therefore is not applicable to those from underdeveloped countries because the major cause of low serum carotene in such countries is nutritional deficiencyThe serum carotene test can be modified to overcome variation in dietary intake. Carotene tolerance test is a measure of serum carotene after daily oral loading of serum carotene Disadvantage:The test is not specific for celiac disease or any other small-bowel disease, nor is it sensitive for detecting celiac disease Normal >60mcg/dLIn carotene tolerance test an increase in serum carotene >35mcg/dL is normal Abnormal <60mcg/dLIn carotene tolerance test an increase in serum carotene <35mcg/dL is diagnostic for steatorrhea Cause of abnormal result All causes of malabsorption or maldigestion, such as cystic fibrosis, pancreatic insufficiency, cholestatic liver diseases, and diseases of the small bowel such as Crohn's disease and celiac disease, will cause abnormal serum caroteneLow intake of carotene or fat may cause low levels of serum carotene Drugs, disorders and other factors that may alter results Patients on a fat-free diet will have low absorption of carotene, and therefore low serum levelsIt takes a while for serum carotene to return to normal, even when celiac disease is in remission Fecal fat estimation Description Qualitative stool fat determination by Sudan black III or IV staining, confirmed by quantitative 72h fecal fat determination.Advantages/Disadvantages Advantage:Steatorrhea is present in many patients with celiac disease and its severity correlates with the severity of the intestinal lesion Disadvantages:Steatorrhea may be absent in patients with disease limited to the proximal small intestinalNot specific for celiac diseaseMore importantly, it is an unwieldy test, with sample collection and the test itself often not performed well Normal 2-6g/24h.Abnormal >7% fecal fat malabsorption.Cause of abnormal result Elevated in celiac disease and any other cause of steatorrhea.D-xylose absorption test Description D-xylose absorption and measurement of xylose excretion in the urine, and peak xylose blood levels to indicate absorption of this sugar.Normal 21-31% excreted in urine within 5h.Abnormal Reduced excretion of D-xylose in urine and reduced peak serum blood levels.Cause of abnormal result Proximal intestine, where D-xylose absorption occurs, is affected.Serologic examination Description Serum antibodies useful in supporting the diagnosis of celiac disease.Advantages/Disadvantages Advantages:Useful for noninvasive screening of celiac diseaseAntiendomysial IgA and antitissue transglutaminase antibodies are more specific for celiac disease than antigliadin, and are the best screening tests for the disorderSensitivity of antiendomysial IgA antibodies is >90% in patients with untreated celiac disease, and specificity ranges from 90% to 100%Can be used to monitor dietary compliance Disadvantages:Although antigliadin IgA and IgG are sensitive, they are not specificAntiendomysial and antigliadin IgA antibodies are not detected in patients with IgA deficiency (common in patients with celiac disease)Antitissue transglutaminase is highly specific for celiac diseaseAntiendomysial and antitissue transglutaminase antibodies often become undetectable when celiac disease is in remission Abnormal Antigliadin IgA and IgG antibodies are elevated in 90% of patients who are on wheat-containing diets.Cause of abnormal result Sensitivity to gliadin.Drugs, disorders and other factors that may alter results Antiendomysial and antigliadin IgA antibodies are not detected in patients with IgA deficiency.Blood chemistry Description Serum levels of calcium, iron, magnesium, potassium, vitamins, and cholesterol may all be reduced in celiac disease.Advantages/Disadvantages Advantages:Simple, cheap, and noninvasive testResults available rapidly Disadvantage:Not specific for celiac disease Normal Normal serum levels of iron, calcium, potassium, magnesium, alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum zinc, serum cholesterol, vitamins, folic acid, and proteinNote that reference ranges will vary, and the individual laboratory should be consulted Abnormal Calcium, cholesterol, vitamin A, vitamin B12, vitamin C, folic acid, iron, and proteins may all be reduced in celiac diseaseKeep in mind the possibility of falsely abnormal results Cause of abnormal result Malabsorption of fat-soluble vitamin D is the main cause of calcium deficiency.Tests of function Hematologic function Description Blood function.Normal Prothrombin time: 10-12sHemoglobin: male 13.6-17.7g/dL; female 12.0-15.0g/dL Hematocrit: male 39-49%; female 33-43%Normal red blood cell morphology Abnormal Prothrombin time is prolongedAnemia is frequently present (hemoglobin and hematocrit below normal range)Red blood cell morphology may be altered secondary to hyposplenism Leukopenia and thrombocytopenia may occur, but are less common Cause of abnormal result Prothrombin time prolonged due to malabsorption of vitamin KAnemia in celiac disease commonly due to iron deficiency, folate deficiency or, rarely, vitamin B12 deficiencyRed blood cell morphology altered depending on the cause of anemiaLeukopenia and thrombocytopenia occur if there is severe folate or vitamin B12 deficiency Biopsy Small-bowel biopsy Description Small-bowel biopsy specimen is obtained by endoscopy or suction biopsy tube, and is the standard diagnostic technique for celiac disease.Advantages/Disadvantages Disadvantage: several biopsy specimens must be obtained for proper diagnosis. Ideally, the correct orientation of the biopsy sample before sampling should be achieved.Abnormal Findings that indicate the presence of celiac disease:Absent, shortened, or flattened villi; hyperplasia and lengthening of crypts; infiltration of plasma cells and lymphocytes in the lamina propriaResolution of changes within one year on a strict gluten-free dietScalloping of duodenal folds has been observed on endoscopy in some patients with celiac disease Imaging X-ray Advantages/Disadvantages Advantage: radiographic examination after a barium meal reveals abnormal findings such as dilation of lumen, edema, and flattening of mucosal foldsDisadvantage: radiography not as sensitive as intestinal biopsy; patients with mild celiac disease often have normal barium contrast studies of the small intestine Abnormal Dilatation of small intestine and altered mucosal folds In patients with mild to moderate disease, the mucosal pattern is distorted in the proximal small intestine, but the ileal region is normalIn severe disease, the mucosal pattern is abnormal throughout the small intestine


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## kschultz (Jul 8, 2004)

http://www.firstconsult.com


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## Guest (Nov 5, 2004)

Thanks so much for all of you. Plenty of food for thought!!Sue


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## Tabitha (Jun 1, 2004)

Hello Sue, just thought I'd put in my few pence as it were; I certainly can understand about the problem getting any kind of medical help for IBS in the U.K..bloody awful, if you ask me.I had suffered in silence until on a long plane flight I got talking with the woman sitting next to me.She was ever so nice, and I could tell she was Scotch,well we were chatting away and after a bit she tells me that she suffers from IBS.I was gobsmacked, I can tell you. Anyway, to cut a long story short, she told me about the medicatiom she took, and about this group as a matter of fact. I got quite inspired to be more serious with getting help for myself.I would suggest that you ask your G.P. to refer you to a gastronteroligist for a consult. It's worth the money.Changed my life quite a bit, it did. I have much more confidence.As it happens, I was having a problem with itching too.I was recommended Aloe Vera lotion, and it has really worked very well I must say.I might add that you should switch to a mild soap powder when doing your wash, and double rinse.If it persists I would get another consult with a Dermatoligist for an accurate diagnosis.Hope that all works out well.Tibby


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## Guest (Nov 10, 2004)

Tibby thanks so much for this advice. I will certainly do as you suggest but in the meantime, I'm off next week to see a fab lady who tested me for food intolerances (she is a fully qualified dietition) about 2 years ago. My IBS as such is reasonably well under control, its just this boggin awful itching. She thinks I may have develop new intolerances (life really does begin at 40 - not, well 42 in my case). Also I'm wondering whether dear old M&S knickers which seem to have alot more Lycra in the gusset may be causing a problem as the itching is so local and specific. Anyhoo I'll keep you all posted. Thanks again everyone for all your input.sue


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