Adrenal problems - can they include sickness and diarrhoea?

[Sharitone]

I'm sure there are some FAQs on this, but apologies, I can't find them.

I am on 3mg, having reduced slowly, and not about to reduce further. For the last few months I have had growing abdominal discomfort and bloating. I saw a GP 3 weeks ago and was asked to increase omeprazole back to 20mg come back soon for follow-up. GP appointments this week have been 'emergency only'. 2 weeks ago I was up half the night with total sickness and diarrhoea, which cleared up entirely. However, last night it was exactly the same story and I'm wondering whether this could be due to adrenal insufficiency. My BP is low but reasonable.

[SheffieldJane]

It certainly could be at your low dose of Pred. Ask your GP for a morning cortisol test initially to see how your Adrenals are doing. Further tests can be done if need be such as a Synacthen test. I am now under an Endocrinologist who may move me on to Hydrocortisone, this may prompt Adrenal recovery.

[Sharitone in reply to SheffieldJane]

Thanks for that. That's what I'm hoping.

[PMRpro Ambassador]

Do you feel otherwise unwell? Did the extra omeprazole make it worse or better?

Not impressed with the GP - any change in bowel habit should be investigated urgently so if increasing the PPI hasn't helped, I personally would say you should have been given a follow-up appointment whether it is emergencies only or not,

[Sharitone in reply to PMRpro]

I always have the DF, though it has got a bit worse. The increased omeprazole has generally helped a bit, but these two violent voidings have been new. The GP 3 weeks ago ordered loads of blood tests, but they all came back 'Abnormal but expected. Make an appointment with GP'. But I can't, they have two off sick. Cheery receptionist was adamant I should see the pharmacist!!

I was just hoping it could be the adrenals🤞

[PMRpro Ambassador in reply to Sharitone]

Fat lot of use the pharmacist is likely to be. It COULD be the adrenals - but that is also a situation that needs medical advice if it is causing severe problems. Trouble is, once your gut is upset, it can remain rather delicate for a while.

[Bluemoonbrummie in reply to PMRpro]

If the practice has a clinical pharmacist they could well be helpful around meds. It’s their specialism. I’ve found the one at my GPs very helpful. Particularly around pred reductions and adrenal issues. If part of GP set up they can refer you to GP as needed which is often useful particularly when appointments are limited.

[Bluemoonbrummie in reply to Bluemoonbrummie]

Info on clinical pharmacists

england.nhs.uk/wp-content/u...

[Sharitone in reply to Bluemoonbrummie]

Thanks, that's useful info. I didn't know you could get an actual appointment.

[Bluemoonbrummie in reply to Sharitone]

If they’re part of your surgery yes.

[PMRpro Ambassador in reply to Bluemoonbrummie]

They know about the DRUG, they don't usually know about the individual vagaries of the disorders for which they are being used nor the finer points of tapering in something like PMR/GCA. And a pharmacist told someone on the forum fairly recently that they needed to get off pred quickly as it was a dangerous drug. I know a fair bit about pharmacists in the UK, got one in the family. He knows loads about interactions, doses, what is safe - but he knows he doesn't know much about PMR ...

[Bluemoonbrummie in reply to PMRpro]

I think like GPs there’s lots of variations. The one I’ve had contact with has taken time to learn about PMR and is very empathetic.

Clinical pharmacists have additional training Many are prescribers and have clinical specialism’s

[PMRpro Ambassador in reply to Bluemoonbrummie]

Nevertheless - they don't have the same medical background.

[Bluemoonbrummie in reply to PMRpro]

But where they are in general practice they are supervised by GP’s and if you see/talk to one know their limitations and will get you a GP appointment if needed

Part of the additional roles scheme in general practice that is bringing new roles into general practice.

[DorsetLady PMRGCAuk volunteer]

yes -and all things adrenals -

healthunlocked.com/pmrgcauk...

[Sharitone in reply to DorsetLady]

Thanks very much.

[SnazzyD]

It can be, but are you ok in between times? Did it coincide with upping the Omeprazole? Some people including me find at low doses they have the appearance of allergies and dietary intolerances. Mine cleared up after months but I still can’t eat cruciferous veg now. Have you kept a food diary? Is your fridge at the correct temperature inside even if the dial says it’s ok?

[Sharitone in reply to SnazzyD]

It was a week after upping the omeprazole, during which time the gut cramps had slowly improved. I don't think it can have been the food, mainly because my husband and son were unaffected, and I hadn't eaten anything that would be an obvious suspect. But the food diary might be good sense. Thank you

[Sharitone]

It was a week after upping the omeprazole, during which time the gut cramps had slowly improved. I don't think it can have been the food, mainly because my husband and son were unaffected, and I hadn't eaten anything that would be an obvious suspect. But the food diary might be good sense. Thank you