Author: Admin (---.cu27.vnnyca.adelphia.net)
Date: 05-17-02 16:25
Belinda,
Abdominal and throat pain in sarc is not very well studied. Most probably because it is generally not regarded as a serious symptom.
There was one reported case from Poland, a patient who complained of abdominal pain and constipation, and who was subsequently diagnosed with sarcoidosis.
I am going to distinguish the abdominal pain based on whether it is associated with a tendency towards constipation or diarrhea.
It is often not comfortable for patients to talk about such things, but sarc patients seem to produce stool of larger diameter, which are firmer and harder than those of the 'normal' population. Often this is accompanied by classic constipation, but not always.
On the other hand, the existence of diarrhea with abdominal pain can indicate damage to the gastrointestinal tract, such as sarcoidosis attacking the local tissues directly. If anyone is experiencing abdominal pain with diarrhea they should see their doctor immediatley.
What I have found is that sarc patients frequently seem to have a cluster of the following symptoms, in approximately this order:
1: Incorrect digestive activity from the gastrointestinal tract
2: Abdominal pain and swelling
3: Inability to swallow properly
4: General peristalitic dysfunction in the intestines
5: Excessive stool size and hardness (one to three days later)
Of these symptoms only the constipation is recognized as a sign of Hypervitimanosis D, yet it is my observation that all these symptoms can be brought on by exposure of the sarc patient to sunlight. In the absence of inflammatory challenge, they can sometimes be put into remission by isolating the patient.
I find that the time frame over which such symptoms occur is typically 3 days rather than the several months for which Hypervitimanosis D is believed to persist in a 'normal' patient. It has been suggested that the difference in time course is because 1,25(OH)2D3 (which is another way of writing 1,25 dihydroxyvitamin D3) is responsible for the symptoms.
The incorrect digestive activity often makes it hard for the body to absorb medicines that you have taken orally. Once this cycle starts it is hard to stop or alleviate it by swallowing pills. They just sit in the stomach and produce irritation, rather than do their job. You can dissolve some drugs (eg Tylenol) in water and then swallow them, but sometimes even that is not effective.
The abdominal swelling often causes about 1-2 inches increase in girth, enough to make clothing become very uncomfortable.
The inability to swallow causes tablets to become 'stuck' in the trachea, unwilling to move down to your stomach (where they end up not-dissolving anyway  ). The throat muscles become tight and painful.
Once the body has 'returned to normal', which generally seems to take about 3 days, the stool again become soft and easily passed. the abdominal pain goes, and normal salivary action is apparent in the throat and mouth.
Most sarc patients never get full control of these symptoms, if control is measured by a soft stool. 1,25 dihydroxyvitamin D3 is secreted directly by the macrophages in the sarcoid granuloma, as well as coming from food and sunlight. You have to have control of both sources in order to get control of these problems.
What I want to emphasize is that these symptoms are reversible, and they can be avoided, albeit with difficulty at this point in time.
..Trevor..
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