Gerd, IBS, and Urinary Incontinence secondary to NSAIDS

[flores97]

I am getting ready to file an FDC claim for IBS-C, Gerd, and Incontinence secondary to NSAIDS and wanted to see if anyone has any opinions or suggestions, if i might have missed anything. So here goes. I have been on a high daily dose of NSAIDS to treat my sc systemic lupus for well over seven years. About two years ago, i began having moderate gastro problems, that has worsened to the point that these conditions are almost as bad as the lupus, which leaves me bedridden about a week a month. Every time i go to urgent care for the lupus, i complained of the constipation, abdominal pain, nausea, and at times, vomiting. After about a year of these symptoms worsening, i was diagnosed with gerd(i thought i was having a heart attack twice, was admitted for severe chest pain, began vomiting/diarhea both times shortly after), and of course, IBS with constipation predominant. Around the same time frame-2 years ago, i began leaking urine frequently when sneezing, coughing, bending, etc, now i leak continuously and must wear pads. I was told by several VA Docs that the NSAIDS were more than likely responsible for the ibs and gerd. Then i was told that constipation also causes urinary incontinence. I am getting an IMO for all three conditions, from my triple board certified gastroenterologist, as well as submitting all relevant treatment records for past three years, medications side effects lists on the meds i take, some medical articles discussing how NSAIDS can cause/aggravate ibs and gerd, and more articles on how constipation can cause incontinence. I am also submitting the IMO(I will upload copy as soon as its complete), and the doctors resume/certifications. I do wear pads due to incontinence, usually go through three a day unless im bedridden, then its more like five a day. If anyone has suggestions/opinions i would really appreciate the input. I wouldnt have filed fir these conditions, but its to the point i only leave the house for med appts. I have daily abdomial pain, nausea, have trouble swallowing(especially meats), and i vomit if i eat more than small portions of food. The cramping feels like food poisoning, this is with taking omeprazole, pantoprazole?, ondasetron, and ranitidine. Thanks again

[Zoomie]

The IMEs are a great plan. Are you being treated through the VA or private docs? If you are using private medical care see if they can fill out a DBQ or write up a Nexus letter. That would be additional insurance.

[flores97]

1 hour ago, flores97 said:

Zoomie, thank you for the response. Yes, I receive most of my treatment through the VA, and I'm very grateful for the care, but these gastro problems have become so severe I am paying out-of-pocket for a private gastro doctor, who is very knowledgeable. He actually is filling out a nexxus form for each condition, in addition to writing the IMEs. I hope since he is a specialist, his opinion will carry some weight. The VA Docs are the ones who told me the ibs-c and gerd are being aggravated by the NSAIDS im taking, in turn the constipation from the ibs is causing the urinary incontinence, and the gastro doc agreed.

1 hour ago, Zoomie said:

The IMEs are a great plan. Are you being treated through the VA or private docs? If you are using private medical care see if they can fill out a DBQ or write up a Nexus letter. That would be additional insurance.

 

[ArNG11]

IME's are good, but I don't think you will need them at first. If you have documentation in your service medical records and you have been treated since service you should be good.  I would recommend when you file to include inservice medical records. 

My service connection claim for this took about 4 months.  The VA performed the C&P at the local VAMC and within 4 months I was service connected.  The main thing that they look for is inservice symptoms and the doctor's nexus. 

I state that I included much more medical records than that and I got service connected, lowballed of course but service connected.  I had the necessary in service medical records and post service treatment records.  The VA was nice enough to provide the C&P examination.  Mind you a gynecologist made the service connection in my claim so I would think you would be okay.

The interesting part will be how they rate the condition and the medical code the VA uses. Hopefully they will follow proper protocol, if not you have avenues in which to fight it. The condition is one of the presumptive, however, that doesn't guarantee a service connections and/or correct rating. The main goal is service connection.

Unless you file for a FDC, you shouldn't need much more than the above.  Check out the regs and the gulf war presumptive list.  That will give you a good base in which to start from. JMO

[broncovet]

I will just add my 2 cents:

1.  If you are incontinent, and not working, you certainly should apply for TDIU.   Its unimaginable that VA could turn down TDIU if you were incontinet.  

2.  For constipation, I recommend Chia seeds.  Chia seeds are available at my commissary, and other places have them, too.  I recommend you put a spoonful of chia seeds in coffee, tea, or even water.  

They have very little taste, but some people dont like the texture.  They kind of remind me of tapioca pudding, after they have been in water for a minute or so.  Some of the very expensive health drinks, such as Kombucha and stuff have chia seeds in them.  They are a "superfood" with many health benefits besides lots of fiber helping with constipation.    

http://authoritynutrition.com/11-proven-health-benefits-of-chia-seeds/

[flores97]

Broncovet, thank you, I will be purchasing some chia seeds tomorrow. I really appreciate the info. ArNG11, I don't have any in service treatment for the gastro because they didn't start me on the lupus meds until right before I discharged, and the docs believe the long term use of nsaids is what has caused/aggravated the gerd/ibs-c, and since I am constipated continuously, the ibs-c has in turn caused the incontinence. Should i still submit my strs, or do you believe that would confuse them? Essentially all they show are moderate lupus symptoms(which are now severe), and they did start me on NSAIDS at that time, which was 2001.

[ArNG11]

15 minutes ago, broncovet said:

I will just add my 2 cents:

1.  If you are incontinent, and not working, you certainly should apply for TDIU.   Its unimaginable that VA could turn down TDIU if you were incontinet.  

2.  For constipation, I recommend Chia seeds.  Chia seeds are available at my commissary, and other places have them, too.  I recommend you put a spoonful of chia seeds in coffee, tea, or even water.  

They have very little taste, but some people dont like the texture.  They kind of remind me of tapioca pudding, after they have been in water for a minute or so.  Some of the very expensive health drinks, such as Kombucha and stuff have chia seeds in them.  They are a "superfood" with many health benefits besides lots of fiber helping with constipation.    

http://authoritynutrition.com/11-proven-health-benefits-of-chia-seeds/

Very informative, learned something new.  : )