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Gastroenterology (Expert Forum)
Weird Symptoms
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Weird Symptoms
by Chuck409, Jun 18, 2005 12:00AM
Hello, I'm a 36 yr old male who has had bouts of constipation off and on for the past 15 yrs or so. These were only temporary and usually relieved with OTC laxatives. About 3 yrs ago I noticed a sudden change in my bowel habits. My stools prior to this were well formed and about the size of a quarter in diam. and always floated. My "new" stools were either small dark round pebbles or thin, mushy and light colored depending on my diet at the time (low or hi fiber) and always sank.
My constipation increased at this time such that I began taking strong laxatives just to be able to "go" once a day. I wound up taking two dulcolax nightly, but soon this stopped working.
About this same period of time I came down with a number of strange symptoms... mainly fatigue, night sweats, heart racing, low grade fever, dizziness and nausea, and weight loss of about 10 lbs. I also developed (after about 2 months of the onset of the symptoms above) a persistant and productive cough. I also had some pain in my right testicle and right lower back and some sharp pains coming from my right ribcage, maybe 2-3 inches below my right nipple. The pain was a sharp stab that would come and go. My doctor tried several things to relieve the above symptoms. After prescribing a Z-pack and albuterol inhaler, he prescribed an Advair diskus which seemed to help at least the cough. I had a heart echo sound and chest CT scan both of which were normal. It should be noted though that two doctors I saw during this time heard a heart murmur on examination. No physician has mentioned hearing a heart murmur since. These symptoms gradually went away after about 4 mo's. with the exception of the ribcage pain which I still get once in awhile.
So it was during this time I developed the chronic constipation and became dependant on laxatives. I saw a GI who recommended a colonoscopy based on family history. My father had crohns disease and my grandmother died from colon rectal cancer. The colonsoscopy revealed only an internal hemorrhoid. My doctor recommended a high fiber diet and prescribed a stool softener to wean me off the dulcolax. I followed this regimen and managed to reach a type of equilibrium though any deviation in diet would immediatly cause constipation.
A year ago my B.M's changed once again. I started having solid small/loose stools covered in a sticky yellowish mucous. These would be associated with cramping almost like diarrhea. These BM's had a foul odor that was like the smell of raw sewage. This type of BM would happen every 3 days or so with "normal" movements in between. These have evolved in the past year to hard/slimy stools and the smell is now very strong and smells like rotting flesh. My GI took some stool samples didn't show anything. My testicle/lower back pain has returned. I'm worried and not sure what I should do now. The constipation has gotten much worse. I should prob. also mention that I was diagnosed with IgA nephropathy at 18.
My constipation increased at this time such that I began taking strong laxatives just to be able to "go" once a day. I wound up taking two dulcolax nightly, but soon this stopped working.
About this same period of time I came down with a number of strange symptoms... mainly fatigue, night sweats, heart racing, low grade fever, dizziness and nausea, and weight loss of about 10 lbs. I also developed (after about 2 months of the onset of the symptoms above) a persistant and productive cough. I also had some pain in my right testicle and right lower back and some sharp pains coming from my right ribcage, maybe 2-3 inches below my right nipple. The pain was a sharp stab that would come and go. My doctor tried several things to relieve the above symptoms. After prescribing a Z-pack and albuterol inhaler, he prescribed an Advair diskus which seemed to help at least the cough. I had a heart echo sound and chest CT scan both of which were normal. It should be noted though that two doctors I saw during this time heard a heart murmur on examination. No physician has mentioned hearing a heart murmur since. These symptoms gradually went away after about 4 mo's. with the exception of the ribcage pain which I still get once in awhile.
So it was during this time I developed the chronic constipation and became dependant on laxatives. I saw a GI who recommended a colonoscopy based on family history. My father had crohns disease and my grandmother died from colon rectal cancer. The colonsoscopy revealed only an internal hemorrhoid. My doctor recommended a high fiber diet and prescribed a stool softener to wean me off the dulcolax. I followed this regimen and managed to reach a type of equilibrium though any deviation in diet would immediatly cause constipation.
A year ago my B.M's changed once again. I started having solid small/loose stools covered in a sticky yellowish mucous. These would be associated with cramping almost like diarrhea. These BM's had a foul odor that was like the smell of raw sewage. This type of BM would happen every 3 days or so with "normal" movements in between. These have evolved in the past year to hard/slimy stools and the smell is now very strong and smells like rotting flesh. My GI took some stool samples didn't show anything. My testicle/lower back pain has returned. I'm worried and not sure what I should do now. The constipation has gotten much worse. I should prob. also mention that I was diagnosed with IgA nephropathy at 18.
Doctor's Answer
by Kevin Pho, MD, Jun 20, 2005 12:00AM
, Jun 20, 2005 12:00AM
Difficult to say without examination. You have had a pretty comprehensive evaluation including a colonoscopy. This test would rule out some of the more serious causes of the symptoms.
You can consider more specialized testing for the constipation - such as defecography or colonic motility studies.
If normal, irritable bowel disease can lead to a constipation-predominant presentation. You can consider medications like Zelnorm which can help.
Regarding the testicle/low back pain - I would consider an evaluation with a urologist. Evaluation of the prostate as well as a transrectal ultrasound should be considered.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
You can consider more specialized testing for the constipation - such as defecography or colonic motility studies.
If normal, irritable bowel disease can lead to a constipation-predominant presentation. You can consider medications like Zelnorm which can help.
Regarding the testicle/low back pain - I would consider an evaluation with a urologist. Evaluation of the prostate as well as a transrectal ultrasound should be considered.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Member Comments
by Inanga, Jun 22, 2005 12:00AM
have you considered dietary effects apart from fibre? I had something along the lines of iritable bowel syndrome and tried to imprivemy diet by eathing 'proper' grain based breakfasts etc. Made things worse! - I discovered I have a wheat allergy although this didnt' show in the allergist's test. I am fine now after avoiding the allergens (for me wheat, gluten, soy, dairy). Worth some experimentation with an elimintation diet (no pun intended). good luck!
by astros18, Jun 24, 2005 12:00AM
Sounds like you definitely need to clean your colon. Fecal matter can back up and stay in your colon for years(although some doctors don't believe this). Since you have a history of constipation and laxative dependence i am inclined to think this is your main problem. A toxic colon can cause many symptoms. There are many good colon cleanses on the market if you are so inclined.
by sera10, Jun 25, 2005 12:00AM
Have you considered a capsule endoscopy which can look at your small intestines? Check out celiac disease symptoms. Good luck.
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