DIGESTIVE DISORDERS / GASTROENTEROLOGY
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Seeking Answers for PostPartum Digestive Problems
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by EEM14, May 12, 2006
I am searching for answers in relation to horrible digestive problems I have experienced since 3 months after the birth of my first child (who is now 9 mos. old)

-It started with a small twinge under my right rib 3 months after childbirth (around the time I started weaning from breastfeeding.)

-2 months later I started feeling 'full' with rectal pressure

-1 month after that I started with bad gas and cramps followed by an emptying of my bowels within 20 minutes of waking each morning. This has been going on for over 3 months! I had chronic diarrhea for 2 straight months!

-While I have sporadic diarrhea now, I usually have firmer stools.  My main problem is the constant rectal pressure (like I need to use the restroom) and often pass a small amount of mucus when I try to relieve myself.  This attempt also makes the pressure feel worse after and creates more cramping.

I have been to my PCP, a GI, a colon dr., soon a Gallbladder surgeon and have had ultrasounds, stool samples, blood tests, sigmoidoscopy (all negative) and a HIDA scan (which showed my gallbladder is functioning at 10% - hence the meeting with the surgeon.) I have also tried going dairy free for a month and gluten free for a week.

My GI thinks my symptoms *may* be due to my gallbladder not functioning properly but said it's about a 50% chance they will resolve themselves after my gallbladder is removed.  Seeing how many people experience chronic diarrhea after surgery I am hesitant to have it done.

I personally think it may be hormonal since I have spoken with other females who have experienced the same symptoms - all starting after childbirth.  Plus, we experience bad ovulation cramping mid cycle and back and front cramping which correlates to gas/bowel movements the week prior to menstruation.  

I am getting so frustrated, constantly feel uncomfortable and don't want to feel like this for the rest of my life.  I hope someone may be able to help me find answers and a possible solution.


Thank you in advance!




Answer:
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by Kevin Pho, MDBlank, May 13, 2006
You have had a pretty comprehensive evaluation, which would rule out many of the major causes.  

A low gallbladder ejection fraction doesn't have chronic diarrhea as a common symptom.

You can consider more specialized testing - like malabsorption or celiac disease - where stool samples and blood tests can be considered to look for these possibilities.  

If everything continues to be negative, hormonal changes after childbirth can exacerbate symptoms of irritable bowel.

You can consider antispasmodic agents - such as Levsin or Bentyl - which may help if the symptoms are due to IBS.

This option can be discussed with your gastroenterologist.

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.
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