my strange symptoms over 9 month

[6man6]

9 months ago I had a sharp pain in my right quadrant.
after ultrasound and blood results, dr said I have faty liver,
my alt and ast enzymes were 2-3 times higher than normal range.
after following a diet, enzymes became normal.
however, then I started to have IBS kind syptoms with pain continuing.
i did  additinally a ct scan, occult blood test and everything was normal.
then, after a time I almost became normal with no pain and with normal
bowel movements. I was normal for about 6 weeks...

then, i started to have an external homerroids but it was healed
after 6 weeks. during that time I just had a little gas problem.
i wanted to solve this gas problem also and then went to another doctor.
he did an upper endoscopy and said there is h pylori infection.
i started to use biaxin and two other antibiotics for the  h pylori treatment.
one month after h.pylori treatment, i started to have diarrhea, burning in the anus.
after a while during one week, i observed blood in the stool when I had this burning.
blood was from rectal region since it was fresh.
then, burning  became normal and no more blood in rectal area.
i think  that blood was due to an anal fissure because it was giving pain during tiolet.
now, it is last 1 month that again I have IBS kind sypmtoms and pain mainly in the right quadrant.
sometimes (but rarely) also pain in the left quadrant. the pain is very irregular and sometimes
it is at a minimum level.
no fever, no weight loose and no blood in the stool.

What is my problem? What should I do?

[6man6]

moreover, it is almost ten years that  i had bowel rumbling from time to time but not so often.

[6man6]

i did the followings:

-ct scan
-ultrasound
-multiple blood tests
-occult blood test
-lactose intolerance test
-upper endoscopy

i visited two gastroenterologists  so far. the first one thought it is possible that it is ibs. the first doctor did not need a colonoscopy. the second doctor also thinks that it can be ibs and he did not need a colonoscopy.
in fact, i was very normal for 6 weeks. in case of a tumor, without a treatment i think one cannot be normal for 6 weeks.

[Dr. Kokil Mathur]

Could be, or it could be shifting pain, in nut shell, all the above things need to be looked into.

[6man6]

thanks for your comments. although it is rare, i have the same  type of pain in my left hand side. i think pain regions are the places where the bowels bend.

[Dr. Kokil Mathur]

Hi!
Yes, it is very stressful to have recurrent or persistent GI symptoms. It is difficult to diagnose on net, but I could guide you regarding what all could be done.

You could be suffering from an inflammatory bowel condition such as Celiac Disease/Ulcerative Colitis/Irritable Bowel Syndrome/ Crohn’s disease. All these result in tender abdomen, loose stool or loose stools alternating with constipation, abdominal distention with gas, cramps etc. Parasites in the gut like threadworm, tape worm, giardiasis etc can behave this way. Hence a stool test is a must. Problems of gall bladder and liver or that of pancreas too cannot be ignored. Possibility of recurrence of H pylori infection should be looked into by carbon urea breath test.

Since you had H pylori infection, you could be having severe acidity that is causing gas on and off. . Treatment is a combination of drugs to reduce the acid and lifestyle changes. You will need to take a combination of medications (under medical supervision) like a proton pump inhibitor such as omeprazole, lansoprazole or pantoprazole empty stomach in the morning and an antacid gel after meals or H-2 blocker such as ranitidine for complete relief.

Life style changes that will help include: Drink cold milk. Avoid heavy meals and eat frequent small meals. Avoid too much of caffeine, tea, smoking, fried food and drinks both alcoholic and non alcoholic fuzzy ones. Avoid heavy exercises within 4 hours of a heavy meal. Raise the head end of the bed by pillows to 30 degrees. Avoid lying down for least 2 hours after food. Take a late night snack. Maybe these tips will help you.

Since you had prolonged antibiotic therapy, and earlier had fatty liver, liver function should be re-assessed as antibiotics can play havoc to both your gut and liver. Take probilotics and see if they help. Also pancreatic function should be assessed and since you have pain in right side of abdomen, possibility og recurrence of fatty liver, drug induced hepatitis, gall stone, common bile duct stone, pancreatic duct stone, and pancreatitis should be looked into.

Log in the food intake and the symptoms as they appear. See if there is a correlation between a particular food item and symptoms. Add fiber to your diet through consuming bran, whole grains, fruits and vegetables. Add crushed psyllium seed to your food preparations. Also, add fibers slowly as adding fibers too fast can cause bloating and gas. Also, add water in any form to your diet—plain water, lemonade, clear soups, etc. Fiber supplements can also be added. You need to go slow on food that increases gas content of the gut such as salads, raw fruits and vegetables (especially cabbage, broccoli and cauliflower), and carbonated beverages.

If symptoms worsen with fiber then you may need colonoscopy and other tests too.

Crohn’s disease is a difficult entity to diagnose and can cause weight loss. Along with gut symptoms skin disorders and arthritis too are commonly seen with Crohn’s. An upper GI series using barium dye is done to see the condition of small intestines. The degree of involvement of the large and small intestine may vary from person to person.  A biopsy is the most confirmatory. An elevated ESR, low protein, minerals and iron in blood are the other findings in Crohn’s which may or may not be present. A recent advancement in Crohn’s diagnosis is video capsule endoscopy.

Gluten is a complex protein present in four main grains---wheat, rye, barley and oats. If you have gluten intolerance, then you probably have celiac disease or Non Celiac gluten sensitivity. There are blood tests called celiac test to detect gluten intolerance.
Diagnosis of IBS is through elimination of other inflammatory bowel causes.

Please consult your doctor regarding this. I sincerely hope you will find this information useful in your journey towards better health.

Hope you get well soon! Good Luck and take care!