Various Symptoms ..Help Please...Going Nuts with Worry

Dr.

I have been having some various symptoms and I am trying to understand and deal with them.  I am a male and am 43.  

1-Vague, general and diffuse abdominal aching and "pains". The first location is in my lower left quadrant (above the groin) that feels like a muscle pull or strain. I feel it on the right side as well very rarely.  Off and on and very intermittent for about 2 months or so.  I feel it when I walk and when I bend over as well.

2-An ache that feels like hunger pain on my upper left quadrant by my rib.  Also intermittent and feels a bit better after eating. I can at times feel it as well if I stretch or bend in a certain way. I have also felt it on the right side in the same place at times.

3-When all of this started to happen I assumed a flare up of IBS (told I had it about 15 years ago) and started changing my diet-tons of fiber, water and other fiber rich cereals and fruits, but not consistently.  My stools went crazy from the normal bowel movement every 2 days to every day to changes in texture, look, being soft etc.  If I cease the above diet, I think I go back to having a bowel movement every other day.  I have had thick and thinner BMs.  Long and shorter ones and frankly I am sick of looking at them and trying to figure out if they are normal or not!! I have been trying to remember if I had a "change in bowel" before this started.

4-I have seen one GI doc who felt it was IBS but she wants to do a colonoscopy.  I had one 3 and a half years ago and it was clear, except for hemorrhoids.

5-I saw a 2nd GI doc who feels the colonoscopy is not warranted and wants to do an upper endoscopy and an ultrasound for gallstones. I was having chest and back pain that has ceased. I am taking Prilosec, but I have no idea if that is why it stopped.

6-I then saw my primary doc, who told me to stop everything and just take 2 Fibercon tabs a day.  I have now done that for 4 days and my bowel movement schedule is a bit off. I went last night, when I would normally go this morning.  Clearly in all of this I can directly affect my bowel schedule and stool composition by what I eat.

7-I have no fevers, weight loss or of appetite.  No blood when I go or any feeling of being run down or anemic.  I had a full physical with DRE and the test for blood in your stool in May and I was fine.  I take a multi vitamin and a vitamin C every day.

I need some help please....I am really confused and don

[Kevin Pho, MD]

You note both left upper and left lower quadrant pain.  Causes of left lower quadrant can include inflammatory bowel disease, cancer, irritable bowel disease or diverticulitis.

Causes of left upper quadrant pain can include various causes of dyspepsia - including GERD, ulcers, inflammation of the upper digestive tract, or splenic disorders.  

I agree with the GIs suggestion of both an upper and lower endoscopy.  These procedures can evaluate for most of the disorders listed above.

If those tests are negative, you can consider irritable bowel syndrome.  Increasing fiber content (as you are doing) as well as possible antispasmodic agents should be considered.  If constipation is predominant, a medication known as Zelnorm may be helpful.

You may want to discuss these options with your GI docs.  I would lead towards to endoscopies for a more comprehensive evauation.

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

[yoshi]

there are better things to do in life than spending so much time studying your feces.
it varies with what you eat,what medication you take and of course what disease!
if prilosev makes you feel better,the problem could be with your stomach ,watch what you eat and avoid certain food like caffeine,soda,chocolate,spicy food,fried food,mint,nuts,dairy products.
try eating a 'bland diet' of rice ,potato,white bread,less meat and some veggies.
try chewing gum,you have nothing to lose but a few sticks of gum,see if it works,it has helped me a lot.