Abdominal Pain

I am a 33 yr old female.  For the last few years, I have had reoccuring right upper abdominal pain.  It is colicky in nature.  I might have it for a few days and then not get it again for months.  It is in a very small area near where my abdomen and lower rib cage meet.  When it happened two years ago, my Dr. sent me for bloodwork, an abdominal u/s and HIDA scan. Everything was normal so he told me it was probably nothing. It started again recently so I went back to the Dr.  The U/S and HIDA scan were normal.  He said my Amylase and Lipase levels were a tad high.  Amylase was 82 (he said range was 20-80) and Lipase was 85 ( range was 5-51).  I asked him if I needed further testing and he said no.  I did not fast for this test and I read somewhere that you should fast prior to being tested.

In addition to the pain, I have had IBS like symptoms since I was in my early 20's. Sometimes the upper quandrant pain coincides with painful cramps in my intestines. Earlier today, I had sudden lower abdominal cramps that were pretty severe which resulted in diarrhea. The stools were extremely loose and sort of orangish.  I consumed one of those Emergen C packets mixed with orange juice prior to this episode but I have done this before without problems.

I should mention that I have not lost any weight, my appetite is just fine, my bowel movements are usually normal and my alcohol consumption is infrequent (and minimal).

My questions are:

1.  Could all of this indicate a pancreas problem?  
2.  Is it common for IBS to present this way?  
3.  Should I be alarmed about the diarrhea or just take the wait and see approach to see if it happens again?  This is the second time it has happened in the last two weeks.  The last time was after I had the HIDA scan with a CCK injection.  I had the episode right after I got home from the test so I think it had something to do with the injection.
4.  Do these symptoms suggest colon cancer?  My grandmother died of it so I am concerned.  

[Kevin Pho, MD]

To answer your questions:

1) An elevated amylase and lipase level can be due to pancreatic inflammation.  The negative ultrasound and HIDA scan would make gallbladder disease less likely, but an MRCP can be done to be complete.

2) IBS can indeed present this way.  If the tests remain non-revealing, this diagnosis should be considered.

3) I would consider a colonoscopy to evaluate the diarrhea and exclude inflammatory bowel disease.

4) The most comprehensive way to evaluate for colon cancer is via a colonoscopy.  I cannot speculate given the information presented.

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.
www.kevinmd.com

[KLB32]

I forgot to add that I have mild GERD diagnosed by Endoscopy last year.

[AliChapman]

Hi!  I am also a 33 year old female with almost the same exact symptoms!  I have had almost every test done including the HIDA scan, upper endoscopy & colonoscopy.  After 7 months of stomach pain (mostly upper right side) and lower cramping & diarrhea my GI Dr found that I have Blastocystis Hominis.  It is microscopic parasite that lives in the large intestine.  YUCK!  You should read about it & have your Dr. do a bunch of stool tests and possibly schedule a colonoscopy.  I also have colitis which maybe from the parasitic infection.  Hope this helps!

[lise41362]

I feel like someone is living my painfull stomach life. mine is since 2/06 when my doctor put me on mettformin for pcos and i have never been the same since. its very painfull the nausea is unbearable and the diarrhea well just to ugly and painfull as well.i have lost jobs . i have gained and lost the same 15 pounds for 2 years now. it seemd to have went away for a while and now its back with a vengance. and i have no insurance. is there something i can do on my own?
please help me