Gallstones, Duodenal Ulcer, or something else?

I started out with episodes of constipation, within the past year or so.  This was occassionaly relieved on its own, but at other times required laxatives (of which I tried both commercial and herbal).  I was wrestling with the constipation, when last December a family member gave me a couple of tablets containing the herb Cascara Sagrada.  I woke the next morning, earlier than usual, with an extremely sore back.  After I got up, I noticed that the pain quickly subsided once I passed gas which had apparently built up.  I thought that was weird - especially since I had never had back pain in this region (middle sides).  I then read while researching my problem, that this herb can cause pain in the kidneys, which made some sense because this could have related to the back pain (kidney pain?).

At any rate, I forsook the Cascara Sagrada, and went on with intermitent bouts of constipation.  Several months later I noticed that I was passing a lot more gas than usual and that I was also belching A LOT more than usual.  I was feeling bloated, especially in the mornings and after I ate, and that my back was occassionally sore (with the most intense pain being in the morning just after waking... once I was awake for a while it seemed to subside somewhat, but remained sore, sometimes throughout the remainder of the day).  I was disturbed by the bloating (distention in my abdomen) and the excessive gas at both ends.  The intermitent back pain wasn't a lot of fun either.  So I resolved to improve my diet, lose weight, and exercise more -  since I was sure that the few extra pounds I had gained in the year were probably to blame for the sore back, and was maybe causing other internal problems by putting pressure on organs, or something.

It just kept getting worse.  I then started noticing that I wasn't having bowel movements for 2 or 3 days at a time.  The bloating and back pain would get worse, until I would finally have a BM, then I would feel some relief. By now I was really starting to worry.  I started thinking "digestive disorder," or maybe I needed an intestinal cleanse.

Then while on a short vacation, I started having symptoms of GERD. This was also accompanied by burning in the stomach and bloating.  I started taking all kinds of antacids, and was finally prescribed Prevacid, which hasn't helped much, overall, except for reducing the acid taste and burning in the throat.  

Now I am feeling constant burning in the upper-right quadrant of my abdomen - like maybe gallstones?  But it sometimes shifts.  I also have pain inbetween the shoulder blades.  The pain is pretty constant - it doesn't come and go.  Although it actually seems to lessen with food - for a little while.  

Why am I experiencing back pain, chest pain, abdominal pain, bloating, gas, acid reflux, constipation, hemhoroids, and all this?  Do I have a disease?  Could it be peptic ulcer, duodenal ulcer - with H Pylori?  I'm nervous about Gallbladder surgery!  Where do I begin?

[Kevin Pho, MD]

There are several issues, the constipation and gas as well as the right upper quadrant pain.

Regarding the chronic constipation and gas.  Irritable bowel syndrome can present this way.  However, before attributing the symptoms to this, I would consider some sort of lower endoscopy (either flexible sigmoidoscopy or colonoscopy) to make sure that there are no anatomical abnormalities that could be causing the symptoms.  

With the right upper quadrant pain, gallstones are certainly a possibility.  A right upper quadrant ultrasound would be a good place to start.  If that is negative, I would then consider an upper GI series or upper endoscopy to evaluate for the causes you mentioned - H Pylori, GERD or ulcers.

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.

Thanks,
Kevin, M.D.

[KBleything]

I have been searching for answers in reference to mid-low back pain upon waking due to excessive gas, which seems to release the back pain shortly after having a bowel movement. This problem for me has been goin on for the past couple of months and has been causing short sleep patterns. I accumulate about 4-5 hours of sleep a night. After reading this post, I wanted to know if this is a condition that could be serious or could be improved with medication. I have normal bowel movements regularly. Ive changed my eating time to around 430-5pm in hopes that this would help, but it hasnt. Any infomation you could provide would be greatly appreciated.. Thank you.

[heroine]

A related discussion, high TSH was started.

[heroine]

A related discussion, gallbladder disease was started.