IBS after colon resection

I am a 36 year old male. I had several bouts of diverticulitis and had my sigmoid colon removed in June of 2001. Since then I have had trouble moving my bowels. It seems like the muscles aren't able to contract to expell the stool even though the stool is soft and small. This in turn causes severe gas and pain. I currently take Zelnorm 6mg twice and Prilosec 20mg twice a day. Neither medications seem to help. I have lost about 20 lbs due to not eating. I've had a small bowel series and several colonoscopies with nothing remarkable. I've been tested for lactose and fructose allergies, both negetive. Lab tests including blood, urine and stool have produced nothing out of ordinary.
The bottom line is that when I eat, no matter what I eat, my lower abdomen goes crazy churning and I get severe gas and pain in both right and left sides.  I don't move my bowels for days at a time then I will go through a period of severe diarhea (diarrhea). My lower abdomen always feels tight and crampy. Any thoughts on what this could be?

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation already.

Another consideration would be various malabsorption syndromes.  You can consider testing the stools for fat malabsorption as well as blood tests looking for celiac disease.  

With a negative colonoscopy, that would make inflammatory bowel disease less likely.  

Irritable bowel disease is possible, and treatment can be considered with antispasmodic agents.

These options can be discussed with your personal physician.

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.
http://www.straightfromthedoc.com