IBS or something else

I was "diagnosed" with IBS about 6 months ago after a colonoscopy, ultrasound, CT scan and upper GI found nothing remarkable, blood tests where all normal.  

For the most part, Levisin (hyocyamine) controls the pain but there are still days when it is a little worse.  The pain is mostly dull and located on the right upper abdomen and occurs most frequently in the late morning or early afternoon.

However, last week I had a extremely different experience.  It was a knife like pain on the right side that only lasted for a few seconds but felt as if something was ripping. (also, felt NO urge to have a bowel movement, which I thought was a prime IBS symptom) I had a lingering effect of general unwellness (shakiness, dry mouth) for a few hours but felt okay the next day.

A few questions:
1. Have you ever seen this type of IBS symptom?
2. Is it consistent with how IBS presents in terms of symptoms?  
3. If not, where should I look next. I'm scheduling a follow-up with my GI doc.

Thank you.

[Kevin Pho, MD]

To answer your questions:
1) I have seen these symptoms in conjunction with IBS.  

2) IBS can present in several ways.  Abdominal pain is not an uncommon manifestation of IBS.  

3) You have had a pretty comprehensive evaluation.  You can look outside the GI symptoms - specifically at the kidneys or the ovaries (if you are female).  An ultrasound of those respective organs can be considered.

4) I would consider the tests mentioned above.  If there is concurrent constipation with the IBS, you can consider Zelnorm.

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.
kevinmd_b

[my4boys]

i think you should have an egd and have some bile aspirated from you gallbladder to check for crystals. if you are having pain on the right upper quadarant then you can have gallbladder problems. i have been down this road. my doctor claimed it was ibs put me on antidepressant which i refused because i didnt have the sudden diarrhea and constipation. this was mostly after a few hours i ate and at night the worse. they did the bile aspiration and found crystals which can lead to small gallstones. i had two gi opinions and both recommended i have it removed. talk further with your gi doctor they know because they are specialist. family practice only puts band aids on. it angers me that everytime you have abdominal pain they chalk it up to ibs. look further into your options and get a true diagnosis.

[RUQGoWay]

thank you. I will follow-up with that suggestion.

[Austin542]

While having an abscess tooth, I was giving Clindamycin for the second time since August.  After being on the antibiotic for several days, I began to have serious pains in my rectum, and my bowel movements were spasmic, I began to become constipated, passed mucous, had the constant urge to strain, and felt full after bowel movement.  I went to my GP, and he examined me with an analscope and told me that I had Proctitis.


I was then prescribed Proctofoam HC.  This relieved the pain, and I began to have normal bowel movements again.  I quickly ran out of the foam, and now, I am having the same problems again.  I'm not experiencing rectal pain, but I'm constipated.  When I do manage to have a bowel movement, I pass very little, and it's coated with mucous, or I get dime size drops of mucous in the toilet.

I have been back to the doctor, and he gave me Butage, and a probiotic.  FYI, all this has occured within a 3-4 week period.  I don't know what to do?  I'm not sure if my doctor is being thourough enough.  Should I get back on the Proctofoam?  Perhaps, I ran out before it was completely healed.  Now, I noticing some upper stomach soreness, and the feeling of bloating (gas).  Any suggestions are welcome.