Please Help/need advice

31/f In 4/07 began having abdominal pain with a lot of foul smelling gas and mucus, afraid to pass while not in restroom for fear of smell, also that mucus would come out, as it did once.irregular bm.Began experiencing joint pain that would shift.1 day felt like sprained ankle the the next my shoulder would hurt.Small amounts of blood when releasing gas and sometimes mixed with mucus. 1 hemmoriod due to child birth.Went to GenPr in 05/07.took a stool sample and blood. stool normal,blood came back with elevated rhuematoid levels not high enough to concern diagnostically.Symptoms continued along with varied stools or no bm's at all.we moved overseas.Went to another Dr who took more blood, levels came back normal, slightly anemic.Sent to GI. colonoscopy ordered 8/07 but all symptoms had resolved.I was having normal but not daily bm.Colonoscopy came back normal Dr.believed it could have been infectious colitis with reactive arthritis. 3 1/2 weeks ago symptoms returned.Gas with mucus, no joint pain.at start,afraid to pass gas outside for fear of releasing mucus. passing gas now is ok.mucus just when on toilet and pass gas.Small amounts of blood when releasing gas mixed with mucus.Abdominal discomfort not extreme.bm's loose at start then no bms just gas and mucus.minor twinges of pain 2x passed very quickly.Went to Dr.who stated everything done to rule out serious,will not refer GI.Took blood to run ESR test.Also given a stool softener.BM;s are not daily but r solid and thin.never have had daily bm's. No pain when I press on my abdomen, just can feel gas shift and sometimes feel need to go.would like to know what I should do next or what I should ask be done. I have not recieved a clear diagnosis.would UC have shown up on the colonscopy even without symptoms present?should I be requesting going back to a GI and why?Dr. I see is not a specialist, only general pract.I'm overseas and scared. Any advice about symptoms,diagnosis and what I should ask and do would help.Thanks

[Kevin Pho, MD]

I agree with the testing thus far.  A normal colonoscopy would exclude colitis or inflammatory bowel disease. It would be unlikely that UC would be present in the setting of a normal colonoscopy.

I would consider malabsorption, which can be evaluated with stool tests to exclude fat malabsorption, or celiac disease which can be evaluated with appropriate blood tests.  

Imaging the abdomen can also be considered with a CT scan for further evaluation as well.  

These options can be discussed with your personal physician or GI 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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com