Thin stools, LLQ abd pain

52 yr old male
HX: Diverticulitis,Asthma
Meds: Prednisone asthma,miralax,flomax,theodur asthma

Started having LLQ abdominal pain (no tenderness) one week ago today. Saw my PCP on Thursday, he said that he thought the pain was due to spasm in the colon..... RX Levsin. Didn't take the Levsin because I was worried about negative impact on BPH, and asthma.

Abdominal pain was worse on Sunday and I went to the ER. CT showed no evidence of diverticulits. No evidence of masses or obstruction. WBC was elevated to 12.1, all other labs within normal limits. NO fever.

Also having some constipation alternating with very thin well formed stools.(last seven days) I had a colonoscopy in May of last year....removed three small benign polyps. Have had several fecal occult blood test in the last year all negative.

Main concern is thin stools. Any ideas on possible causes. I'm guessing IBS-C as the most likely. Can't imagine that I have developed colon CA in less than a year post colonoscopy.

[Kevin Pho, MD]

IBS is certainly possible.  The colonoscopy and CT scan would rule out many of the major GI disorders leading to the symptoms.  

You are right in that colon cancer is unlikely given a negative colonoscopy last year.

You can also consider motility disorders leading to constipation, which can be evaluated with colonic motility studies.  Neuromuscular problems with the anal sphincter can also be considered and evaluated with an endorectal ultrasound.  

A repeat sigmoidoscopy can also be considered if there is an acute change in the bowel shape.

Levsin is appropriate for IBS.  Zelnorm would also be an option, but it has been pulled from the market.  

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.
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