ulcerative colitis?

I'm a 31 year old female who used to smoke a half a pack of cigarettes a day for 8 years.  Besides smoking I would have considered myself active and healthy.  Within a month of quitting smoking (July 2008) I noticed a strange internal pain under my left shoulder blade.  It is a hollow pain that occaisonally burns.    Initially my doctor was convinced it was a muscle.  Physical therapy did nothing and I kept insisting to my doctor that it was internal.  She gave me a chest x-ray and nothing was seen on the x-ray.  I waited a couple months and eventually I started to notice that sometimes my pain changed when I ate certain things.  I also noticed that stress made it worse.   My doctor sent me for an upper endoscopy to check for an ulcer.   The surgeon only found mild gastritis and a very small hiatal hernia. The surgeon said that he did not feel that the gastritis or hiatal hernia could be causing my problem at all.  At this time I also began to notice pain in my lower left abdomen.  It almost feels like something is swollen in my stomach.   The surgeon and my doctor sent me for several different tests after this pain began.  These included an abdominal ultrasound, chest ct, and hida scan.   All of my tests came back normal.   Since being tested I have seen small amounts of dry blood in my fecal matter on two occaisions.  I have also noticed that I bleed in my rectum during my period and the pain gets worse at that time.   I've mentioned the blood to my doctors, but they just said it could be a fissure.  I have also just felt sick for the past couple months.  Like overall I just typically feel like I'm on the verge of catching a flu.  Certain foods like greasy stuff make the pains worse, but also high fiber foods can make it worse too.   I do not have diarrhea, but I was wondering if there was anyway I could have a form of colitis without the diarrhea?  Otherwise, any suggestions of tests that I should ask for?   I'm desperate for answers.  

[Kevin Pho, MD]

I agree with the testing done thus far, and it has been comprehensive.

With the blood in the stool, an evaluation of the lower GI tract is warranted.  A colonoscopy would be the appropriate test to start with, and can exclude ulcerative colitis.

I would also send off stools for malabsorption studies, as well as blood tests for celiac disease.  

Sometimes, chronic pancreatitis can lead to loose, mucous-filled stools.  Obtaining blood tests to look at the amylase and lipase, as well as evaluating the pancreas with the CT scan you had, can be considered.

These options can be discussed with your personal physician.

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 Pho, M.D.
www.kevinmd.com
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