Abdominal pain with change in bowel movements

[les1965]

I am a 40yr old male and have been experiencing pain in my right lower abdominal/inguinal pelvic area for approx 6 months. At first i thought it was ruptured appendicitis scar tissue as I felt a burning sensation right around my appendix scar. I went to my physician who performed an exam and diagnosed torn scar tissue. On a subsequent visit, my hip/pelvic area was x-rayed to check for bone damage and was negative. I have been referred to an ortho surgeon and am scheduled for an MRI of the abdomen, hip and right flank area. I have pain that radiates from the inguinal nerve area up and around to the back hip bone.
And recently I have noticed a slight change in the consistency of my bowel movements. I am regular, usually in the morning, and the first movement is of normal size, but after that any subsequent movements are smaller in diameter. Not pencil thin, but noticeably smaller and sometimes not well formed. No sign of blood and normally a healthy brown color.
I took part in a dry eye study that required CBC test and as of the last on Feb 18, 2005, showed no abnormailities.
My abdominal pain is definetely aggravated by standing for any period of time and sometimes by sitting for long periods of time, but seems to be alleviated by lying down and doesn't bother my when sleeping unless I lay on my right side.
I haven't exerienced any watery bowel movements or constipation, but have had a noisy stomach. My last comprehensive physical was 2 years ago and all was well. If I were to self-diagnose off my symptoms, I would lean towards an inguinal hernia, but I don't have any visible lumps.
I am not overly concerned about the abdominal pain as I think it is related to a muscle/tendon injury from sports as it does seem to get better when I cease all exercise and is aggravated by running and biking. My biggest concern is the bowel movement change. please advise. Thanks, LES

[Kevin Pho, MD]

Tough to say without examination.  However, changes in stool caliber as well as bowel habits is certainly concerning for an anatomical mass (either cancer or stricture).  The MRI you are scheduled for can evaluate the organs comprehensively, but what is suggested is a colonoscopy.  This is the best test looking for polyps or colon cancer, and biopsies can be sent if anything suspicious is found.  

If the MRI and colonoscopy are negative, it is unlikely that a major GI disease is present.  Irritable bowel syndrome can lead to the symptoms you described, but this is a diagnosis of exclusion.  If that diagnosis is suspected, you can consider increasing the fiber in the diet or possibly anti-spasmodic agents.  

You can discuss these options 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.
Medical Weblog:
kevinmd_b

[meena65]

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