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Gastroenterology (Expert Forum)
Bowel Problems
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Bowel Problems
by Ebea, Feb 25, 2004 12:00AM
38 year old female, BMI 18.5, with endometriosis.
Lap 12/00
Total Laparoscopic Hysterectomy, kept ovaries 11/03
Summary of my bowel problems & tests:
18 pasted out several times with acute stomach/rectal pain prior to bowel movement. No color in face or lips.
Age 21-37 primarily constipated with bloating. Diarrhea 1st day of period.
Age 30-33 in addition to above severe rectal pain prior/during bowel movement or passing gas, 1st day of period.
Age 35 Positive Fecal Occult Blood Test. Colonoscopy negative, but EXTREMELY painful, the nurse had to hold me down. I was given the maximum medicine possible. I was told that I just had a intolerance to the procedure.
Age 34-present intermittent (associated with period) white with areas of pink, yellow or brown mucus with bowel movements, at times looks like dead fish flesh floating attached to bowel movement. Intermittent brown jelly like stuff with bowel movements. Cramping with bowel movements. On occasion mucus hangs out of my rectum following bowel movement.
Age 37 Barium Enema - Radiologist findings normal. General Surgeon findings - Massively elongated redundant colon with an area of what he thought was volvolus. Referred to GI for second opinion, GI didn't really address volvolus, until I asked, and than bluntly said no.
Age 38 went to a Endo specialist for what I thought was going to be a thorough surgery. Bowel prep was done prior to surgery. Colon was never checked during surgery, no operative notes or anything on video indicated this; despite emphasizing that it was my primary concern.
Post surgery
Cramping, diarrhea day 2-3 post hysterectomy.
Day 7-14 severe pain prior to and during bowel movements.
Week 3-4 things calmed down.
Week 5 the following returned: Bloating, intermittent (associated with cycle) white with areas of pink, yellow or brown mucus with bowel movements, at times looks like dead fish flesh floating attached to bowel movement. Intermittent brown jelly like stuff with bowel movements Cramping with bowel movements.
I really think that my bowel problems are endo related. I'm not ready for more tests at this point. I would like to have a medical opinion. Thank You.
Lap 12/00
Total Laparoscopic Hysterectomy, kept ovaries 11/03
Summary of my bowel problems & tests:
18 pasted out several times with acute stomach/rectal pain prior to bowel movement. No color in face or lips.
Age 21-37 primarily constipated with bloating. Diarrhea 1st day of period.
Age 30-33 in addition to above severe rectal pain prior/during bowel movement or passing gas, 1st day of period.
Age 35 Positive Fecal Occult Blood Test. Colonoscopy negative, but EXTREMELY painful, the nurse had to hold me down. I was given the maximum medicine possible. I was told that I just had a intolerance to the procedure.
Age 34-present intermittent (associated with period) white with areas of pink, yellow or brown mucus with bowel movements, at times looks like dead fish flesh floating attached to bowel movement. Intermittent brown jelly like stuff with bowel movements. Cramping with bowel movements. On occasion mucus hangs out of my rectum following bowel movement.
Age 37 Barium Enema - Radiologist findings normal. General Surgeon findings - Massively elongated redundant colon with an area of what he thought was volvolus. Referred to GI for second opinion, GI didn't really address volvolus, until I asked, and than bluntly said no.
Age 38 went to a Endo specialist for what I thought was going to be a thorough surgery. Bowel prep was done prior to surgery. Colon was never checked during surgery, no operative notes or anything on video indicated this; despite emphasizing that it was my primary concern.
Post surgery
Cramping, diarrhea day 2-3 post hysterectomy.
Day 7-14 severe pain prior to and during bowel movements.
Week 3-4 things calmed down.
Week 5 the following returned: Bloating, intermittent (associated with cycle) white with areas of pink, yellow or brown mucus with bowel movements, at times looks like dead fish flesh floating attached to bowel movement. Intermittent brown jelly like stuff with bowel movements Cramping with bowel movements.
I really think that my bowel problems are endo related. I'm not ready for more tests at this point. I would like to have a medical opinion. Thank You.
Doctor's Answer
by Kevin Pho, MD, Feb 28, 2004 12:00AM
, Feb 28, 2004 12:00AM
With a negative colonoscopy, it makes inflammatory bowel disease or colon masses less likely.
Other possibilites to consider would be malabsorption syndrome, chronic pancreaitits, or irritable bowel syndrome - all of which can cause changes in the bowel habits and mucous in the stool.
To test for malabsorption - sending off the stool tests for fat or blood tests looking for celiac disease can be considered.
Pancreatitis can be evaluated via a CT scan and pancreatic enzymes.
There is no test for irritable bowel syndrome - this is primarily a diagnosis of exclusion. If all the tests are negative, you can consider treating this with increasing the fiber in the diet and discussion of antispasmodic agents.
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.
Thanks,
Kevin, M.D.
Other possibilites to consider would be malabsorption syndrome, chronic pancreaitits, or irritable bowel syndrome - all of which can cause changes in the bowel habits and mucous in the stool.
To test for malabsorption - sending off the stool tests for fat or blood tests looking for celiac disease can be considered.
Pancreatitis can be evaluated via a CT scan and pancreatic enzymes.
There is no test for irritable bowel syndrome - this is primarily a diagnosis of exclusion. If all the tests are negative, you can consider treating this with increasing the fiber in the diet and discussion of antispasmodic agents.
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.
Thanks,
Kevin, M.D.
