IBS - Stomach Pain -

[noblejohn]

I am a 37 year old male.  

In July of 2006 - 10 days after returning from Mexico, I came down with watery diarrhea and severe gas.  I never had a stool sample but suspected parasites (Giardia maybe) and took 10 days of Flagyl.  I was fine after 1 week.

After two weeks, I started getting IBS symptoms, which have gradually worsened.  Now (March 2007) my symptoms are:

Lower GI
• Stools are small and dark (but not quite black)
• Lower Abdominal bloating / cramping
• Much more gas than normal, especially with fat intake
• Some pain in lower abdominal area
• Some signs of mal-absorption in stool – floating stools, mucus, undigested pieces
• Alcohol and not taking Metamucil causes stools to be messy / not formed
• Rectal itching sometimes – especially with beer or alcohol.  This symptom pre-existed the episode in July 2006.
• Reduction in caffeine and alcohol has reduced episodes of spasms in my gut to rarely occuring

Upper GI
• Some burning in stomach and upper GI area (not drinking and prilosec helps with this)
• Drinking alcohol sometimes causes mild burning if stomach is empty
• My stomach gets full very quickly, but I haven’t lost my appetite and still eat

I take Metamucil, pro-biotics and antispasmodic for my symptoms.
I took Prilosec OTC for only two days and it helped reduce the mild stomach burning.
I have cut out all starbucks, coffee and cut way back on alcohol – maybe a drink every two weeks.

I have colonoscopy and endoscopy scheduled in 3 weeks.

[Kevin Pho, MD]

I agree with the upper and lower endoscopy.  

Possible upper GI causes would include GERD, an ulcer or inflammation of the upper digestive tract.  Colonoscopy can exclude inflammatory bowel disease and other causes of infectious colitis.  

If the endoscopies continue to be non-revealing, imaging the abdomen with a CT scan can be considered.

Repeating the stool cultures, including testing for a bacteria known as C Difficile, can be considered to exclude other infections.

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.
kevinmd_

[noblejohn]

Can a stool sample be taken if you do not have diahhrea?

Would a breath test for H Pylori but just as effective as an endoscopy?

For the first several months my symptoms were lower GI (cramping, altered stools), now they are both upper and lower (feeling of fullness shortly after eating, some burning).  

Could gastritis present symptoms only in the lower GI and then show symptoms in the upper GI as it becomes worse?

Thanks for your help.

[wassupwassabi]

Hey,
I don't think the docs usually browse the comments section.  

I've had stool testing done before, you can certainly have it done if you're not having diarrhea.

Also had an endoscopy before... the idea behind it is not only to do H Pylori testing but also to look for structural abnormalities like hiatal hernia or non-functioning sphincter, and whether or not damage to your esophagus has occurred.

[noblejohn]

Is an endoscopy and colonoscopy painful?

I am worried that nothing will be found.  It seems that everyone that posts on this forum has problems that are never solved.  I am depressed thinking that my digestive problems will be with me the rest of my life.

[tanns]

I have had both a colonoscopy (2)  and an endoscopy.  Neither was painful although the junk you drink for the prep of the colonoscopy is NASTY.  That is truly the worse part.  You'll be fine.

Also, as far as a stool sample, I think they prefer you DON'T have diarrhea.  I recently had some lab tests at the Mayo Clinic and because I was coming off of a stomach bug I had to wait for the stool sample until I was passing normally again!  Wow, too much information!!

Good luck and I hope you get some answers soon!

[noblejohn]

In case any one reads these -

I had a Endoscopy and Colonoscopy.  The process was not bad, I had undue anxiety.

The results were non-specific colitis with ulcers in my colon.  Also, gastritis and esophogitis.

I am taking Asacol and aciphex to reduce inflamation (inflammation) and acid.

It is very frustraiting that only the symptoms can be treated.  What caused this?  There are still many questions.  These tests ruled out certain things, but why can't doctors figure out what causes these problems.  I was normal until I went to Mexico last summer, now I have a cronic disease which could last the rest of my life.