Multiple GI Symptoms!!

[PhillyMan]

Dr.-

I am 42 y/o white male.  I do not smoke, drink and am about 10 lbs overweight.  I am dysthymic ( depression) and sugger from terrible anxiety and I worry about everything.

I have a variety of GI symptoms that I want to get your opinion on.  For about 6 weeks I have had some vague and transcient abdominal aching and discomfort.  It ranges from a "stitch" feeling in my lower left abdomen to a soft ache in my right side to slight aches under each rib.  They are pinpint and very intermittent. None of these are contant or are getting worse.  My appetite it fine and I am not losing weight or feel anemic. The whole mess has subsided a bit over time.  Now, last Thursday after lunch I had some pain all over my chest that went away very quickly.  I called my GP who told me to eat a bland diet for the weeeknd and that helped.  I did not have pain like that again.  The pain is (was) dead center in my chest.

I want to point out I was diagnosed with IBS about 12 years ago.  I have not been constipated, and I go every 2 days in the morning.  I have been gulping Metamucil and my stools range from darker brown and sink to medium brown and are much softer and float.  They also break apart a bit when I am evacuating.  This morning I had a BM that was more like the first type noted above and I was off the Metamucil for 2 days.  

Today I saw a GI doctor who gave me LEVSIN SL for the pain and suggested I get a colonoscopy, as a precaution. My exam was no problem. My belly felt fine, no jaundice or nausea or vomiting.  I have been belching alot though. She was very adamant that she does not suspect colon cancer.  I had one 3.4 years ago and it was clear. She also confirmed the IBS and felt that my symptoms are very consistent with that. After lunch I had pain again and the pain is dead center in my chest and I feel it in my back as well.

Can you please comment and advise?  I also welcome comments from anyone here as well.

TCPhilly.

[Kevin Pho, MD]

I would certainly be evaluated for dyspepsia - which can cause your symptoms.  There are a variety of upper GI diseases - such as ulcers, inflammation of the stomach or esophagus or GERD.  Tests to evaluate for these disease would be an upper GI series or upper endoscopy (with the latter being the more comprehensive test).

I would also consider blood tests for a bacteria known as H Pylori - which is associated with ulcers or inflammation.

The colonoscopy is a good idea to evaluate the lower bowel.

If the tests return negative, then irritable bowel certainly can be possible - and treatment optimized.  Levsin is an antispasmodic that sometimes works.  You may want to discuss with your GI doc about other options.

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

[PhillyMan]

One more thing-I had a complete physical last May and my DRE and fecal blood occult tests were negative.

TCPhilly

[PhillyMan]

This morning I have woken up to incredible stomach hunger pains and a pretty strong pain that might feel like burning behind my sternum.  It feels like it might be running straight down my sternum. Please kindly consider this in your collective response.

[cyndi mvc]

After reading the symptoms you've been experiencing I would certainly reccomend getting tested for Celiac Disease, as well as educating yourself about this disease, as the blood tests are not always reliable. I don't know if you've ever heard of Celiac Disease, seeing it is one of the most grossly Underdiagnosed and Misdiagnosed conditions in the US, but it is a rather severe allergy/intolerance to wheat Gluten,which can, and often does maifests itself with a broad and rather diverse array of symptoms.Press on and Good Luck to you.