Need some help here...

[kbcraze]

I have a very busy, stressful life and consider myself a "Type A" person.  For about 12 years I have struggled with periodic episodes of stomach pressure/pain, bloating, gas, constipation, headaches, bloodshot eyes, waking up tired.  About 5 years ago I was diagnosed with IBS (constipation variety) and was prescribed Librax.  This was a close to 8 or 9 years ago and I recall not seeing any improvement from that treatment.  I tried homeopathic remedies (Nox Vomica, acidophilus) again to no avail.  I find that in particular after lunch I get hit almost immediately with these sypmtoms and feel them until after dinner and a few alcoholic drinks, about 9-10PM.  I almost always need to have a bowel movement just before bed, but sometimes not much comes out and I go to bed with that feeling.  Recently I've observed an increase in recurring viral infections/cold symptoms in my throat and ears that seems to coincide with my stomach troubles.  My paternal grandmother died of stomach cancer in her late 50s.  I believe my paternal grandfather also had colon cancer.  I'm sick and tired of feeling sick and tired and more importantly I'm concerned that these may be early indications I'm on the path to some type of GI cancer.  Particularly since I've read about a linkage between H pylori infection and cancer risk.  Recently I've been trying to cut back on caffeine intake and increase my fiber and water intake.  I probably still drink too much alcohol for my good (2-3 drinks a day).  What course of action would you recommend?

[Kevin Pho, MD]

In addition to IBS, there are variety of reasons that can cause your symptoms.  This can include an ulcer, inflammation of the esophagus or stomach (esophagitis/gastritis), GERD or gall bladder disease.  

Before attributing the reason to IBS, you may want to consider further testing to make sure it isn't anything more serious.  This would include an upper GI series or upper endoscopy (which would be the more comprehensive test).  You mentioned H Pylori - this is a bacteria that is associated with inflammation or ulcers in the upper GI tract.  This can certainly cause symptoms if not properly treated.  Diagnosis can be made if you had the upper endoscopy or during a simple blood test.  

If negative, I would then consider an abdominal ultrasound to ensure that the gall bladder isn't causing your symptoms.

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.

[kbcraze]

You mentioned gall bladder issues.  Are there specific symptoms that would point to a gall bladder problem?  Any possibility that periodic rashes/hives would be present due to that type of issue?