Pain in the morning

[morningpain?]

Hello.

I am a 26 year old male.  When I was 19 I had recurring bouts of sever pain in the morning, down in my lower abdomen.  I never figured out why, and it just quite happening.  Lately, I have had mucusy stool with feelings of urgency in the morning (not diarreah, but just stool that is a little soft and covered in mucus) and the morning pain has returned the past couple of days...though much less severe.  It feels like a dull ache, that radiates to the lower right side and back...also directly above my belly button.  It tends to subside within an hour or so of waking.  I had a flexible sigmoidoscopy when I was just having the mucusy stools, which was negative.  The pain returned well after the procedure (two weeks or so) and I am scheduled for an upper GI/small bowel x-ray in a couple of weeks.  My doctor said that he wants to rule out Chron's disease.  It is very distressing to think I have Chron's disease, and my symptoms don't seem to fit the descriptions I have found online (except for abdominal pain...but I have found no mention anywhere of it happening only in the morning).  

Furthermore, I quite smoking three weeks ago and the morning urgency seems to have subsided.  Does any of this sound like Chron's disease?  Please Help.

PS.

I was also diagnosed with Reiter's syndrome three years ago because of Urethritus (can't spell), conjunctivitis that didn't respond to antibiotics, and joint pain.  The Urethritus has come and gone since then, as well as VERY MILD joint pain (never have needed to medicate) and red eyes (sometimes).  Could there be a connection?

[Kevin Pho, MD]

Inflammatory lesions of the bowel is associated with Reiter's syndrome.  This is likely why your physician is vigilant in making sure that inflammatory bowel disease (i.e. Crohn's disease or ulcerative colitis) is not present.  

The flexible sigmoidoscopy/UGI series are good initial tests.  If those are negative, I would also consider tests for malabsorption - serum tests for Celiac disease, fat tests for fat malabsorption - since they can also present with mucous in the stools.  

If the flex sig is not revealing, a full colonoscopy can also be considered.  

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.

[kevinmd]

Hello - I will be on vacation until August 9th. I look forward to answering your question when I return.

Thanks,
Kevin, M.D.