Stomach and Back Pain

[kitkat31625]

Hi,  I am 36 year old female.  I was diagnosis with Irritable bowel syndrome and Gerd approximately 8 years ago. I had polps removed from both my Esophagus and colon about 5 years ago. About the last 2yrs I have had off and on problems with bloating,Severe gas and lower to middle backache especially at night. It keeps me awake and I can not sleep. Within the past 5 months the problem has gotten worse. The problem is worse a week before my periods. I do have episodes where I will have a big bowel movement ( Stool comes out in one long strand) that will relieve the symptoms. Even though my doctor thinks this is related to my IBS. I have had been checked for kidney stones with a CT scan w/ dye. I have also had an abdominal ultrasound. Both came back negitive. I have tried Zelnorm which after taking for 3 weeks bloated me up worse and give me diarreha that I couldn't control. Along with prevacid, antispasmics and other IBS medications. None have helped.  I am getting frustrated. I do not know what direction to go into to find a cause for the problem. Is there any intestinal or stomach problem that causes back pain that is worse at night? What do you think that this could be?

[Kevin Pho, MD]

IBS can certainly be considered.  You can also consider pancreatitis as well as inflammation of the upper digestive tract or an ulcer.

In addition to the tests you have already had, I would consider an upper GI series or upper endoscopy to evaluate for these other causes.  

Another consideration would be untreated GERD.  A 24-hr pH study can evaluate for this possibility.

If negative, then IBS can be optimally treated.  You mentioned that Zelnorm and antispasmodics have been used.  You can also try tricyclic antidepressants which may have some success (seen in small trials).

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.
http://www.straightfromthedoc.com

[jaspur]

I had a hiatial hernia repair done 9 years ago. I have Barretts Esophagus so I have to be "scoped" every year. My GI doc is @ Beth Isreal Hosp in Boston. My symptons before the operation were (besides acid reflux)stiff neck especially the left side and sinus blokage (left side)these symptons would come on when I became bloated. All of my Docs say that it unrelated to the hiatial hernia. So now it is IBS,they think. I have had all of the tests that you mentioned. I also get relief when I have a big bowel movement. I do not sleep well when I am bloated. I do not sleep well when I eat anytime after 2pm. I wake up when my dinner reaches my lower (?) bowel and cannot get back to sleep.I even had sleep tests.The docs just do not want to beleive that the bloating/IBs can cause back or neck pain and seem not to able to do anything to releive this problem. Gas x works better for me that all of the meds you mentioned and gasx only works 25% of the time.. good luck

[twixcc]

I have similar problems.  I have to sit up in bed sometimes before the pain goes away, before I can sleep.  I also bloat out quite a distance.  I cannot say for you but I think my problems are hormone-related. (I am female.)  When it's my time of the month I can't digest as well and bloating gets much worse, also at mid-cycle, day 14.  The pain at night I am almost positive is due to stomach acid and simple heartburn, and my stomach is small so the pain radiates to my back as well. I have helped my symptoms by avoiding fats, caffein, sugar in any form, and alcohol.  These foods I find, trigger stomach acid release. I make sure to eat regular meals.
I had a lower examination (I forget the word) colonoscopy and also endoscopy and it did reassure me that my insides were ok.  I am willing to say it is hormones and diet.  The biggest advice I can give, which won't hurt, is to eat bland, regular meals, eat enough, exercise to feel good, and above all, try to avoid stress which will make your female hormones go haywire and might aggravate symptoms.