Vague Abdominal Discomfort

[Alexmo]

In the last year and a half I have had some vague abdominal issues. In September of 2003, I had about 14 days of consitpation with abdominal discomfort on both right and left side. During this time a family member was diagnosed with cancer so I always wonder if it was stress related. I had an abdominal series that showed moderate constipation, but no obstrcutions, ascites, etc. After the consitpation was gone, I started suffering from nausea, weakness and continued abdominal discomfort, mostly on left side. Had a CT scan of abdomen/pelvis done which showed slighlty enlarged spleen(12CM) but everything else was ok. Soon the pain subsided and I felt fine for a few months until February 2004. More abdominal discomfort, fatigue, but no nausea. GI doctor did blood test, h. pylori test, and fecal occult test which were all normal. For 6 months I was feeling great until September of 2004 when my family member died. I was given a benzo for anxiety and about this time I started having left side abdomen discomfort. Burning pain, almost feeling like a knot. Gurgling in the stomach and bouts of flatulence. I still have this discomfort to this day. Since this time I have had 4 or 5 instances of blood(very small amount except 1 movement had more) on top of the stool, but no constipation and stools are softer, but sometimes thinner. I had a sigmoidoscopy last month which was negative...GI doctor said I have more blood vessels than normal in rectal region. I will be having an ultrasound of abdomen and upper GI endoscopy as well in a week. I am doing the correct procedures for these issues? Have had 3 blood tests in the last year and all are normal. NO WBCs in stool, nor parasites. My doc said since my sigmoidoscopy was normal it is unlikely anthying would be higher up in the colon, but maybe this is a bad assumption. I am 37 years old. Can all these symptoms be due to anxiety/stress, or possibly sensitivity to the benzo I have taken which I am weaning off of. Opinions please.

Thanks

[Kevin Pho, MD]

You are undergoing a reasonable workup for your symptoms.  I agree with the ultrasound and upper endoscopy - which can evaluate the liver and gallbladder as well as comprehensively evaluating the upper digestive tract.  

If negative, you may want to consider a colonoscopy - which can evaluate the lower GI tract past the point where a sigmoidoscopy would hav eended.  

If the tests remain non-revealing, you can consider irritable bowel syndrome - and possible treatment with antispasmodic agents.

You can discuss this option with your personal phyician or gastroenterologist.

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

[Alexmo]

Can blood, even in small amounts be related to IBS.