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Gastroenterology (Expert Forum)
Various 'upsets' (for lack of better description)
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Various 'upsets' (for lack of better description)
by borninquisitive, Sep 01, 2006 12:00AM
Hi Doc,
I apologize up front for the length of this post. I just want to put all the cards on the table and allow you to decide what is pertinent and what isn’t.
The history:
Around Fall of last year, my stools changed. They used to be of one medium sized, firm “log.” They became thin and smaller. What’s in the bowl now is a bunch of thinner, short pieces and “softer.” They aren’t pellets. Oft times, it smelled very acidic for lack of a better word.
Later, around Nov./Dec. when under stress and mostly at night (trying to prepare for the holidays) I would occasionally get very bad left side aches. I would find myself trying to sit tall trying to work the "cramp" out while on the computer. In worsening, I would put myself to bed. I walked gingerly to bed. I could hardly breath. I didn’t think much of it: STRESS. It subsided.
I was also experiencing pain dead center, below my rib cage on occasion. As well, regurgitating tea (if I drank too much.)
On a number of occasions, my digestion moved very slowly. The reason I think this, there were times I had eaten and up to 6 hours later, would burp and smell the food I had eaten much earlier.
The beginning of this year, I was given anti-biotics (tonsil issues which they were removed April and lost quite abit of weight on account of it).
The anti-biotics seemed to really throw my BMS through a loop, as well the first round (Ery) really upset my stomach.
Finally, after 2 courses of evening Metamucil on two nights and taking fiber (after the anti-biotics), things toned down.
Today: My bms are still small, more of it (to be expected) and soft (not diarrhea). On a good day, it will come out in one long stool.
In checking it weeks ago, there appeared to be orangish mucus on my stools.
I still get some discomfort dead center, below my rib cage.
Recently, while on the ferry to attend a funeral and having a few beers whilst on the ferry, I experienced terrible right side stitches, followed by gas (burping and “tooting.”) After the funeral, again-I had a few beers and the same happened though with lots of burping and flatulating (sometimes my right shoulder would briefly ache with it) all the way up to the time of going to bed. Alcohol never affected me in this way.
Around those few days, felt like liquid was trapped in my left side.
Just last night, trying to put it to test: I drank one beer but this time, only belched a few times.
My ENT was suspicious of my possibly having LPR. I did take Priilosec for a month and this did seem to help my previous throat irritation. What brought me to it, is in tasting something awful and in spitting it up: found it to be yellow. Note, shortly after my tonsils were removed: I had thrown up what appeared to be lots of mucus and yellow within. However, attributed this to a liquid diet and upset stomach on account of it.
Today, I tried some “test”: mixing ¼ tsp. of Baking Soda in 8 oz. of water first thing this AM. I only burped 3 tiny burps. What I’ve read about this: burping quickly and frequently might suggest too much acid. The opposite being true if the opposite occurs. The reliability of this-I have no clue but was curious anyway. lol
1) Does this sound like something that I should continue thinking on?
2) Is there anything that I can try on my own to resolve this?
3) If this needs to be looked into further, what tests should be performed: are there non-invasive tests (such as blood work etc.) that could/should first be looked into rather than first moving into other tests involving scopes/radiology? ß I’d rather not.
4) Is it possible that all this is psychosomatic?
5) Could stress alone be causing this?
Very recently, I had a complete CBC and with the exception of a high WBC, apparently the rest was normal. Previous CBC this year shown a low BUN but apparently this is of no concern. Strangely, my Cholesterol dropped this year to normal (last year it was “High”)
Family history: diverticulitus with a number of family members, I.B.S. (with one-doctor suspects it with me also) and my father nearly died in ‘76 from a bleeding ulcer. He was hospitalized, some of his stomach removed and he required copious amount of blood.
As an aside, if this is a G.I. influence, I have been going through what seems like Perimenopause (8 months irregularity) as has my 38-year-old sister (I just found out recently).
Along with it, frequent flushing (recently posted in Dermatology about this and other skin changes). However, my TSH came back within normal limits.
I will be reporting back to my GP (we have no specialists here, I reside on an island) as he wants to recheck my WBC.
In reading this, this all sounds mixed up. I have to wonder, how much has affected my mind and/or vice versa. Hence question number 4 & 5. Up until last summer, with the exception of feeling tired (I have 4 kids: 2, 4, 11 & 15)-I’ve been fine. All my life, I’ve been just fine. So, I am having a very difficult time dealing with all this.
I do not take any drugs (I do smoke), not overweight, not on any medications (recently finished Nistatin for oral thrush) and only on occasion do I drink beer and only in moderation.
Thank you for your time,
Kate
Alaska Age: 34
I apologize up front for the length of this post. I just want to put all the cards on the table and allow you to decide what is pertinent and what isn’t.
The history:
Around Fall of last year, my stools changed. They used to be of one medium sized, firm “log.” They became thin and smaller. What’s in the bowl now is a bunch of thinner, short pieces and “softer.” They aren’t pellets. Oft times, it smelled very acidic for lack of a better word.
Later, around Nov./Dec. when under stress and mostly at night (trying to prepare for the holidays) I would occasionally get very bad left side aches. I would find myself trying to sit tall trying to work the "cramp" out while on the computer. In worsening, I would put myself to bed. I walked gingerly to bed. I could hardly breath. I didn’t think much of it: STRESS. It subsided.
I was also experiencing pain dead center, below my rib cage on occasion. As well, regurgitating tea (if I drank too much.)
On a number of occasions, my digestion moved very slowly. The reason I think this, there were times I had eaten and up to 6 hours later, would burp and smell the food I had eaten much earlier.
The beginning of this year, I was given anti-biotics (tonsil issues which they were removed April and lost quite abit of weight on account of it).
The anti-biotics seemed to really throw my BMS through a loop, as well the first round (Ery) really upset my stomach.
Finally, after 2 courses of evening Metamucil on two nights and taking fiber (after the anti-biotics), things toned down.
Today: My bms are still small, more of it (to be expected) and soft (not diarrhea). On a good day, it will come out in one long stool.
In checking it weeks ago, there appeared to be orangish mucus on my stools.
I still get some discomfort dead center, below my rib cage.
Recently, while on the ferry to attend a funeral and having a few beers whilst on the ferry, I experienced terrible right side stitches, followed by gas (burping and “tooting.”) After the funeral, again-I had a few beers and the same happened though with lots of burping and flatulating (sometimes my right shoulder would briefly ache with it) all the way up to the time of going to bed. Alcohol never affected me in this way.
Around those few days, felt like liquid was trapped in my left side.
Just last night, trying to put it to test: I drank one beer but this time, only belched a few times.
My ENT was suspicious of my possibly having LPR. I did take Priilosec for a month and this did seem to help my previous throat irritation. What brought me to it, is in tasting something awful and in spitting it up: found it to be yellow. Note, shortly after my tonsils were removed: I had thrown up what appeared to be lots of mucus and yellow within. However, attributed this to a liquid diet and upset stomach on account of it.
Today, I tried some “test”: mixing ¼ tsp. of Baking Soda in 8 oz. of water first thing this AM. I only burped 3 tiny burps. What I’ve read about this: burping quickly and frequently might suggest too much acid. The opposite being true if the opposite occurs. The reliability of this-I have no clue but was curious anyway. lol
1) Does this sound like something that I should continue thinking on?
2) Is there anything that I can try on my own to resolve this?
3) If this needs to be looked into further, what tests should be performed: are there non-invasive tests (such as blood work etc.) that could/should first be looked into rather than first moving into other tests involving scopes/radiology? ß I’d rather not.
4) Is it possible that all this is psychosomatic?
5) Could stress alone be causing this?
Very recently, I had a complete CBC and with the exception of a high WBC, apparently the rest was normal. Previous CBC this year shown a low BUN but apparently this is of no concern. Strangely, my Cholesterol dropped this year to normal (last year it was “High”)
Family history: diverticulitus with a number of family members, I.B.S. (with one-doctor suspects it with me also) and my father nearly died in ‘76 from a bleeding ulcer. He was hospitalized, some of his stomach removed and he required copious amount of blood.
As an aside, if this is a G.I. influence, I have been going through what seems like Perimenopause (8 months irregularity) as has my 38-year-old sister (I just found out recently).
Along with it, frequent flushing (recently posted in Dermatology about this and other skin changes). However, my TSH came back within normal limits.
I will be reporting back to my GP (we have no specialists here, I reside on an island) as he wants to recheck my WBC.
In reading this, this all sounds mixed up. I have to wonder, how much has affected my mind and/or vice versa. Hence question number 4 & 5. Up until last summer, with the exception of feeling tired (I have 4 kids: 2, 4, 11 & 15)-I’ve been fine. All my life, I’ve been just fine. So, I am having a very difficult time dealing with all this.
I do not take any drugs (I do smoke), not overweight, not on any medications (recently finished Nistatin for oral thrush) and only on occasion do I drink beer and only in moderation.
Thank you for your time,
Kate
Alaska Age: 34
Doctor's Answer
by Kevin Pho, MD, Sep 02, 2006 12:00AM
, Sep 02, 2006 12:00AM
To answer your questions:
1) I would further evaluation your GI symptoms. The stool changes can be caused by any number of lower GI disorders, such as inflammatory bowel disease, cancer or irritable bowel syndrome. A colonoscopy can fully evaluate for these possibilities.
Regarding your upper GI symptoms - GERD, an ulcer, or gallbladder disease can lead to the epigastric pain. Workup can include an upper endoscopy and ultrasound.
2) I cannot make specific recommendations regarding treatment without evaluation.
3) Endoscopy and imaging are the recommended tests. A blood test that can be helpful in evaluating the upper digestive pain would be looking for H Pylori - which is associated with inflammation and ulcers.
4) If all the tests come back non-revealing, it may be psychosomatic in nature.
5) Again, stress may be an inciting factor. However, this should be considered if the tests come back negative.
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.
kevinmd_
1) I would further evaluation your GI symptoms. The stool changes can be caused by any number of lower GI disorders, such as inflammatory bowel disease, cancer or irritable bowel syndrome. A colonoscopy can fully evaluate for these possibilities.
Regarding your upper GI symptoms - GERD, an ulcer, or gallbladder disease can lead to the epigastric pain. Workup can include an upper endoscopy and ultrasound.
2) I cannot make specific recommendations regarding treatment without evaluation.
3) Endoscopy and imaging are the recommended tests. A blood test that can be helpful in evaluating the upper digestive pain would be looking for H Pylori - which is associated with inflammation and ulcers.
4) If all the tests come back non-revealing, it may be psychosomatic in nature.
5) Again, stress may be an inciting factor. However, this should be considered if the tests come back negative.
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.
kevinmd_
In March, a stool sample was taken and came back negative for baddies-so am hoping Cancer is out of the picture. My hunch is that it isn't that bad.
If due to stress, I will come to the conclusion that it affects me far more than I had ever thought it could.
Thanks again.
Sincerely,
Kate