help!!

[normandy311]

I am a 20 y/o 5'9" 155lb white male.  I dont smoke, rarely drink, and have a typical college kid's diet.  I eat alot of eggs, chicken, and probably not as many fruits and vegetables as i should.  As i entered adolescence, i remember always having somewhat of a nervous stomach, but it never nearly got bad enough to warrant medical attention.  Through highschool, i would always have this "window" of time where my bowel movement would usually occur.  it usually was 8-10AM, and if i didnt go during that time, i pretty much wouldnt go at all that day.  I call this a window because, as i entered college, i found myself sleeping through this window when i had later classes.  Now, if i did have a bowel movement in this window, it would usually be loose with stomach pain similar to diarrhea but would instantly relieve me for the rest of the day.  If i did not hit this window (say i slept till 11 for a 12:30 class in college) i would not have any urge to have a bowel movement, and would usually have a normal consistency, BM later in the day with minimal abdominal pain before hand.  This may or may not be useful background info.

However, about 5 or 6 months ago, i started having peculiar intestinal problems.  I would have 3-6 very loose bowl movements per day, with much breakage of the stool upon evacuation, and an almost oily accompanying liquid.  Strangely, i would ALWAYS have a very uncomfortable, but never unbearable burning sensation in the center of my chest underneath my sternum BEFORE each one of these bowl movements(similar to hearburn).  This was followed by stomach pain and a strong urge to use the bathroom.  Burning sensation would come in waves and ONLY be relieved by the proceeding bowl movement.  Temporary relief would come through flatulation (gas would smell VERY BAD, have never had gas smelling this bad).  Eating would provoke (but not always) the onset of the chest pain.

Bowl movements would come in groups, after completing one, i would sit down, and another would follow 15 minutes later.  Repeat 2-3 times for full relief.

Upper GI series and bloodtests showed no abnormalities.  During Upper GI however, my physician commented on how "extremely quickly the barium was moving through my system."  This is a phenomenon that i had been experiencing ever since my symptoms began.  I would eat a meal, and see bits of the same food i had just eaten in my stool not 3 or 4 hours later.

Regular doses of metamucil only seemed to ensure a regular bowel movement 3-4 hours after a meal, with stool texture and symptoms still very prominent.  Usually, 1-2 Immodiums would relieve ALL burning sensations after eating and drastically reduce gas for 2-4 days, but symptoms would be back in full force after the immodium-induced hiatus.

Symptoms have been experienced on a daily basis for 5 months.  

Any thoughts?

[Kevin Pho, MD]

Things that could cause the change in bowel habits would be irritable bowel disease, colitis, an infection, or inflammatory bowel syndrome.  The colonoscopy or a flexible sigmoidoscopy would be helpful in eliminating some of the more serious diseases.

If negative, I would consider irritable bowel disease - which can cause "spasms" of the colon, leading to the symptoms.  Increasing fiber in the diet (as you are doing) can help.  If the symptoms continue, you can consider antispasmodic agents.  

Regarding the stomach problems - if the UGI was non-revealing, an upper endoscopy can be considered for a more comprehensive evaluation.

You may want to discuss these options in conjunction with a GI referral.

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

[planetmars]

Hello again,
I went to the GI doctor yesterday, and it went as expected.  I told him my history, and all the symptoms of diarreah, gurgles, burning sensations etc...IBS.  He perscribed Levbid, which supposedly is going to "regulate" my stomach.  I did research on it and sure enough it is a med that is common for IBS sufferers.  He said because of my history (previous upper GI's, and Internal Med Doc's diagnosis of IBS) he wants to start there, and since I do not have any other symptoms of other disease like blood, fever etc...it is a classic case.  Also of my age.  He said he will consider a colonoscopy in 3 months after I do this perscription if symptoms still persist.  It is not common, but can happen that someone under 50 could develop pollups, but he didn't seem at all concerned at this time.  I had been perscribed Axid for the burning sensation a long time ago, but only take it when I want to eat something I shouldn't, so he wants me to take that all the time too (for the burning sensation).

So, hopefully taking the axid & the Levbid will take care of things!  He also said taking the fibercon every day is good and not harmful to be taken forever.  The starch diet he was not all convinced on, he just said sensible, whatever sensible is!!!  

Good luck, hopefully your GI doctor will be able to route you in a good direction, I will try & post in a couple of days to let you know how the Levbid works!

maria