irritable bowel syndrome or diverticulitis

[Barbara__0__0]

  I am 68 and generally healthy.  I have no history of constipation and eat a good diet.  12 years ago I had sudden sharp low abdominal pain that was acute diverticulitis with fever that lasted a couple of weeks.  Since then I take psyllium daily and don't eat seeds.  I have taken antibiotic treatment for 10 days a number of times when I felt sharp pain coming on.  This past year I have had much more frequent attacks of both sharp pain and intense dull pain and pressure.  The only time I EVER have had pain is in the night and I lose a lot of sleep.  Sometimes I then have several bowel movements before and after breakfast.  My doctor thinks it is IBS. I no longer take antibiotics - sometimes it came right back when I finished them.  I don't have fever.  Belladonna helped just a little.  Bentyl helps some - I'm taking it 3 times a day.
  I had barium imaging 12 years ago and again 3 years ago.  My last sigmoidoscopy was 3 years ago.  My mother had successful surgery for colon cancer at age 46. I had bladder repair in 1990 involving placement of nylon threads.
  I have good health insurance and am willing to pay for whatever might help.  Why does the pain come only at night?
Dear Barbara,
Irritable bowel syndrome and diverticular disease (diverticulosis and diverticulitis) can coexist. The episode that you describe from 12 years ago sounds like an attack of diverticulitis. Diverticulitis usually presents with fever, left lower abdominal pain and elevated white blood cell count. A CT scan of the abdomen and pelvis can rule out an abscess or fistula (abnormal connection)and may be helpful in defining the nature of your abdominal pain. If you have recurrent, documented attacks of diverticulitis or a stricture (narrowing) surgery may be indicated. Since you have a family history of colon cancer, you should have a colonoscopy to rule out adenomatous colon polyps. The colonoscopy should not be performed during an acute attack of diverticulitis. The colonoscopy will also provide the best visualization of the lining of the large intestine and define narrowed or angulated areas. Previous abdominal surgery may cause adhesions (scar tissue) which can also cause chronic pain. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians’ Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: diverticulitis, irritable bowel syndrome, abdominal pain