occassional pain with constipation

[sandi__0__0]

  For four months now I have been getting abdominal pain. It usually comes on at night and is so painful I can not even sleep no matter how tired I am due to the cramps. They seem to flow like waves on a beach. Some are more severe in their degree of pain. It seems to be in my intestines. When they come [about once a week, sometimes twice] it feels like if I just had a bowel movement I would be ok, but, I can't go. I feel the urge, but nothing happens. Sometimes I feel feverish with the cramps and break a little sweat.  I had a complete hysterectomy almost three years ago, I had cysts , endometriosis, etc.. prior to hyst.. I have been taking  premarin [with success] for hormone replacement therapy for almost one year now without side effects. I eat a well balanced diet, drink 8 eight oz glasses of water a day. I have an occassional cocktail and drink ice tea once or twice most days ( I have for about 20 years)  I will be 41 in October. I exersize regularly. I do not notice a reaction to any food in particular. The cramps come on quite suddenly for no apparent reason. My stress factors are normal and have not changed recently. This all happens sometimes within an hour of eating or sometimes hours later and lasts for up to eight hours. When I have a bowel movement I feel some relief. But my stomach remains tender and takes hours after an episode to completely calm down.Yet, I will still be hungry.  On a couple of occassions I noticed bright red mixed with dark blood in my stools [at their end]. Even when they are not hard.  thank you for the help. I will go to my doctor. I first wanted an idea of the possibilities so I don't get unnessecary tests.
Dear Sandi,
The abdominal pain that you are describing may be associated with diverticular disease (diverticulosis or diverticulitis), fecal impaction,  irritable bowel syndrome-constipation predominant with colonic spasm, straining and possible bleeding from hemorrhoids or a fissure, or partial intestinal obstruction secondary to adhesions (scar tissue secondary to surgery). On the other hand, some of the features that you describe are not consistent with a diagnosis of irritable bowel syndrome (for example rectal bleeding and pain that awakens one from sleep). It would be important for you to be more thoroughly evaluated (with either endoscopy or x-rays) before further conclusions can be reached. I would recommend that you see a gastroenterologist.
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.
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*Keywords: abdominal pain, constipation, differential diagnosis

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