strange sensations

[davmid]

To whom it may concern, I think you guys are doing a great job and thank you for your knowledge and willingness to help people get some general ideas on certain problems. I am a 38 year old generally healthy male non-smoker and social drinker. My diet could be better, but better than some I think. My bowel habits are usually somewhat normal I guess, but over the last couple of years my regularity went out the window. Sometimes I would go once a day, and sometimes twice a week, but never any feeling of discomfort or feeling of constipation.Then the next week it seems like I would make up for it. I would have long, firm stools everyday that week and think, man where does this stuff sit on weeks that I dont go everyday. Anyway, to make a long question longer, For about three weeks now I started to get these weird sensations anywhere from my stomach to below the belt, to sometimes on my side. Almost like an electrical shock. Not painful but enough to let me know they were there. Then I had about a week of very little bowel activity. A little bit here, a little bit there, very smelly firm stools, sometimes a little watery and foul smelling gas.No visible blood or real cases of diarhea (diarrhea). Then the past couple of weeks I have been waking up with this crampy feeling in my lower back and sides at the hips and a hunger that I can barely satisfy. I have had a little anxiety lately since my daughter was born and have a second daughter on the way soon. I also was not drinking enough fluids for a while as I was partially dehydrated, and my fiber and whole grain intake could be better. Does it sound like a classic case of constipation, something else or am I having sympathy pains for my wife. Always a little nervous being a new father. Please let me know what you think.

sincerly,
Dave M.

[Kevin Pho, MD]

Hello - thanks for asking your question.

Congratulations on being a new father.  

There are many causes for altered bowel habits.  In general, any change in bowel habits warrants an endoscopy looking for cancer.  

Diseases associated with constipation include neurologic and metabolic disorders, obstructing lesions of the gastrointestinal tract, including colorectal cancer, and endocrine disorders such as diabetes mellitus. In addition, patients with irritable bowel syndrome often complain of periods of constipation, which may alternate with periods of diarrhea or normal bowel function.

Initial tests to consider would be an endoscopy (either flexible sigmoidoscopy or colonscopy), looking for obstructing lesions (i.e. cancer).  If that is negative, colonic transit studies can be considered to evaluate for colonic inertia.

Other tests to consider would be anorectal manometry testing the function of the anal sphincter, and various tests for the pelvic floor (defecography, measurements of the pelvic floor).  

If every test is negative, then a diagnosis of irritable bowel may be considered.  

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.

Thanks,
Kevin, M.D.

[davmid]

Thanks Kevin, I think I will take your advice. Although I am suprised of your answer considering there is no vomiting, diarhea (diarrhea), noticable blood in stool, etc. Given the fact that some recommend 25-30 grams of fiber a day to keep your bowels running smoothly, I am willing to bet that most people fall way shy of that given the fact that to eat that much fiber one would need to eat about 3 bowls of oatmeal, 3 apples, a couple of slices of stone ground whole wheat bread, and still fall way short. With the lure of processed foods, soft drinks, and things like this, wouldn't you suspect that most people have many periods of changes in bowel habits through their lifetime due to not enough fiber, lack of fluids, stress, etc.? Also what is the likely hood of getting bound up because of this. Do the bowels actually get backed up like a pipe and when you get back on the right dietary track, actually loosen all of this up and clean the pipes out? Is this possible? Also a brief explanation on what malabsorbtion is. Also would you recommend a visual colonoscopy? Are they almost as good?

Thanx again for your time.

sincerely,

David M.

[eveningstar]

A colonoscopy is by far the best way of visualizing the colon.  Polyps and other suspicious things can be removed during a colonoscopy.  A virtual colonoscopy cannot do that.  So if something is seen, then I guess you would then have to have a colonoscopy to remove it for biopsy.  
Vomiting and diarrhea and blood do not always present in colon problems.  Two years ago I decided I should have a colonoscopy because I was over 50.  I had absolutely no symptoms of anything wrong at all.  An early cancer was discovered and I had surgery two weeks later.  So I am a little radical on the subject of everyone getting this life saving test.  
Fiber One cereal by General Mills has 14 grams of fiber in 1/2 cup.(the taste isn't great)  I snack on this during the day, eating it dry with some almonds thrown in, which are also a good source of fiber.  A couple of pieces of the right kind of bread and a couple of bowls of  broccoli and or peas or whatever veg., and thats getting pretty close to the 20 or 25 grams we should eat.  Don't forget to drink lots of water.
Most likely you don't have anything serious, but be sure to get checked out soon.  It could very well save your life!!

[kevinmd]

Although the chances are low, colon cancer should always be on the back of your mind when there are changes in bowel habits.  Virtual colonoscopy has not been evaluated in extensive clinical trials.  There are some isolated reports, but the main disadvantage is that you cannot biospy if there are suspicious findings.

Thanks,
Kevin, M.D.

[davmid]

Thanx for your help guys. I had a visit with a gastro doctor today, and he said it seemed like everything was o.k. He didn't find anything obvious by a general exam, but since I had had a slight bleeding hemmoroid  quite a while ago, he had thought it a good idea to have a colonoscopy done. He said the same thing you did that given the symptoms, it doesn't seem anything to worry about, but good insurance.

Thanx again, keep up the good work,

Dave M.