expert opinion is needed

[6man6]

I am a 34 years-old  male. The history of my symptoms are as follows.

1-) When I was a university student from time to time i had bowel rumbling. This
was not so often (2-3 times a  week) but continued like that till now.

2-) At October 2012, one day i wake up with a sharp pain in the right quadrant and and went to a gastroenterologist. They did an ultrasound and blood test and from these results they told  I have liver inflammation.
My alt and ast enzyme levels were 2-3 times higher than the normal range.

3-) I followed a diet and  lost weight. Then, I did blood tests every 2-month and at the end of 4 months (February 2013), my  liver enzymes became normal but the pain continued!

4-) In addition to the previous pain in the right hand side, starting from February  2013,
i had mucous in the stool, had to go to toilet many times, get bloated and a lot of gas.
I went to my  gastroenterologist again and I did a ct scan for the right hand side. Everything was normal (liver, pancreas, gallbladder, appendix). Doctor told me that liver inflammation is not a problem anymore. I asked her why then I still have the pain in the right side and she said she did not know.

5-) I then ordered a lactose intolerance test and gluten test and they were negative.

6-) Next, I did an occult blood test and that was negative also.

7-) Around the end of April 2013, my pain in the right quadrant stopped and my bowel behavior became normal. Except, I had gas.

8-) I was very normal  for 6 weeks, except gas. Then, later, I had an external hemorrhoid which disappeared  6 weeks later.

9-) On June 2013, I went to another gastroenterologist  for the gas problem. He did an upper endoscopy and blood test. Blood test was normal but from upper endoscopy he said i have h.pylori infection but told that this is possibly not related to my symptoms. I used biaxin and other antibiotics for 2 weeks for h.pylori infection. After two weeks, I started to have again gas, burning in my anus and accompanying blood in the stool 2-3 times. The blood was not mixed with stool but was covering the outer surface. I thought that burning in the anus and the blood was due to biaxin and then stopped it. After 2 weeks, no burning and no blood.

10-) Starting from July 2013-till August 2013, I had again pain in the right and sometimes in the left quadrant. But mainly, in the right. It was irregular and sometimes at the minimum level. It was shifting sometimes from right to left and when it was on the right, I was feeling on a larger part of right quadrant. At the same time, again abnormal bowel behavior and a lot of gas, bowel rumbling, noise etc.

11-) It is last 2 weeks that this right hand quadrant  pain is very reduced but now mainly I have rectal spasms, anal itching, moisture around rectal region and
again a lot of gas, going to toilet many times.

12-) all the test i did are: multiple blood tests, ultrasound, ct scan, occult blood test, lactose and gluten intolerance tests, upper endoscopy. The doctors did not  consider colonoscopy  necessary and hence i did not do this test.

So far no vomiting, no fever, no appetite and  no weight loose.

What are the possible causes of my problems when you look at the history of my symptoms and the tests done.
I will be happy for comments.

[Dr. Kokil Mathur]

I am sorry you feel this was a copy pasted answer, but all these are all guidelines that I have been writing for years on medical forums as a confirmed diagnosis is not possible on net. So a more broad-spectrum answer is given listing all possibilities.You have provided a detailed history, but sometimes even this is not enough to diagnose something on net that doctors who are examining you are baffled with. Even despite investigations people are later found to suffer from conditions they have been previously investigated for.

Your symptoms do sound like an inflammatory bowel condition: celiac or Crohn's or food intolerance to certain substances. All these things are pretty difficult to diagnose. Sometimes you need to do a detailed gluten test in blood and from urine to diagnose celiac. A simple gluten test comes negative. Same with Crohn's. Barium meal and follow through too can come negative and a video capsule endoscopy is often the only way to diagnose it.

Since you have gas, I have listed several causes of gas in abdomen, hoping that something will click. The same with right upper abdomen pain. If you go through this with your doctor and ask whether some other test an be done to look into things in detail for your liver, gall bladder, pancreas and gut, then maybe you will find a solution.

I sincerely hope you will find an answer to your problem and feel better soon. Take care!

[6man6]

this is just a copy-paste of classical sentences, which I doctor should not do!!!

[Dr. Kokil Mathur]

Hi!
You could be suffering from an inflammatory bowel condition such as Celiac Disease/Ulcerative Colitis/Irritable Bowel Syndrome/ Crohn’s disease. Other than that it could be due to H pylori infection. It can also be food intolerance. Diabetes can cause slowing of gut and can cause bloating and hence get your blood sugar tested. It can also be due to excess consumption of food rich in sulfites like juices, molasses, yellow dye in ready made food stuffs, and red wine. Sulfites are present in lesser amounts in mashed potatoes made from dry powder, pickles, tinned shrimp, cookies, crackers, and readymade pie dough. Constipation can also cause bloating. Very sedentary lifestyle is another cause. Cancers of the gut (intestines, stomach, colon, rectum) too could be a cause.
If you have pain under your right rib (upper right quadrant of abdomen) then there could be a liver infection, pancreatitis, or a gall bladder problem. Get a liver function test, ultrasound or CT of abdomen (recent), HIDA scan, and pancreatic enzymes. You may also need specialized imaging tests like ERCP etc. It can also be due to acidity and duodenal ulcer. Take a late night snack. Raise head end of bed. Take Omeprazole empty stomach in morning and an antacid gel at bedtime. Refrain from smoking, alcohol, fuzzy drinks and spicy food. Walking around also helps clear gas. Pain under right ribs with gas can be due to any inflammatory bowel disease like Celiac or Crohn’s, IBS or due to food intolerance. Pain under right rib case can also be due to pleurisy, asthma, or any other lung problems. Usually this is accompanied by lung related symptoms like breathlessness, cough etc.
Since I cannot examine you and know other related conditions you may be having, nor is a detailed history possible on net, I have listed the various possibilities that should be looked into. Please discuss with our doctor. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.