Frequent Diarrhea, Sharp Pains, No Warning Signs.........

[Mike1976]

I have had a problem that would come and go for many years. I have been to the doctor and E-Room serval times, all the treatment they give works for a short time, and comes back.  The problem was first thought to be GERD, with axcid as a 3-week treatment and change of diet.  It worked at first then no change.  After that I had turned 21 and began drinking with my friends on a regular schedule (2-3 nights a week), and during that time I can only recall one "attack" in about a year.  After that lifestyle grew old I began to have these stomach pains again.
   It feels like a sharp knife, or someone twisting my intestines.  It is only releived by a BM, occuring about 1-2 times a week regaurdless of what I eat.  Many thought it was a lactose problem, so even with no milk products it still did not change.  A few times it was so bad I had to leave work to go to the E-Room.  They had mixxed up a "cocktail" and it seemed to work very well.  Problem is that the E-Room MD thought it may be a ulcer, but my regular MD don't think so.
   Well now a few years later I had got married and my wife was very concerned with my "restroom habits", so we made anouther visit to the MD.  He beleives it is IBS (which is very rare for a mid-20's male), he prescribed one Prevacid and one Hyoscyamine in the AM and 2 FiberCons in the PM.  At first that worked well for about 2 months.  Now it is back, but when I have attacks, they are Violent and come with very little warning (I have a BM with in 2 minutes of the pain).  He suggested that I refrain from the medication and start again to form a trend, well it really don't matter any more if I take them or not.
   The only thing that seems to work is Imodium, as I have no choice when this can happen 1-3 times a week and have 3-6 BMs per attack.  It makes it very hard to go anywhere other than home or work!  I had it come and go since I was 10, but never as sudden and violent as now.  We have lived in 3 houses over that time and now I eat a diffent menu than before also.  
   I hope I desribed everything.   And am looking for some ideas on what it could be and how to treat it.  Thanks

[Kevin Pho, MD]

Hello - thanks for asking your question.

You note chronic diarrhea and stomach pains.  A diagnosis of IBS has been made.  Without seeing you it is difficult to say what it is for sure.

Here are some possibilities.  Before the diagnosis of IBS is made, you should make sure it isn't anything more serious.  Chronic diarrhea can be caused be irritable bowel, inflammatory bowel disease (i.e. Crohn's disease or ulcerative colitis),  malabsorption syndromes or chronic infections.

You should have your stool evaluated for ova/parasites, and have it cultured for bacteria.  Tests for malabsorption including a fecal fat test may be considered.  If this has been going on for years, then endoscopy should be performed (either a flex sig or colonoscopy) to evaluate whether there is inflammatory bowel or a mass that may be causing your symptoms.  

If those tests are negative, then irritable bowel may be the diagnosis.  

As for your stomach pain, causes includes dyspepsia (caused by an ulcer, GERD, or inflammation of the stomach or esophagus), gall bladder disease or pancreatitis.  You may want to obtain an upper GI series or upper endoscopy to comprehensively evaluate this.  If this is negative, an ultrasound to evaluate the gall bladder or blood tests to evaluate the pancreas 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.

[jjon53]

A related discussion, unexplained diarrhea was started.

[Pixie1969]

I'm sorry I can't respond to much of what you said, but the stretch mark thing really hit me.  Please do some research on Cushing's Disease, which is an endocrine problem involving the pituitary gland.  Stretch marks are a red flag for Cushing's.  I wish you and your daughter lots of luck, I myself know how frustrating unrelenting medical problems are.

Hope you find some answers soon!

[longbeach]

Since I am out of health insurance (was laid off last year)
and I too am going through the same nightmares that have
been posted above, what are the few things that have worked
outside of prescription drugs?  In fact, it seems that
prescribed drugs are not even the primary treatments to
these ailments.   Things like Pepto-Bismol, Imodium
and Axid have helped me but not to solve anything.  I am going
to watch my diet very much and throw out alcohol (since
even if 9 out of 10 times that drinking doesn't trigger anything, the one time it does, it is not worth it)

But that leave the question, what really triggers these
problems in our digestive system? Why can they lay dormant
and then attack? And then not be easily detected? Are
the problems usually in the intestines or the stomach?
I am starting to believe that it is in the intestines and
a blockage must happen that allow for terrible runny BM
but yet leaves us constipated and bloated.  So should we
use a laxative instead of something like Imodium if there
is a blockage?

I did go to the hospital, doctors, x-rays even without
insurance last fall since the pain was really bad.  After
about $1,000 in medical bills they just said I had acid reflux.

I think that reflux might be a symptom of my problems but not
the cause.  Something else must be lurking.

[stadybum]

Mike1976,

Wow your post is so much like what my 11 yr. old daughter is going through!  

For the past 2 years she has had severe abdominal pain, frequent diarrhea (sometimes 3/4 times per day & then alternates to constipation), chest pain, leg weakness, etc.  As with you these attacks come on all of a sudden without warning!  

We started with our family doctor on this and she had 2 ultrasounds that didn't indicate anything, his 1st recommendation was a change in diet (2 diets tried & nothing), he then recommended we se a GI specialist.  The appointment was scheduled for April 2003, but I managed to get in sooner with a childrens GI doc at childrens hospital in January.  Again they did normal workup and prescribed Protonix (which did absolutely nothing, except make it worse).  With these tests having been negative they asked for stool samples which came back negative as well.  We returned to the childrens hospital 1 month later for a endoscopy & colonoscopy - these also came back negative!  My daughter has missed school since Jan. 2003 & is now on home bound schooling.  Since the childrens hospital visit we have taken her back to our family doctor who then tried Zelnorm (again this made things worse).  The pain was so severe we took her to the ER and they did Xrays and blood work - again everything negative - except they noted she was constipated and gave her an enema and prescribed Percocet at a 1/2 to 1 tablet for pain as needed.  Thankfully for the percocet she can be relieved from pain, but this doesn't help the diarrhea or the underlying problem as it is only temporary.  

Now she is suffering from stretch marks (EXCESSIVE!) too and I'm wondering if this is all related somehow.  

If you get any answers to your problem please post them - maybe I can get my daughter the help she needs.  IBS seems to be the only explanation docs can give now and don't know what else to recommend doing since changes in diet don't really matter.

Thanks.