In pain for YEARS!

[MissyV.]

Hello, I'm a 39 y.o. slightly overweight female who has suffered with G.I. problems for as long as I can remember.  During my younger years, belly aches, then BM/diarrhea, at times accompanied by vomiting.  At this age, here are the specifics: (diagnosed w/IBS - I don't believe it)I have one BM daily (no constipation), but at night, past number of yrs., 3-4x wk., I am wakened by sharp stabbing on & off cramps middle and lower, mostly towards left-side.  This is accompanied by gas (at times) but always with loud high pitched gurgling (distinctly on left side) bowel sounds, and then the sound of liquid rushing under pressure.  I end up having 2-3 BMs, with last ones being very soft (but not liquid), and a film on the water. No relation to foods I've eaten (that I can tell), or the time that I've eaten, stress, medications, etc.  No nausea or vomiting. Ninety percent of these "episodes" occur while sleeping and I awake from the pain (pressure fom laying down?), 5% late at night, 5% triggered by car rides (vibration?). After, pain is more "uncomfortable" and I can go to sleep.  Upon waking it's as if my body is "sensitized" and coffee or food will certainly bring on more episodes.  I typically stay till mid-day/late afternoon feeling this way.  The whole thing may repeat itself the next night; I have gone 3-4 consecutive night like this.  Recent colonoscopy was normal, no biopies.  The only thing outstanding on Upper GI was a "mild prominence of fold" in the duodenal bulb, and "intermittent narrowing post bulbar" having "slight irregular configuration to post bulbar duodenal mucosa but is changeable and able to distend normally".   No endoscopy yet (I've backed out).  CBC typically shows slight anemia, slightly high WBC.  Hx of endometriosis, ovarian cysts with surgery 2x 20 yrs. ago, reflux a few years back (resolved now), also chronic back pain/stiffness upon rising. My Rheumatologist tried numerous anti-inflammatory meds for my back problem; among them prednisone - that was the ONLY time I didn't experience ANY GI problems (or back pain)!  However, I am not on any medications now, nor have I been for over a year.  Between my bouts of pain at night, I've taken to researching various disorders - does Eosinophilic Gastroenteritis sound possible?  Any idea of what this could be (including IBS) would be so greatly appreciated.  I feel exhausted so much of the time, between the pain and lack of sleep.  Thank you.

[planetmars]

I have had similiar problems all my life as well...a little different in that I have constipation, and then diarreah sometimes.  I do get the extreme grugling on the left side and gas also.  I went to emergency once, because I had such a horrible pain in my left side I was doubled over.  I was diagnosed with IBS and left it at that,  I didn't want to get more testing done.  My doctor told me I needed more fiber, which I started taking Fibercon 4 years ago.  Two tablets a day every day.  i must say it helpes extremely.  I don't have the bouts of diarreah anymore, and my BM's are regular...once a day in the morning.  They are not alway's great, sometimes soft, sometimes not complete, and I do get gurgling or gas sometimes after eating something, ...but I know what bothers my stomach now, so if I am going to eat something, I will take a half immodium and it helps emmensley.  I would try the fiber thing and see if it works.

On the age note, I am 36 also slightly overwieght, and my mother is 56 and last year she had such horific diarrea...they ran every test in the book on her and finally diagnosed IBS.  She takes Citricel (another fiber) and she is normal again.  I know it is hard to chalk something so annoying up to IBS, but try the fiber and see.  I know I only like Fibercon, she swears by Citrucel, but everone is different

If it is IBS, expect to get flare-ups once in a while, but you learn to live with it by not eating certain foods, and stress is a significant role as well!

Good luck!!

[ozark]

this is a long shot, but since you've had this since childhood you could possibly have an intermittent malrotation of your small intestine....usually it can be seen on barium swallow but sometimes only when symptomatic......ask your gi md              good luck

[Kevin Pho, MD]

IBS is certainly possible - and should be considered if the tests remain non-revealing.  I would consider going through with the upper endoscopy.  This is a markedly more comprehensive test than the upper GI series and can evaluate for inflammation that was not previously seen.  

I would also consider further imaging with a CT scan or ultrasound, that can evaluate for liver, gallbladder or pancreas disorders.  The CT scan can evaluate for any bowel problems that may not have been seen with a colonoscopy.  If an H Pylori test hasn't been done, I would consider one - this is a bacteria associated with inflammation or ulcers.

I would suggest these options in conjunction with a GI consult.  

If IBS is the diagnosis, treatment can be considered via increasing the fiber in the diet as well as antispasmodic agents.  

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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[MissyV.]

Hi, the reason that I don't believe that the IBS diagnosis is correct is from everything that I've read on IBS (on the web).  Granted, it's probably too much info., and some of it may be incorrect, but from what I've gathered the majority of IBS Sx don't occur at night, the onset of a BM is usually an altered consistency (if that occurs with me, it's typically the last BM, but only occurs half of the time), and it's severity should decrease as one ages (mine are getting more frequent and intense).  As I mentioned, this may or may not be true, but it's what I've gathered from various sources.

[hollyd28]

Just a thought, but have you been tested for Crohn's or IBD.  With the elevated white cell count, slight anemia and the fact that you felt better when on the meds for your back, I would be inclined to get some more testing for something like that.

[MissyV.]

Hi, I'm not aware of any tests for Crohn's or IBD other than a colonoscopy - any info. I'd greatly appreciate.

[yoshi]

WHY DONT YOU BELIEVE IT??
(diagnosis of IBS??)

[yoshi]

I am not aware symptoms of IBS decrease with age??
Your stool is telling you something.