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Uncertain Cause Of Right Abdominal Pain?

  Please Help.
  I am a 39 year old white male that has had a past history of
  IBS, but it was on my left side and I only experienced it when
  3 things happened at the same time in my life.  They were my
  mother passing away, a divorce and loosing a job as a policeman
  due to an injury of my hand.  This initial encounter with IBS
  was when I was 25 years old and cleared up within about 3 years.
  During this initial episode of IBS I never had all the other
  associated pains.   I also had viral hepatitus (sp?) when I was 15
  years old.  My mother & father both had histories of
  gastro problems and my father died 3 years ago due to colon,
  liver and pancreatic cancer at the age of 75.
  I have been to a few doctors over the past 4 years for pain in my
  lower right abdomen, lower right ribs, lower right back, lower
  right buttocks & hip and lower right pelvic area.  During this period
  of time I have had a marked increase in "air" passing through my
  colon as well as passing gas and reverting between normal bowel
  movements to diarreah.  The end of my rectum sometimes feels sore
  up inside even when I'm not having diarreah. Sometimes, very
  rarely, I feel a little sick or maybe a bit of nausea.  I never
  have thrown up.
  The most painful areas are when my lower right-side ribs become sore
  and when my lower right abdomen becomes very sore.  When sleeping,
  I try to avoid laying on my right side as this causes the ribs to
  become more sore.  The whole process of the different pain seems
  to be siclical.  
  It seems as though I may be relatively fine for about a week or
  so & then my right bone in my buttocks starts getting sore.  I then
  know I am starting to get the PAINS again!  After the buttocks,
  then I start getting a real sore right hip & then a sore lower
  right abdomen. It is sore to the least amount of pressure.  
  It is about 2 inches above my hernia scar.  I had a childhood
  testicular repair when I was about 13 years old.  Then my back
  starts hurting on the lower right side, then my lower right ribs
  get REALLY SORE!!!  The last thing is that I start getting alot
  of gas on the right side colon & then I get diarreah.  The
  diarrheah is then just a "dumping" form.
  It seems as though the lower right abdomen, the buttocks, the
  diarrhea and the back ache go away before the ribs quit hurting.
  Sometimes the ribs never actually get better before it all
  starts again.
  I have had 2 colonoscopies over the past 3 years.  I have
  had a bone scan of my right hip.  I have had 1 CT scan of my
  abdomen.  I have had a couple x-rays of my back.  Numerous
  blood tests, including CBC & liver profile as well as about 6
  urine tests. I also had a lower GI x-ray.  All the tests have not
  shown any abnormalities.  The only exception was that my
  first colonoscopy revealed 2 very small polops that were
  removed.  It also showed that I have quite a few very small
  diverticulie.  My doctor seems to think I have IBS that causes
  all of this.  He has never actually been very reassuring with
  his thoughts however.  The doctor I am seeing has also recently
  been having me consult with a surgeon that has palpitated my
  abdomen & he has had thoughts that I may have a hernia or a
  appendix(sp?)that may be the culprit.  However he is not really
  sure & suggested the best thing may be to perform a laproscopy
  of the lower right abdomen.
  All this has me really wondering if there are any further tests
  that could be performed such as a ultrasound or further specific
  blood tests or the genetic marker test for the Chrohn's/Arthritis
  combination.  The reason I mention the later is because of the
  involvement of the bones and documentation of the VERY common
  right hip, right buttocks, right rib pain???  My doctor says
  "no way" that I have this because I don't have Chrohn's.
  Please let me know if you have any suggestions as to what my
  doctor can do? or if I could be directed to a doctor in your
  facility that may have far more experience?  My doctor is a
  family practice doctor.
  Thank You Very Much,
  This pain is very hard to live with when
  I have to go to work everyday & take care
  of my home.
  David / Eugene, Oregon
Dear David,
Your symptoms are very suggestive for irritable bowel disease. Your clinical sympotm complex is not strongly suggestive for Crohn's disease and there are no genetic markers to establish whether you have Crohn's disease.  If you have not had a dedicated small intestine barium study, you should ask your physican to consider ordering one.  This test, if normal, would go a long way towards excluding Crohn's disease.
This information is presented for educational purposes only.  always ask your personal physician specific questions.
*keywords: irritable bowel syndrome

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