CT w/contrast vs. colonoscopy

[goolarra]

My husband has had recurrent pain in the left side of his back, just above the waist, and across the front, just below the waist.  This is an aching pain which sometimes has a slight burning component.  It's been going on for six months to a year, is not constant, but comes and goes.

Our PCP ordered blood work and a liver U/S, which came up with nothing that would cause the pain.  He was then referred to a G/E who did more blood work, urinalysis and ordered a CT w/contrast of the abdomen and pelvis.  We have and have read the CT report, which has no findings that explain the pain.  The G/E is now referring us back to our PCP.

The CT report, under bowel/mesentery, says "The small bowel is normal.  The appendix is normal.  No bowel obstruction.  No mural wall thickening of the bowel.  There are no mesenteric infiltrative changes."

Question #1 - After this CT, is a colonoscopy redundant, i.e. is the CT a more sensitive test than the colonoscopy or might a colonoscopy show problems that the CT would not?

Question #2 - Given the location of the pain, would a colonoscopy even explore the area of his pain?

Question #3 - Does this pain pattern suggest a diagnosis to anyone?

Question #4 - Does anyone have any idea where to go from here?

I'm not sure I'm posting this in the right community since his G/E workup found no answers and he has been discharged by the G/E.  If you think it would be better posted in another community, please feel free to make suggestions.

Thanks.

[patient915]

Sounds good, good luck to you and your husband.

[goolarra]

Thank you so much...you've been very helpful.  Since we are both self-employed and have very high-deductible health insurance, the stool sample is an excellent suggestion for us.  I'm sure it will be a hugely less expensive alternative to colonoscopy (or something to explore first, I should say).

Thanks again...I really appreciate your suggestions.

[patient915]

Haha, sorry about not letting you win.  Most people with intestinal issues won't have pain in their back but the front part is partly where your intestines are.  Your large intestine runs from your rectum up along the left side, across and then down the right side.  It seems unlikely that it would be a problem with his intestines because the pain pattern doesn't really fit and because he isn't having any bowel changes.  A stool sample looks for blood in the stool (sometimes you can't see this), parasites, some bacterial diseases, some viruses, and some malabsorptions.  The only thing I can think of is that you both got some parasite/bacteria/virus and the only symptom you are showing is loose stools.  It could be diverticulitis but again, this doesn't sound quite right.  Sorry I couldn't be more helpful.

[goolarra]

Thanks...I'm a frequent contributor in the thyroid community, but a complete newbie here.

1.  Thanks for settling our argument...next time make sure my husband doesn't win!  LOL

2.  I guess I'm just wondering if the scope (no pun intended) of a colonoscopy goes into the areas where his pain is located.  I'm thinking that the colon runs across the front, but does not go into the back above the waist???  I should mention that the front pain extends left to right across a wide area.

3.  No bowel changes, no other G/E symptoms, i.e. constipation, diarrhea, nausea, vomiting, etc.  No blood in urine.

4.  No diet changes, either,  However, we do eat a very fiber-intense diet with lots of fruits and veggies, and although we are omnivores, we tend to load up on plants as per current nutrituional recommendations.  As a result, both of us have loose stools fairly frequently, but since it's both of us, I figure it's diet-related.  What would you look for in a stool sample?

What about diverticulitis?  I only mention this because his father has it.