ct findings -left flank pain

[gkids1424]

Hello, I am 55 and have had diverticoltis about 3 time and admiited to hospital 1. I have been having abdominal and left flank pain for 4 weeks. The Dr ordered CT and the findings was: There is diffuse mucosal thickening of the colon from the cecum distally, worse from the splenic flexure distally. There is a few scattered diverticula of the sigmond. What would your concern be and the next step?
Thank you for your input!

[W5w5w5]

Blood in kidney. Lemons juice helps slot

[gkids1424]

Thank you so much for your input!! I was told about 2 yrs ago I have a hital hernia, don't know if that means anything. I really thought it was a kidney stone but everything showed no. I did have a 1+ on blood in my urine test and the only thing the CT said was urinary bladder not well distended???    My bowel habits have changed from diarrhea to the other. I always could just eat something and have to run. (IBS) But not now!!
I will try the antispasmotics and probiotics.
Thanks ,just trying to get to the bottom of this before I lose my health ins. in 5 months.
I REALLY APPRECIATE THE INFO!!

[Christopher R Watters, MD]

He is right. Sometimes CT scans show thickening when the lining is completely normal on colonoscopy. In this situation the colonoscopy would be the believeable study. If inflammation is seen around the colon on CT and the colonoscopy is normal it would generally be the CT that would be the most reliable. With this said, you are still looking for a diagnosis. It sounds like the diagnosis of diverticulitismin the past is rather soft. Im am assuming that you are no longer on antibiotics. There are still several posibilities. If the colon is the source it may be more of a functional issue such as IBS or bacterial overgrowth that the antibiotics actually worsened. I think they have ruled out urinary causes such as a kidney stone but a urine culture would possibly be in order. Has anyone examined you standing up to be sure you don't have an inguinal hernia? The pain from these frequently is referred to the flank. I have also seen shingles present with flank and abdominal pain. It may be worth a run of antispasmotics and probiotics to see if they would help.

[gkids1424]

Dear Dr Watters, I would appreciate any input ! I had the colonscopy and he said the colon looked good, just had diverticulosis. he didn't do a bisopy. He said the Ct scan could have been wrong?? The problem is am still having the pain in left flank and lower left quadrant. Somedays worse than others but always feel it. If you go back and see what the Ct scan said is where it hurts. I am so confused and tried of hurting almost 7 weeks. What should I do next? any input would be appreciated!!!
surgeries: total hysterctomy b/c endometrois
               both thyorids removed
               gallbladder removed

I understand if you can't answer back.
Thank you!!!!

[gkids1424]

hello Dr, I went to the Dr and he has schedule colonscopy. He believes it is some type of colitis but was confused why no diarrhea or blood. All the stool testing was negative. I want to think for your info and telling me to get to a Dr sooner than later! I would have put this off ! THANK YOU

[Christopher R Watters, MD]

If two weeks of treatment haven't resolved the symptoms you need to be furter evaluated. This should be sooner rather than later. Typically, uncomplicated diverticulitis is symptomatically better within 7-10 days on treatment. Failure to improve makes one question the accuracy of the diagnosis or whether there could be a complication such as an abscess. In your situation, diffuse mucosal thickening  without stranding in the fat round the colon is not very supportive of a diagnosis of diverticulitis. Some form of colitis would be more likely.

[gkids1424]

Sorry to bother you again, I'm getting concern since I have been constipated but when I do go its very little and thin and still hurting. I have been trying to work and I notice the more I'm up on my feet,  I hurt worse. The diverticula seems better but , my stomach is so swollen and tender and still huting in the left flank area.. I guess this is from the thickening of the colon area. My question is should I try to get in a Dr sooner or just wait it out??
Any ifno  would be appreciate!!
Oh I have been on Cipro 500mg  2x a day and Flagly 500mg 3x a day for almost 2 weeks.
Thank You

[Christopher R Watters, MD]

Although you can never be sure until the colonoscopy, your story is not very worrisome for possible malignancy. The CT would argue more for a diffuse inflammatory process.

[gkids1424]

The first time was from CT Scan and I was put in the hospital for a week. This Ct Scan did say "There are a  few scattedred diverticula of the sigmoid colon. There is minimal adjacent fat stranding and no evidence of an abscess. I have been having the pain for about 6weeks but i thought it was from diverticulitis but, my left flank area and my stomach was hurting to much. I'm so glad I went to the Dr.  My Dr is sending me to a gastro Dr next week. I do have  a gastro  Dr but couldn't see me for 3weeks and she wanted me be seen soon as possible. Is there any reason I should be concern of colon cancer? I had a cousin with colon cancer.  I really appreciate your info.

Thank You

[Christopher R Watters, MD]

The first question is how they diagnosed diverticulitis previously. Was this from a CT scan or just based on left lower quadrant abdominal pain? Your CT is more consistent with diffuse inflammation rather than diverticulitis. In diverticulitis the infection / inflammation arises from a single diverticulum and produces severe inflammatory changes outside the wall of the colon. Your CT would indicate the possibility of inflammation of the lining. This could be infectious  from either bacterial, viral, or even protozoan infections or autoimmune such as ulcerative colitis. A colonoscopy would be in order to further delineate the source of your problem.