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Abdominal pain with bloating. Had UTI. Is it IBS?

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Practicing since : 2003
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Hello, here's an interesting one for you. My doctor seems to think I have IBS, but I think I may have a hookworm infection. There are a few very key reasons. Obviously I have abdominal pain and bloating which can occur in both. It is very localized and can be anywhere but is usually in the upper left quandrant or almost directly beneath my belly button. These symptoms started six weeks after I returned from non-profit agricultural consulting in Guatemala, but they also started in the middle of a second antibiotic regimen to cure a CT scan and ultrasound which show nothing wrong. An endoscopy by a gastroenterologist revealed eosinophilic esophagitis which they told me was related to food allergies. Celiac disease was also ruled out. I only recently have felt symptoms of EE, but only every now and then. The last time I really noticed a reaction was a few minutes after a small coughing bout, which was weird because I don't have a chronic cough and I haven't coughed in the days since. I do not have raised levels of eosinophils in my blood. Other symptoms: pain and discomfort in both collar bone areas and a lump in my neck on the back right side, feelings like insects on the skin but on the inside of my body, pulsing feeling on the scalp from time to time, back pain, twitches that feel like muscle twitches but are much deeper and can happen anywhere in my torso, and constipation and abnormal bowl movements that can be dark brown one day and pale gray the next. Oh and my anxiety is ridiculous. The doctor keeps asking what is causing it other than my symptoms, but there is nothing. I just landed a six figure job, I'm recently in love, and I have a year (now a half year) left in my MBA program where I can relax much more than last year. My symptoms are causing my anxiety, not the other way around. I just had one stool sample turn up negative. Two more should have results in 4 days. Any insight? Thanks so much.
Posted Thu, 27 Dec 2012 in Abdominal Pain
Answered by Dr. Jonas Sundarakumar 3 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

IBS (abdominal pain or cramping / bloating and frequent bowel irregularities. The diagnostic criteria requires that the symptoms should be present for at least 12 weeks. So, if you haven't been having 'chronic' symptoms, it is less likely to be an IBS.

Your symptoms could be due to a hookworm infestation, but if so, this has to show up in your stool tests. So, you'll have to wait for the results of the pending stool test results.

Abdominal symptoms like loose stools, etc. can be associated with antibiotic use, but these symptoms are almost always transient and should subside within a few days of discontinuing antibiotic treatment.

You also seem to be having other associated symptoms like crawling, tingling sensations, twitching sensations, other pain symptoms, etc. You have also mentioned that you have been experiencing increased anxiety of late.

Now, it is important to understand that anxiety can manifest itself with not only psychological symptoms but with physical symptoms as well. Often, the person may not be able to directly co-relate the anxiety to his / her physical symptoms, and sometimes, there can be only physical manifestations also (i.e. without actually feeling anxious). Many of the symptoms which you have described like tingling / crawling / pulsating sensations and multiple pains and discomfort are common presentations of anxiety. Abdominal symptoms such as discomfort, bloating and bowel irregularities are also wll known physical manifestations of anxiety. Now, I am NOT implying that'everything is in your head' or something to that effect, but all I'm saying is that you should be open to this possibility as well, especially, if your stool tests also turn out negative.

I would also like to suggest the following simple measures which can possibly reduce your symptoms:

1) Try dietary adjustments such as increasing the fibre content in your diet, avoiding foods that 'stimulate' your gut like spicy foods, coffee, tea, carbonated drinks, etc. (Smoking can also be an irritant)

2) Trying a probiotic medication or supplement (probiotics contain healthy bacteria which help to "normalize" the gut ecosystem), often helps.

3) Try to avoid stress and try relaxation methods like XXXXXXX breathing, meditation, etc.

4) Try to have a healthy lifestyle with regular exercise and proper sleep habits.

Hope this has been informative and useful to you.

Dr. Jonas Sundarakumar
Consultant Psychiatrist
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