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Experiencing Lower Abdominal Pain And Altered Consistency Of Stool. Suggest Some Proper Medication

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Posted on Tue, 27 Nov 2012
Question: hello doctor,
i am 19 year old,weighing 45kgs.
Symptoms-
intermittent cramps and pain in the sigmoido rectal region(just above my illiac crest),{localised pain}
pain is more durig defecation,
mild acidity ocassionaly,
no bloody/mucoid stools
no nausea/vomiting,
stools of semisolid/semiformed consistency and foul smelling.
symptoms are occuring since last 1 month.
h/o IBS since 5 years.
h/o endoscopy done 3 years ago- revealed an esophageal ulcer[histologically-non specific inflammation]
colonoscopy done 2 yrs ago-- acute angulation at sigmoid-descending junction,erythematous mucosa from rectum{biopsied-rectal ulcer(possiblity of SRUS)}

routine stool test done a week ago and stool culture was normal.

i thought it must be amoebiasis,
so have already taken a dose of secnidazole 2g (secnil forte).
and also taken antihelmentics[mebendazole 100mg for 3 day]
symptoms are not getting cured. please HELP
doctor
Answered by Dr. Charles S Narasi (55 minutes later)
Hello, XXXXXXX,
You are 19 years young and experiencing lower
abdominal pain and altered consistency of your stool.You
mentioned about an ulcer in the esophagus and also an
ulcer in the recto-sigmoid area.You mention acute
angulation also.Hard retained stool can cause ulcer.
You have been treated for Amoebiasis with two different
drugs.
My concern is to rule out Inflammatory Bowel Disease
Especially Crohn's disease.This can affect any portion
of the GI tract from the mouth down to the anus.
There are good screening blood tests to rule this out.
I would also recommend x-ray studies of the small
intestine and perhaps a "Capsule Endoscopy" to look
for abnormalities.You should also get screening blood
tests for "Celiac Disease".
You can discuss these with your doctor.
Wish you the very best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (25 minutes later)
dear sir,
thank u so much for your reply,
sir i forgot to mention a few things

1)that i am an medical student currently,
2)i have already been screened for celiac disease via a blood test which has been come out to be negative....and neither have i experienced gluten intolerance anytime.
3)i have lactose intolerance
4)there is occasional bloating and flatulence (i think thats because of ibs only)
5)i do routine stool test every fortnight and rarely i get occult blood.

by x-rays u mean i should get an barium meal follow through and an barium enema done..??

any other alternative to capsule endoscopy ...??
since i dont think capsule endoscopy is yet practised in INDIA (Mumbai) where i live
doctor
Answered by Dr. Charles S Narasi (1 hour later)
Hello, XXXXXXX,
I want to welcome you to the medical field !
It is a great profession and it rquires lot of
dedication and committment on your part.
I am glad your celiac tests were negative.
If you are lactose intolerant, make sure you
every label on food and drinks to look for
lactose. If you can get "Lactaid XXXXXXX tablets, you
can take that daily also.
When I mentioned X-rays, Barium or gastrograffin
is used to x-ray the small intestine. Barium enema
can show the terminal ileum better.
If you do some research on line, I am sure you can
find out a gastroenterology group in Mumbai may
be already using the capsule technology.
I wish you the very best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (18 hours later)
thank you sir,

sir do u think i may be suffering from diverticulosis...??

sir is there any other condition you can think of except "crohns"...??

[since i don't have any family history of crohns nor do i have had any episodes of diarrhea or intense bleeding]


please assist me with this, since i have very little time for doing the x-rays and the endoscopy in this month.(have to study for my exams)[pharmacology,pathology,microbiology]
doctor
Answered by Dr. Charles S Narasi (4 hours later)
Hello, XXXXXXX,
You are too young to have Diverticulosis. It is very very
uncommon at your age.
Crohn's disease , if it involves the ileo-cecal area does not
cause bleeding. If it involves the colon, then you can see
bleeding.
Probably, your symptoms are worse because of stress
due to your studies .
I wish you well.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Charles S Narasi

Gastroenterologist

Practicing since :1962

Answered : 693 Questions

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Experiencing Lower Abdominal Pain And Altered Consistency Of Stool. Suggest Some Proper Medication

Hello, XXXXXXX,
You are 19 years young and experiencing lower
abdominal pain and altered consistency of your stool.You
mentioned about an ulcer in the esophagus and also an
ulcer in the recto-sigmoid area.You mention acute
angulation also.Hard retained stool can cause ulcer.
You have been treated for Amoebiasis with two different
drugs.
My concern is to rule out Inflammatory Bowel Disease
Especially Crohn's disease.This can affect any portion
of the GI tract from the mouth down to the anus.
There are good screening blood tests to rule this out.
I would also recommend x-ray studies of the small
intestine and perhaps a "Capsule Endoscopy" to look
for abnormalities.You should also get screening blood
tests for "Celiac Disease".
You can discuss these with your doctor.
Wish you the very best.