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What causes pain in abdomen,belching and constipation?

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General Surgeon
Practicing since : 2002
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This is likely a question for a Gastroenterologist. Overview of Me 1) Caucasian male 2) Age 53, living in North XXXXXXX 3) Health prior to this point in time - excellent, rarely seeing a dictor 4) No known history of ailments, sickness in family. 5) No known allergies. My symptoms were/are: 1) Abdominal pain, 2) Burping (random) 3) Constipation, 4) And on occasion, floating stools. 5) In order to have bowel movements, I have resorted to daily enema's with warm tap water as otherwise they do not seem to move on their own. I can feel them inside me, but when I sit on the toilet, they do not come out. Background In February 2013, I started experiencing pain in my abdomen. The pain was bad enough that I ended going to Emergency 7 times with no conclusive results. I also visited my Family Doctor numerous times, and his thoughts I must have IBS. I was then referred to a Gastro Specialist, he thought it might be Diverticulitis. I am scheduled for a colonoscopy in January 2014. Subsequent to this, I was also referred to Urologist,and after doing some tests, said I had a small kidney stone in my left kidney. It was/is too small to operate, and he thought with some home care, I might be able to dissolve it on my own. Tests Done To Date 1) Sigmoidoscopy - negative 2) X-ray - negative, other than the kidney stone in my left kidney. 3) Upper Ultrasound - negative 4) Barium Enema - negative 5) Barium Swallow - negative 6) Diabetic Test - negative 7) CBC (Complete Blood Count) - negative 8_ Celiac Test - Negative 9) H.Pylori - positivem for whuch I was given a 10 day H.Pac Treatment by family doctor. 10) CT Scan with Dye(abdomen) - some possible ulcerative colitis Home Treatment Having said that, I also took the XXXXXXX of doing some home herbal treatment on my own. My feeling was that all of these symptoms that I am experiencing are out of character. The reason is that up till now, I have XXXXXXX in OUTSTANDING health. One of the possibilities I explored was a possible parasitic infection. So, I started taking wormword, and cloves, and black walnut pills. Soon after doing so, what looked like some kind of dead fluke worm came out of me in my bowel movement. So, I thought that this would explain the constipation - an intestinal obstruction. Not sure what kind it would have been as I flushed it as I was grossed out. My guess is that given my location, a parasitic infection like a fluke was never even thought off and as such, not looked at. As well, based on my reading, I am not even sure where I might have picked it up. The only tropical place I was at was a 5 start Mexican resort in July 2012. A second possible guess is that perhaps I picked it up outside when working in my garden by not properly cleaning my hands. I also thought that it is possible that the fluke worm may have caused some problems in my intestine where it had attached itself, whch may be leading to some ulcerative coilitis. I view this as a bit like when you give a person a "hickey". After you let go, there is a red mark on the skin. I would think that this would be the same thing that would hapen when a parasite is sucking on you inside - when it lets go, there will likely be some redness/soreness. Situation as of Now (January 1, 2014) 1) Continued problems with proper bowel movements(constipation). 2) Abdominal pain. The pain is located primarily in left hypochondraic region, although it has also XXXXXXX felt in the epigastric region and on rare occasions, right hypochondriac region 3) On occasion - floating stools. Currently, I am taking a number of herbal medications as follows: a) Digestive Enzymes - 1500 mg daily b) Marshmellow Pills - 900 mg daily c) Garlic Pills - 3000 mg daily d) Goldenseal Pills - 800 mg daily e) B-12 Pills - 1000 mg daily f) Cinnamon Pills - 1000 mg daily g) Slippery Elm Pills - 720 to 1000 mg daily h) Renew Life CleanseMore - 2 pills daily i) Milk Thistle Pills - 2000 mg daily j) Renew Life FloraSmart - 2 pills daily k) Garlic Pills - 2000 mg daily l) XXXXXXX Cider Vinegar Pills - 1000 mg daily , and in some cases, XXXXXXX cider vinegar/lemon juice drink once a day m) Metamucil Powder Drink - Once a day Other Information a) Blood Pressure (as of December 31, 2013) - 101/67 b) Pulse (as of December 31, 2013) - 87 c) Temperature (as of December 31, 2013) - 95.8 F d) Enemas- are being administered out of a small enema bottle (130 ml), and I am doing this 3 to 4 at each sitting 1-2 times per day to clean the colon as much as I can. I also have on occasion been including a cap full of XXXXXXX cider vinegar, and a 1/4 of an eyedropper of wormwood. e) Some pain in the buttocks. My guess is that this "may be" hemmoroids. Given the obstruction, it is possible that my body was strined and hemmorroid were created, and have not yet healed, adding to the problem. Again, it os only a guess. f) Bowl movements (when they come out of the colon) vary. Using the Bristol Stool Chart - they typically range from Type 1 to Type 6. Having said that, I have detected that on occasion, things that look like bits of tomato or tomato skins are in the stools, even though I have not ate any tomatoes. Looking on the internet, this seems to indicate that these may still be pieces of dead parasites but, do not know for sure. g) Bowel color - seem normal, No blood is visible. Having said that, on occasion, they do come out with a white mucas on thm, but, again, my reading is that this is due to the stools spending too much time in the colon. As mentioned it happens only some time. Aalso, sometimes, my stools come out in what appears to be green water. Again, looking at the opposite extreme, my readinng tells me that this is due to my stools not spending enough time in my colon to be able to turn brown due to my use of the enema's. h) Bowel Smell - no real difference in smell detected (i.e. no foul smell detected) i) Knees - not sure if it is relted, but, they seem dry. j) Baths - I have also XXXXXXX trying to take EPSON SALT baths to help though no noticable difference is noted. k) At this point, nit sure if I still havde parasites in me or not, but, as noted, based on the look of tomatoe looking things in my stools, my guess is yes. So, I mam hoping that the coninued use of Cinnamon, Garlic, Cloves and Black Walnet Oil will look after this. l) Some upperr back pain (sometimes). This may or not be related to poor posture. m) Some underarmpit discomfort on occasion (sometimes). n) Some buttocks pain (sometimes). o) Bowel Sounds - on occasion will mak an almost "gurgling noise" like water running. p) On occasion - my stools also look like they contain white chic pea looking things. Concluding Questions 1) WHAT if anything else should I be doing? 2) Should I be concerned about anything? My Own Thoughts: 1) Possible continued parasite infection. 2) Celiac Sensitivity (not very likely) 3) Lactose Intolerance (not very likely). 4) Pancreatis - when coupled with the kidney stone, it might give some credibility to the ulcerative colitis. 5) Ulcerative Colitis 6) Gastroenteritis 7) Gastritis Can you HELP ME? I am very frustrated.
Posted Tue, 21 Jan 2014 in Abdominal Pain
Answered by Dr. Deepak Kishore Kaltari 4 hours later
Brief Answer: Colonoscopy and Gastroscopy required Detailed Answer: Namasthe Welcome to Healthcare-Magic Greetings of the day Dear XXXX Thank you very much for the very detailed and elaborative history provided by you. It really helps us. Lets analyse your complaints 1. Pain in abdomen and belching ( especially upper abdominal left hypochondriac, epigastric and right Hypochondriac): This is likely to be due to associated Upper Gastrointestinal cause, in majority of cases its functional cause )---- This will require assessment by Upper Gastro-intestinal Endoscopy. 2. Constipation: In the absence of organic cause(it can be ruled out by Colonosopy) its likely to be diet and lifestyle related. Flukeworm is not known to cause Ulcerative colitis. Also you have already de-wormed yourself, if you have not then taking a single dose of Albendazole will suffice. The character of stool is unlikely to be due to worm infestation. I would advise you the following workup and investigation for further management 1. Colonoscopy: This will rule out presence of colonic and terminal illeum pathology 2. Upper Gastro-intestinal Endoscopy: This will rule out presence of contributing stomach pathology 3. Stool examination: Routine and microscopic examination for oval and cyst. Also quantitative assessment of fat in stools to rule out Steatorrhoea. If the above investigation are normal and in the light of other investigation being normal then it can be labelled to be due to Irritable Bowel syndrome. IBS is diagnosis of exclusion, and its a dictum to label the condition as IBS only after thoroughly investigation and ruling out organic cause. I do understand the mental trauma and anxiety you may be undergoing because of your symptoms. I would suggest you the following which will definitely help in your case 1. Stop all herbal medication: They may worsen the symptoms and they are just blind treatment without rationale . They may induce gastritis . 2. Drink plenty of water: Ensure a water intake of 2-3 liter a day. This will go a long way in helping you solve the issue of constipation 3. High Fiber Diet: Two serving of vegetable salad a day along with 2 serving of whole fruit , one of which is a citrus fruit will provide you with the fiber requirement. 4. Avoid constipation causing diet: Refined sugr, Refined wheat flour, Braed, biscuits, cookies 5. Rule out local anal lesion: Presence of fissure in ano or complicated hemorrhoid may contribute to the constipation 6. Abstain from consumption of following: Caffeine, carbonated drinks, alcohol, nicotine. these will worsen the symptoms. 7. Judicious use of enema: Use a combination of Glycerine and Normal saline. its more safe and less likely to cause enema induced hyponatremia. Use enema only on alternate days. Spend a good amount of time in rest room referable 30-45minutes which should promote bowel movements and help in complete evacuation. After thorough investigation and ruling out presence of significant cause, religiously following the above advise will go a long way in helping you get relief. I hope it helped. In case you need any further assistance, will be glad to assist you. Wishing you and your family a very "Happy New year 2014" Take Care Best Regards Dr Deepak Kishore MBBS,MS,MCH Consultant Surgeon
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