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Abdominal pain, diagnosed with IBS. Have fibromyalgia. Had surgery for scoliosis, tubal ligation and endometrial ablation. Is it all IBS?

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Gastroenterologist, Surgical
Practicing since : 1984
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Hi I am hoping you can advise me about my on-going abdominal pain. I am a 47 yr-old female, 4'11, 205 lbs - I have had major surgery for scoliosis 13 yrs ago and have recently been diagnosed with fibromyalgia. The muscle pains are starting to be controlled by increasing doses of Lyrica (I'm up to 150mg on the way to 300mg). I take omeprazole for reflux, Lipitor and COQ10 plus citrical and vitamins.

I have been having a lot of abdominal pain off and on for over 5 months and it has been worse for the last 2 months (I had to take a leave from work). I've been through lots of tests and told I have IBS, but I'm not sure that's all that is going on.

Last October, the week before I had a tubal ligation and endometrial ablation (for heavy periods), I suddenly had shooting pains through my groin area on both sides and sharp abdominal pains. When I woke up from the anaesthesia, the groin pains were gone. In the weeks following, I had a great deal of pain in my abdomen (more than was expected from surgery) and in my lower right side, was sent for a CT scan, ultrasound and lots of blood tests but nothing was found. The pain settled down somewhat and I just had twinges in my right side.

A couple of months ago, the abdominal pains were back, as well as the pain in my side, which was also now in my left side. A colonoscopy showed nothing but a muscle spasm was observed. I have had occasional diarrhea but not regularly. I am sometimes constipated. For the last two months I have been bloated as if I had swallowed a beach ball. The pain is sharp especially in the center of my abdomen and it really hurts when I cough, sneeze, laugh or have a bowel movement (no blood in stool) and I usually cannot bend over comfortably. I am not passing gas much. Sometimes it hurts more after I eat but not consistently. Sometimes I am nauseous but not consistently.

I had another CT scan with contrast last month. My appendix and gall bladder were fine. I have a small umbilical hernia (probably from the tubal ligation) and endometrial hyperplasia (which my gynecologist was not concerned about.) Tests for lupus, parasites and Celiac's were negative although I have a slight vitamin D deficiency. For the past month I have been on a protein shake diet with one meal a day of meat and vegetables as recommended by my gastroenterologist and have lost 10 lbs this month. I have no food allergies although I am slightly lactose intolerant. (the protein shakes don't upset my stomach).

Dicyclomine and amytriptoline have not helped. Gas X helps minimally and only for a short time. I have had a few days lately where the pain is less but many days where it still hurts a lot, especially in the morning when I first stand up. I can feel ok at first, but as soon as I stand up, I can watch my stomach inflate and then it hurts terribly. The only thing that brings relief is to lie down. I am afraid to get out of bed in the morning. The other day I had the sharp pains through my groin again and sharp abdominal pains. (Both times the groin pains happened I have had my period. The ablation did not take, apparently, because I still have had a period every month.)

So is it all IBS? What will bring relief? How long will this go on? Any advice would be appreciated!

Posted Tue, 22 May 2012 in Abdominal Pain
Answered by Dr. Ajit Naniksingh Kukreja 9 hours later

Thanks for posting your query

It is really appreciable that you have been tolerating these issues for a long time

From all the information that you have provided it seems you are definitely suffering from IBS, but that can be managed if you have positive approach

Yet before stamping it I would like to consider these two aspects :

1] The contents of the umbilical hernia ? If it is intestine there are chances the symptoms can be because of the loops getting held up there

2] Did you ever go for an Upper GI Endoscopy? A good number of your symptoms can be related to reflux and hiatus hernia ?

Had I been your doctor I will rule out the above two possibilities and then stamp it as IBS

Anyway to manage IBS here are few tips :

1] Manage your stress levels
2] Take lot of fiber in your diet
3] Drink plenty of fluids daily
4] Take a probiotic twice a day for 6-8 weeks
5] Take a seven to ten day treatment of Ofloxacin and Ornidazole twice a day , this will control your collitis , your symptoms of diarrhea and groin pains are suggestive of the same

Hope this helps
Am available for any followup queries
If there are no further doubts, do accept my reply and rate it

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Follow-up: Abdominal pain, diagnosed with IBS. Have fibromyalgia. Had surgery for scoliosis, tubal ligation and endometrial ablation. Is it all IBS? 13 hours later
Would a CT scan with contrast show whether some intestine had got into the umbilical hernia? That's what showed the hernia. My doctor dismissed it as the cause of my pain. If not, what test would show it?

I have not had an upper endoscopy. I don't think the doctor will offer me one since I have not been vomiting and the pain has been on my sides as well as in the center, but I can ask when I see him in a couple of days. Thanks
Answered by Dr. Ajit Naniksingh Kukreja 6 hours later

Thanks for posting your followup

As I have mentioned in my reply I would like to rule out hernia as a cause

An Ultrasound scan is the easiest way to do so

Again an upper GI scopy is also to confirm your abdominal symptoms

Hope this helps
Am available for any followup queries
If there are no further doubts, do accept my reply and rate it

Get Well Soon
Above answer was peer-reviewed by
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