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CT Abdomen & Pelvis Scan Show Sigmoid Diverticulitis.Had Polyps Removed. Heavy Bloating, Discomfort In Lower Back. Why This Constant Flare Up ?

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Posted on Wed, 4 Jul 2012
Question: I have had a CT Abdomen & Pelvis Scan done recently & it picked up Sigmoid Diverticulitis - I have since visited a Gastro specialist & just had a colonoscopy & some polyps removed & a biopsy for further testing however he also suggested I may have IBS & thsi could be the major cause of my bloating. I have started a food diary - here I am 2 days fater the colonoscopy & already am seriously distended around my abdomen. My scan also referenced anteverted & slightly bulky uterus but no adnexal mass - suggested there may be a small folicle or cyst noted involving my right ovary. It also mentions minor aorto-iliac calcification but no lymphadenopathy. I am concerned that maybe the cyst could be Ovarian Cancer as my symptoms as almost exactly the Ovariam Cancer symptoms - however surely this would have been picked up on the CT Abdomen & Pelvic Scan? I am concerned that my symptoms continue ie heavy bloating & discomfort around lower back - I am late 40's & was taking some progesterone cream for a few years as my symptoms suggested I may be peremenopausal, now I am wondering whether since stopping the progesterone, is it possible this is why I am now getting serious bloating? I have also seen an Endochronolgist & he has tested all my hormones & they are fine - help I really need to sort out this bloating - do I just need to be patient & review my food diary & see whether there is something causing these constant flare ups?
doctor
Answered by Dr. Ketan Vagholkar (2 hours later)
Hi XXXXXXX
Thanks for writing in.
There are a few issues which need to be addressed here. We’ll take them one by one.
Diverticular disease could be the main cause of your bloating. This problem does give rise to a certain amont of inflammation which causes slowing of the bowel movement. This can give rise to a distended or bloated feeling. However, if your bowel movement is normal, there is nothing that you need to worry about.
The second cause of the bloating could be perimenopausal symptoms. In this case, you do not need any more workup.
Maintaining a food diary at this stage would be the most appropriate next step forward. Often people with IBS would benefit from a restriction of lactose and gluten.
The second issue is that of polyps. These polyps are notorious for cancerous changes. So you should be on the surveillance program which comprises of colonoscopy, occult blood in stools and CEA levels. If rest of the organs on CT scan are normal, then its fine.
It is unlikely that you do have an ovarian tumour as it would definitively have been picked up on a CT scan. Periodic sonography and CA 125 levels will help pick up any cancerous changes fairly early on. I would need you to see a physician for the bulky uterus. It is not something we'd be normally expecting at this age.
I hope my explanation clears all your doubts. I would be available for follow ups.
With regards

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Ketan Vagholkar (9 hours later)
Thank you
Re Bulky Uterus, would you suggest I get my GP to write a referral to a Gyno just to cover these things off? My Gastoenterologist has already suggested regular checkups on polyps too :-)
doctor
Answered by Dr. Ketan Vagholkar (7 hours later)
Dear XXXXXXX

Thanks again,

Yes, it would be good if you could ask your physician to write a referral to gynaecologist. If the bulky uterus causes symptoms or if the adnexa harbours suspicious lesions confirmed by Computed tomography scans and Cytology it would be advisable to go in for a total hysterectomy.

With respect to the polyp problem your specialist has rightly advised to be under constant checks.

Hope I have addressed all your concerns. Let me know if I have missed out on any concerns.
If you do not have any further follow ups, please close this discussion.

Wish you good health.

With Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ketan Vagholkar (27 hours later)
sorry but one more question - I referred to "adnexa" from my scan terminology however I am not familiar with what this is? Can you please advise?
Many Thanks
doctor
Answered by Dr. Ketan Vagholkar (1 hour later)
Dear Ms. XXXXXXX

Adnexa refer to the organs adjacent to the uterus on either side in the female pelvis. These include the fallopian tubes and ovaries along with their supporting tissues.

I hope this answers your doubt.

With regards
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
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Dr. Ketan Vagholkar

Gastroenterologist, Surgical

Practicing since :1989

Answered : 883 Questions

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CT Abdomen & Pelvis Scan Show Sigmoid Diverticulitis.Had Polyps Removed. Heavy Bloating, Discomfort In Lower Back. Why This Constant Flare Up ?

Hi XXXXXXX
Thanks for writing in.
There are a few issues which need to be addressed here. We’ll take them one by one.
Diverticular disease could be the main cause of your bloating. This problem does give rise to a certain amont of inflammation which causes slowing of the bowel movement. This can give rise to a distended or bloated feeling. However, if your bowel movement is normal, there is nothing that you need to worry about.
The second cause of the bloating could be perimenopausal symptoms. In this case, you do not need any more workup.
Maintaining a food diary at this stage would be the most appropriate next step forward. Often people with IBS would benefit from a restriction of lactose and gluten.
The second issue is that of polyps. These polyps are notorious for cancerous changes. So you should be on the surveillance program which comprises of colonoscopy, occult blood in stools and CEA levels. If rest of the organs on CT scan are normal, then its fine.
It is unlikely that you do have an ovarian tumour as it would definitively have been picked up on a CT scan. Periodic sonography and CA 125 levels will help pick up any cancerous changes fairly early on. I would need you to see a physician for the bulky uterus. It is not something we'd be normally expecting at this age.
I hope my explanation clears all your doubts. I would be available for follow ups.
With regards