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Dr. Andrew Rynne

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Can enlarged prostate cause abdominal pain while on medication for IBS?

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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1942 Questions

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Posted on Mon, 14 May 2018 in Digestion and Bowels
Question: I was just diagnosed with low or intermediate risk prostate cancer. I can't remember when sometime after my biopsy or diagnosis I started to get mild abdominal pain. It started down in very lower abdomen then moved upwards - I have had it for well over a month I am taking medication for IBS - maybe it helped a little. It migrates around though there are some spots that will have a bit sharper pain now and then. Right now it seems to be mostly lower abdomen and a lower right spot. Sometimes feels a bit gassy. Could it be from the enlarged prostate (ultra sound said moderatley enlarged prostate. Anyideas
doctor
Answered by Dr. Ramesh Kumar 43 minutes later
Brief Answer:
Dear patient needs few more details.

Detailed Answer:

Hello my dear patient,
Thanks for choosing HealthcareMagic for your query.
Have gone through your details and i appreciate your concerns.
Prostate cancer commonly metastasizes to the bones and lymph nodes only.Its spread to the gastrointestinal (GI) tract is rare. A revent case report reports revealed only three cases of prostate cancer metastatic to the stomach.
So initially i would be taking your case as a normal
presentation of prostate pathology and in such scenario i would not consider the pain in lower abdomen is due to prostrate pathology i need to rule out gastric involvement firstly.

Secondly association with gassy feeling again points out to involvement of intestines in your case.
Before proceeding i need few answers my dear patient-
1) How are your bowel habits.You are a IBS patient do you remain constipated ever?
2) Divide your lower abdomen in right middle and left zone.Now tell me in which zone you feel pain most and any sort of migration ever noticed?
3) Intensity of pain on a scale of 0 to 10?
4)Relieving factor or aggrevating factors?
5)Pain is dull aching or constant or is sharp and off and on in nature?
6)gassy feeling increases pain?
7)Medicine you are on for IBD? Doses? From how long?
8)Any history of enetritis or diverticulitis in back?
9)A stool microscopy or a urine microscopy was ever done?
10)CT or MRI abdomen ever done before?

Waiting for reply my dear patient.

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 52 minutes later
Thank you for your thorough reply
1) How are your bowel habits.You are a IBS patient do you remain constipated ever?
---Bowel habits pretty much the same - usually soft stool most mornings - perhaps sometimes a bit more constipated as of right now but then I never paid much attention to them earlier. I did not have IBS but doctor thought maybe I do when these symptoms started. Perhaps stress from learning about my cancer.
2) Divide your lower abdomen in right middle and left zone.Now tell me in which zone you feel pain most and any sort of migration ever noticed?
--Started low down from testicles to lower abdomen (just a recent epydymitis was) but then went to upper abdomen - has pretty well been everywhere - right now lower adbomen with one spot lower right a bit more sharp - at first had some spasm in lower right

3) Intensity of pain on a scale of 0 to 10?
--Only about a 2 or 3 - just mildly unpleasant - I wouldn't really mind it if it didn't worry me or thought it would pass
4)Relieving factor or aggrevating factors?
--Only thing is early morning before rising is best.

5)Pain is dull aching or constant or is sharp and off and on in nature?
--Dull aching with on and off sharper spots. Last night noticed a lower abdomen felt full as if had gas or needed to defecate - but really didn't
6)gassy feeling increases pain?
--gassy feeling increases the gassy feeling not too much more the pain
7)Medicine you are on for IBD? Doses? From how long?
Dicetel 100 mg 3 times a day been on for about a month. Pinaverium Bromide

8)Any history of enetritis or diverticulitis in back?
--Not sure what they are but pretty sure I never had it - I have always had a very strong stomach and gut - though when I was 18 I had diahrea for a few months
9)A stool microscopy or a urine microscopy was ever done?
-- No has not been done
10)CT or MRI abdomen ever done before?
-- Had an ultra sound of abdomen found only moderately enlarged prostate.

I look at my stool and do not see any blood. Also I lost about 10 pounds - now I also went on a diet about that time - cut out snacks - it seemed a little too easy to lose the weight but I was consuming about a litre of chocolate milk and a carbohydrate snack most days.

I am very active - bike about 20 km a day summer and winter , xc ski, kayak etc
I have lots of energy - feel good. except for this.

thanks again XXXXXXX
doctor
Answered by Dr. Ramesh Kumar 8 hours later
Brief Answer:
folow up.

Detailed Answer:
Hello again XXXXXXX
Thanks for follow up.

Lower right pain is very usually associated with constipation or improper bower and other digestive issues while lower left is seen usually in diverticulitis(infection of large intestines).
Localised pain through outt the abdomen is also very suggestive of problem.
High levels of stress may also stimulate the vagal and autonomous nerves and may cause severe spasms in intestines at times resulting in pain.Intensity 2-3 is again mild spasmodic in nature.Spasms due to infection is very painful.Pain due to appendix or other viscera is also very painful so again i don't feel like its IBS or infection related pain.

When ever a person is constipated there is stagnation of food in large intestines this stagnated food is acted upon by a number of toxic bacterias causing severe gas release.This gas compresses and exerts pressure on intestines causing compression of nerves leading to mild irritation and inflammation again a cause of pain This gain is mild in nature and usually passes away with flatus or burps.

Overall in my opinion dear patient you are having a disturbed gut flora.Our gut consists of good and bad bacterias this is called microflora of gut.Our body has its own enviroment called gut flora.Gut flora is the complex community of microorganisms that live in the digestive tracts of humans. The intestinal microflora is a complex ecosystem containing over 400 bacterial specie.Long term disturbance of this flora and can lead to various problems with digestive system like indigestion,abdominal pain,belching, bloating and increased gas formation loose motion or constipation.These symptoms may vary from person to person.
.I would suggest you to start good quality probiotics for a few days.Take VSL#3 for few weeks.
Get stool test done.
Take food rich in probiotics like yoghurt curd kimcchi etc.

Follow up with report.
I don't feel it has any thing to do with prostrate cancer.

Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar 37 minutes later
Hi

Very interesting - I took antibiotics for prostatitis and also for the prostate biopsy - could this have upset my gut flora. Where would I get VSL#3 - I eat quite a bit of yogurt.

thanks
XXXXXXX
doctor
Answered by Dr. Ramesh Kumar 21 minutes later
Brief Answer:
Antibiotics are biggest enemy of our gut flora dear therefore they are always given with probiotics and vitamin b complex.

Detailed Answer:
Hey dear we have got it sir,
Antibiotics destroys the flora of gut therefore antibiotics are always prescribed with probiotics and B complex.
Start taking VSL#3 thrice daily for 1 week followed by twice daily for 2 weeks followed by once daily for one week.Its over the counter in canada can also get it online.
Along with it take a digestive enzyme supplement for a week or two.I would suggest you MRM digest all(online) natural and very effective.
Take B complex capsule once daily for 4 weeks.
Keep taking antispasmodic you are on.
Isapghul husk is available online.Its a natural husk and is a bulk forming agent. Soak2-3 tsf of it in half cup of XXXXXXX warm water in evening and take it before going to bed.

Don't worry all of them are completely natural.They are a sort of add on supplement in form of capsules.
Things would take time.
Initial response would be seen in a week or so.
So remain patient.
Try to avoid meat for 14 days.
Take brown rice with curd,yoghurt fermented probiotic products are available in super markets.
Try to avoid too much protein in diet,Stay on carb diet easy to digest and have lots of fibers for 10 day.
Take 2 banana one pear and 2 orange daily.
Have apple before sleep one medium sized.

You would feel much better in ten day.
Please do rate the answer if you were helped any suggestions for improvement of answers would be appreciated dear.

You can send me query directly on this forum by following this link once this thread is closed or in future.
http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660

Don't worry.
Try it and you would feel better in a week or so.
Hope i was helpful.
Warm regards and a very happy new year.


Above answer was peer-reviewed by : Dr. Vaishalee Punj
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