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Had intestinal issues. Had colonoscopy. Found diverticula. Suggest

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Practicing since : 1962
Answered : 693 Questions
Yes, I have been having some intestinal issues for a few months. Initially I thought there was a hernia but was ruled out with Ultrasound and CT Scan. I had a Colonoscopy and there were diverticula found otherwise normal - see attachments.

The issue is on my left side. I can sometimes feel what I was told was my intestines along the top left near my hip bone down to the bottom of my lower abdomen when the ultrasound was conducted. Throughout the day and in the mornings especially its like I can feel my bowel forming and it eventually feels like a thick rope that I can move side to side when pressing on it.

The thing is, this has never been the case before so I'm not sure what it is. It feels like I have a constant dull swelling sensation in that area with tingling along my left side and left abdomen after a bowel movement.

I had taken Cipro (500mg) 2x a day for 10 days in December 2012. Could this have interrupted my digestive system some how. I have been having this issue since after exercising and leaning on my left side for a few hours. When I got up I felt a pain in my left groin area and that's when I started noticing the feel of my intestines. Initially it just felt like I over tensed my side and pulled/strained a muscle. So there was a period where I was pressing in that area as well to try and ease the pain/strain. The pain eventually went away but now I just have the intestinal issue.

Is it possible to irritate nerves in this area that is just taking a long time to heal? Did I irritate the diverticula which is causing the dull tingling sensation? Is it normal for me to be able to feel my intestines or is it just the muscle surrounding the intestines. The rope like feel goes away after a bowel movement.

From my statement above, do you have any possible diagnosis or suggestions? I also have my Colonoscopy results posted as well as ultrasound images.

I know this is a lot but I wanted to give as much information as possible.

Thank you.
Posted Wed, 5 Jun 2013 in Digestion and Bowels
Answered by Dr. Charles S Narasi 12 hours later
Hello, XXXXXX,
Thank you for contacting XXXXXXX with your quiery.
You have had sonogram of the abdomen and also
a colonoscopy which revealed diverticulosis.
From the description of your symptoms , it seems
like you may have Irritable Bowel Syndrome associated
with diverticular disease. It also appears that you were
treated with antibiotics with a presumed diagnosis of
diverticulitis . I am not sure if you had a CT-Scan of the
abdomen to confirm Diverticulitis and also a complete
blood count to see if there was elevated white cell count.
Regardless , ten day therapy of Cipro should be sufficient
to take care of any infection if present. After a course of
antibiotic therapy , it is possible that some of the good
bacteria that we need get knocked out as well. It may
be beneficial to take probiotics to introduce good bacteria.
After any intestinal infection , condition of IBS can appear.
The vague sensations in the abdomen that you feel is due to
spasms and irritability of the intestines.
There is increased sensitivity to distension in this case.
It is very important for you to stay on a high fiber diet. This
will help to prevent repeat attacks of diverticulitis .
You do need to consume enough liquids as well.
If the spasms are really bad, your doctor can prescribe
an antispasmodic medications such as hyocyamine or
dicyclomine in smaller doses. Higher doses can have side
effects such as constipation, blurred vision or dry mouth etc.
If you have not had an upper GI x-ray series along with
small bowel follow through , get this done as well to rule out
any problems.
Hope this gives you some information that you can further
discuss with your own doctor.
I wish you the very best.
Above answer was peer-reviewed by
Follow-up: Had intestinal issues. Had colonoscopy. Found diverticula. Suggest 3 hours later
Thank you for your response Dr. Narasi,

I did have a CT scan but diverticulosis did not show up or at least it was not diagnosed via CT scan. I found out about the diverticula when I had the Colonoscopy. I have attached the results to this query for your review. The Dr. said I did not have diverticulosis as the diverticula were not inflammed or infected and were very small.

Honestly, I didn't have the symptoms like this until after exercising and laying/leaning on my left side in an awkward position for a few hours. When I got up quickly it felt like I pulled something then there was pain in that area which is why I thought I had a hernia but was ruled with ultrasound and CT scan.
Is it possible that I caused the small divirticula to occur while laying/leaning on my side in an awkward position too long? Then afterwards I was pressing/massaging my intestinal area that I thought was a muscle. Ironically this is where the issue is. I hope I didn't cause this condition inadvertently.

These symptoms are particularly frustrating as I have notice more frequent bowel movements since and the bowel is significantly larger. In the mornings it feels like my intestines want to pop out at the lower left portion of my abdomen (along the side and at the very bottom). It’s almost like I can feel the bowel at the very surface which I have never noticed before. Sometimes if I push in that area I can make it go down into my abdomen. But again, it’s not a hernia and there is no significant pain. I am a relatively thin person, but have been all my life -- Is this normal?

Is it possible that I overstretched muscle in that area that is taking a long time to heal? The reason I also asked about the nerve irritation is it seems like the bowel just sits on my left side sometimes and eventually moves downward when I touch in that area.

I hope I have provided enough information to assist with your opinion.

Thank you.
Answered by Dr. Charles S Narasi 1 hour later

Thank you for sending additional reports.

Looking at the colonoscopy pictures , you do have a few early diveerticular disease. The CT-Scan is done to rule out infected diverticula called Acute Diverticulitis . Apparently you did not have this. But , I think your doctor decided to give you a course of antibiotics , just in case , based on some of your symptoms.

I don't believe any harm was done by that. It is possible that you might have sprained or experience some muscle sprain after the awkward exercises. That does not cause diverticulosis. This can some times run in families.

If one or both of your parents had this , it is possible that you are also developing this. These are a little pouches or pockets that develop from the weakness in the layer of the colonic wall. The best way to handle these is to go on a high fiber diet or even take fiber supplements such as metamucil or effersyllium daily. Drink enough fluids. There is no contraindication to be active and exercise. This is actually good.

A strained muscle should heal in 7-10 days as long you don't do anything to aggravate the same area. You could use analgesic creams ,gently rubbing on the area that is giving you pain. You should heal completely.

I wish you well.
Above answer was peer-reviewed by
Follow-up: Had intestinal issues. Had colonoscopy. Found diverticula. Suggest 47 hours later
Thank you for your responses thus far Dr. Narsai, it has been very helpful and informative speaking with you.

During the ultrasound that I have the doctor did mention that I lost a lot of fat in that area which is why I am able to feel my intestine/bowel. Does this sound familiar. It does go away quite a bit when I have a bowel movement but in the mornings and a couple of hours after I eat the rope like thing that I feel is more pronounced.

He also mentioned that my iliacus/iliopsas and Trans versus Abdominal muscles are very tight and are almost like squeezing my intestines upward.

Have you ever heard of this? I read on the internet that the cramping of these muscles could take months to stop and may possibly require physical therapy -- what are your thoughts.

I went to the ER today because after cutting grass yesterday for about an hour and a half, my left side was just burning and tingling and the lower portion of my abdomen that I mention felt very inflamed. All blood work and urine was normal. This is really frustrating because there is not a lot of pain involved, just a dull inflamed/swollen feeling on my left side.

I will be seeing a General Surgeon next week to recheck for Inguinal Hernia but the CT Scan and Ultrasound already ruled that out. But I guess it's still possible.

Another question; when looking at my Colonoscopy report [picture 2] in the far back are those diverticula? -- it appears to be about 4 or 5. Or is is that just the light reflections during the procedure.

Thank you for your time.

Answered by Dr. Charles S Narasi 15 hours later
Hello, XXXXXX,

Good to hear from you again. When you lose abdominal fat, infact it is easy to feel the distended intestines and the spasms or contractions due to movement of the trapped gas. That is O.K.

As for muscle sprain or strain , physiotherapy such as massage, hydrotherapy (Warm water) or even acupuncture may help.
You have to avoid the type of activity that could aggravate the problem.

Colonoscopy pictures show 4-5 pockets that I could see but the doctor probably saw some more but not photograph all of them which is not necessary.

I wish you well.
Above answer was peer-reviewed by
Follow-up: Had intestinal issues. Had colonoscopy. Found diverticula. Suggest 5 hours later
Thank you for your response again Dr. Narasi.

That makes sense because when I pass gas sometimes the pressure is released also. I did start eating more to gain weight in that area but I think the stress of dealing with everything has prevented that from happening so I will work on gaining more weight again.

The one thing I concern myself with is the fact that I must have trigger this to get worse somehow because it wasn't like this before the day I feel asleep on my left side and when I woke up it felt very numb and tingling and slightly painful so I thought it was a cramp. Then I started pressing really hard in that area to try and ease the cramping but I seems like what I was really doing was pressing on my intestines over a period of a few weeks. That's why I thought I somehow caused some of the diverticula to appear. Since then things haven't been the same and it just won't go away.

I'm hoping it's not a hernia but I will go to the Surgeon and see what he says. My Primary Care Manager wants be to go back to the GI doctor to get a sigmoidoscopy which I'm not sure how this is different from a Colonoscopy. Can you explain.

Otherwise it just may be something I will have to live with.

Thank you for your time again.
Answered by Dr. Charles S Narasi 1 hour later

I can assure you that you did not do anything to make the diverticulosis to appear. It just does not occur that way.

The difference between sigmoidoscopy and colonoscopy is, one is partial examination limited to approximately 22-25 cm. of the lower part of the colon. Colonoscopy is the examination of the entire colon upto the junction of the small bowel. If your colonoscopy was very recent , I am not sure why they plan on sigmoidoscopy unless you had some recent bleeding or any pain in the rectal area.

I wish you well during your next visit to your doctor.

Above answer was peer-reviewed by
Follow-up: Had intestinal issues. Had colonoscopy. Found diverticula. Suggest 27 minutes later
Thank you Dr. that's exactly what I was thinking.

I think I have exhausted most means of trying to figure out what's going on. Although the doctors suggest that I could have a hernia which has been ruled out by both CT Scan and Ultrasound, I really dont have a lot of pain just feels like a big muscle contraction/bulge that has been there off and on since December 2012.

For now, I am going to lean on the side of it being a muscular problem as the Ultrsound Dr. suggested and perhaps try to get some more physical therapy to get my iliac/iliopsoas and Transverse Abdominal muscle to relax.

What type of doctor should I consult for this type of problem?

I do thank you for being so patient and understanding with me thus far. It makes me feel better when I get your advice and clarifications.

Answered by Dr. Charles S Narasi 16 hours later

You can get a referral for Physiotherapy facility.
They will have massage therapy and also hydrotherapy (Like whirlpool treatment).
You can also use some cream containing Menthol and apply it over the area.
I am sure you will come out of this O.K.

Have a nice day.
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