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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had mild pre-hypertension, overweight and contact dermatitis on penis. Suffer from depression and anxiety. Is it serious?

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Dr. Ajit Naniksingh Kukreja

Gastroenterologist, Surgical

Practicing since :1984

Answered : 922 Questions

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Posted on Thu, 14 Nov 2013 in IBS(Irritable Bowel Syndrome)
Question: Hi



Thank you in advance for reading and answering my question. I am writing because I am experiencing mild, dull, intermittent (it comes and goes) discomfort in my lower left abdomen. (The pain is usually like a 1 or 2 out of 10) I will send a pic of the region, but it's in the fold between the abdomen and leg when one sits, or the very bottom of the abdomen. It feels like it's in the frontside of my body, not in the middle/inside of my body.



Backstory: At the beginning of this year (January), I suffered from a severe gastro bug that involved severe diarrhea, constipation, gas and a high fever that lasted three days. I am uninsured so I just waited it out. That was many months ago. I think it was partly a lactose issue (I am mildly lactose intolerant and had consumed lots of cheese at a fondue party), and partly an infection, possibly related to a mold outbreak in my apartment at the time.



Much later, starting about two or three months ago, I began to notice this intermittent dull pain. Some days I would not have it all, and others I would notice it more. At one point, in late August, I experienced a sudden, extremely sharp pinpoint of pain in this region that lasted like a tenth of a second. It was very sharp and painful (8/9 out of 10) but was over with in an instant. It hasn't recurred and I was fine afterward.



SOMETIMES, but not always, it seems to be improved upon changing positions. Like this morning, I was laying on my side, stretched out, and I felt the pain. I changed position so I wasn't stretching that side out, and it got better. But sometimes shifting position doesn't make a difference.



At some point this year, I noticed a peculiar stretch mark in the same area that I have this dull pain. I do not know how long the mark has been there. I have included a photo of it. I am holding up my abdominal fat to show the mark. I have other older stretch marks but this one seems different. The pain is in this region, but not exactly where the mark is.



I recently have felt a bit bloated, as if I can't pass enough gas. My bowel movements have been either normal/regular stools or loose and mushy, not quite diarrhea. There has been no mucus or blood in the stool. Having a bowel movement does not make the pain go away.



Also, if it helps, I was diagnosed by a Ear/Nose/Throat doctor five years ago with Laropharyngeal Reflux Disease. I modified by habits and took omeprazole and I am mostly symptom free. I no longer take omeprazole regularly. I avoid spicy foods, etc and sleep with my bed at an angle to keep the acid from washing up. I also lost about 35 lbs by diet/exercise. My LPRD seems to be under control.



I suffer from depression and anxiety although I made the decision four years ago to stop taking medications for it and to try to make it on my own. This sensation is intensifying my anxiety as I worry that it's something serious and I do not have health insurance.



Is this Irritable Bowel Syndrome? Colon cancer? The beginning of a hernia? Something I can manage on my own? Or something urgent?



Thank you,
XXXXXXX
doctor
Answered by Dr. Ajit Naniksingh Kukreja 10 hours later
Brief Answer:
Could be IBS ?

Detailed Answer:
Hi XXXXXXX

Thanks for providing a detailed hisotry

The initial dull pain could have been some for of inflammation which would have remained there after the acute infection

The sharp pain you had once could be because of any colic secondary to GI symptoms

I can not opine on the stretch marks till I have the images

Regarding you impression, it does not seem to be colon cancer, also I cannot opine on Hernia till I examine the inguinal region as the pain is in that region

But yes it can be IBS

I would suggest you manage your stress levels
Avoid Junk food
Add a probiotic for two weeks

If this does not work, go for a stool examination and if need be a culture report and take antibiotic accordingly

Hope this helps
Do write back in case of concern
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajit Naniksingh Kukreja 1 hour later
Dear Dr. Ajit Naniksingh Kukreja,

Thank you for your time. I appreciate the chance to get your opinion. I put stars (*) around the issues I'm hoping you can address.

There's been quite a gap of time -- eight months -- between the intense and acute gatstrointestinal illness (beginning of January, lasting approx 1.5 weeks) and the approximate onset of these symptoms (roughly August -- it was infrequent at first).

In that time -- from the end of the acute illness until the onset of the abdominal pain -- eight months -- I did not experience any abdominal pains. *But am I correct in understanding that there could nonetheless be a relationship despite the time gap?* I just want to be sure I am communicating my history clearly and understanding you correctly.

(The one-time, strong pin point of pain did occur a just couple hours after finishing a long cross country airplane flight in late August, just in case that is relevant. Then, when I returned a week later back home, I came down with a 48 hour diarrhea illness -- but so did the friends I visited -- we had attended a massive public event & assumed it was a bug we all picked up while at the event)

Also, I have tried coughing hard, and observed/felt for any lumps per Dr Deepak's suggestion -- in other words, I can't find anything out of the ordinary (bulging, pain on coughing) regarding the possibility of a hernia. Testicles seem normal.

I did however read about a "sports hernia" and wondered if that could be a possibility? *Can you tell me in your response your opinion on this possibility if you are familiar with the term -- "sports hernia"?*

My symptoms are generally relieved (although not 100% always) by lying flat. Sitting seems to be the most likely to cause discomfort.

I sent a photograph of the stretch mark when I originally submitted my original query a few days ago. So it should be there in my file somewhere.

I took 2 naproxen sodium tablets tonight upon your suggestion that it could be inflammatory. I have been taking probiotcs and will do so as you have suggested for the next two weeks.

*I can resend the stretch mark photo, but I would need instructions as this part of the process doesn't include an option to send a photo.*

Many thanks for your time !!! XXXXXXX



doctor
Answered by Dr. Ajit Naniksingh Kukreja 2 hours later
Brief Answer:
Please find replies to your * Queries Below :

Detailed Answer:
Hi XXXXXXX :

*But am I correct in understanding that there could nonetheless be a relationship despite the time gap?*

Probably no, but the infection can reoccur

*Can you tell me in your response your opinion on this possibility if you are familiar with the term -- "sports hernia"?*

Chances are very remote if there is no swelling in local region of groin

Am of the opinion that probiotics should help you in the long run along with some stress relieving measures like meditation etc

*I can resend the stretch mark photo, but I would need instructions as this part of the process doesn't include an option to send a photo.*

Do write back in case you have any doubts
Wishing you a healthy life ahead
You need to write to the customer care, they surely will guide you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajit Naniksingh Kukreja 10 hours later
Image uploaded
doctor
Answered by Dr. Ajit Naniksingh Kukreja 9 hours later
Brief Answer:
Nothing to worry about

Detailed Answer:
Hi XXXXXXX

Have seen the uploaded image

Seems you have probably put on weight

These are stretch marks normally seen with obesity

Otherwise if it is not itching I feel just leave it as it is

If there are any symptoms, do go ahead and see a dermatologist

Hope this helps
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajit Naniksingh Kukreja 45 hours later
Dear Doctor,

Thank you for your response. It does help.

I am feeling a little bit better.

Last follow up question:
I was very upset last week following a car wreck I was in. And as I said, I have a history of anxiety and depression. Is it possible that extreme stress could cause or worsen symptoms like this in my abdomen?

The pain was most intense during the week and a half after the car wreck, during which I was also very stressed. And now time has passed...the pain seems to be a little better. I also noticed that I am not quite as stressed out as I had been. I have been trying hard to meditate and relax just like you suggested. Thank you.

Do you think the stress has anything to do with it?

Regards, XXXXXXX
doctor
Answered by Dr. Ajit Naniksingh Kukreja 3 hours later
Brief Answer:
Very True.......

Detailed Answer:
Hi XXXXXXX

I am glad the line of management worked

Yes immense stress can worsen the symptoms.....

If you recollect, my first reply I have advised you to manage stress levels....

If you are able to do this, half of your symptoms will vanish

Do not hesitate to write back in case on concern
Wishing you a very healthy stressfree life ahead
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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