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Have IBS, abdominal pain, bloating, headache, diarrhea. Weakness, loss of appetite. What can I do?

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Practicing since : 2004
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I posted last week about abdominal pain. And a kidney infection was what I was diagnosed with. I have these problems including bowel problems my whole life. So about four years ago I had my gallbladder removed. Now I have had IBS my entire 30 years of my life. I had chronic constipation as a child till a little over four years ago. At that time I began to have explosive Diarreaha. Went to the doctor cause I bargain to have stabbing pains in my upper right side. Did tests high liver enzymes and more test. After the removal of my gallbladder because it was not allowing bile to pass they found out that it was acalculous gallbladder disease that caused it to go bad. Well ever since the IBS had gotten worse. For the past two years I have been I'll quiet frequently infection (including kidney, upper respitory), flu u name it, it seemed like I had it. I work in a group home environment for three years and if someone caught something I almost always got what they had. So I switched jobs in the company about 8 months ago figuring that was gonna change the stress which it did. But then I started to pass I undigested food and having horrible abdominal pain. The illnesses and infections still continued as I said before and was even hospitalized for the kidney infection. But I was not having symptoms
Of the kidney infection and believe me I know what the symptoms are have had then 2 to 3 times a year since I was 9. So I didn't even know that it was kidney infection. After the tests in the hospital came back that there was no signs of infection I begain to wonder if it was kidney stones. They did a ct scan and there was no stones well it has been well over three weeks and I'm still having the same abdominal pain. Sharp pointy pains in my lower right abdomen, bloating, headaches, severe Diarreaha,now what looks like skin tags and cuts with slight bleeding from the cuts and sharp pain in my anus. Plus abdominal bloating in upper abdomen. I am also experiencing weakness and sometimes severe fatigue and the newest symptoms is loss of appetite. Only because to eat cause the pain to be worse and I really need to see a specialist but my doctor keeps putting me off and putting me on antibiotics and meds I don't know what for and doing upper exams in my small bowel when I believe it is in my lower bowel. And he won't give me a referral. What can I do?
Posted Fri, 14 Sep 2012 in Digestion and Bowels
Answered by Dr. Om Lakhani 52 minutes later

Thanks for writing in.

From what I understand your current problems have three sets of problems

1. Diarrhea, bloating in upper abdomen and abdominal pain
2. Kidney infection
3. Anal tags with bleeding per rectum and painful defecation.

We will take '3' first because it is a simple one. It is what is known as 'anal fissures'. The best treatment for it is Seitz bath and a local ointment application. A GP can prescribe you an ointment to reduce pain and bleeding while defecation. Also he can do a per rectal examination and confirm the diagnosis

The other is recurrent kidney infection. It is no unusual for females to have recurrent kidney infection as females have a short urethra and infection can seep in easily. If they are frequent you need long term antibiotic prophylaxis. Drink lots of water and have citrus fruits. Some even recommend voiding after coitus to prevent infection after intercourse. A local GP again can very well treat a recurrent kidney infection and a specialist may not be required.

The third symptom is that of pain, bloating and diarrhea. Well your doctor is right. It is the small intestine which is often the culprit in this case. Small bowel absorbs the nutrients and in conditions where the small bowel fails to absorb the nutrition it can cause prolonged diarrhea. However, a diagnosis of IBS is diagnosis of exclusion and we need to rule out other organic causes of these symptoms. I would recommend the following tests

1. An ultrasound of abdomen
2. An upper GI endoscopy with biopsy from duodenum
3. A stool fat estimation
4. If required a barium meal and follow through (BMFT)
5. Blood tests for celiac disease (anti TTG and anti EMA)

Since you have had a history of a previous surgery, it can do two things

1. Removing the gall bladder often causes symptoms of what is known as 'Post cholecystectomy syndrome'. Drugs which bind to bile acids ('cholestyramine') often help in such condition
2. A recurrent abdominal surgery can often cause adhesions in the stomach which can sometimes obstruct the intestine partially or completely giving raise to symptoms of constipation, vomiting, pain and bloating of abdomen. A BMFT can help rule a narrowing of the intestine out.

If the above investigations are normal often IBS is the diagnosis made. There are many new products like 'Digestive advantage- IBS' and probitoics which are in vogue for IBS and quite helpful. Discuss these issues with your GP. You are always welcome to the forum and I would be happy to review the reports which I have advised above.

Hope I have answered your query. If you have any further questions I will be happy to help

Dr. Om Lakhani
Above answer was peer-reviewed by
Follow-up: Have IBS, abdominal pain, bloating, headache, diarrhea. Weakness, loss of appetite. What can I do? 8 hours later
Ok IBs causes people to have a fever? I have been over the kidney infection for over a week. Still have a fever really sharp lower right abdominal pain, headaches, and my anus is on fire from the Diarreaha with anal bleeding, and the upper part of my stomache feels bloated and painful. They did an upper Gi series and it came back normal. This pain that I am having is constant not flare ups from IBs I have had this pain for over three weeks. I have have Had IBS my whole life and I have never had constant pain nor have I ever carried a fever with the flare ups. I need to see a specialist so they can run a scope thru my rectum but My doctor won't referr me to one so do I just keep feeling this pain or go to the ER? Or Can you help me with a referral?
Answered by Dr. Om Lakhani 11 hours later

Does IBS cause fever ? Answer is no. IBS doesn't cause fever. The fever can be explained by your recurrent kidney infection.

Since you said the upper GI series is done, if you can send over the reports I would be glad to have a look at it.

As far as the burning in anus is concerned - I have answered this in the earlier post- you can ask you GP for a per rectal examination and a some local ointment for a probable anal fissure.

As far as helping with a referral is concerned... you can show the transcript of the conversation to your doctor... if that helps. But most of the time your treating physician who has seen you and examined you is the best judge and you should trust his judgement. You can ask for a sigmoidoscopy (a smaller scope through the rectum) which is nowadays in the era of colorectal screening often done by XXXXXXX medicine specialist and surgeons as well.

Hope this helps

Dr. Om Lakhani
Above answer was peer-reviewed by
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