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Have abdominal pain and IBS. Feeling fatigue, weakness and mild fever. Treatment to be done?

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Dr. Ratnakar Kini

Gastroenterologist

Practicing since :1996

Answered : 1856 Questions

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Posted on Thu, 10 Jan 2013 in Digestion and Bowels
Question: i have been suffering pain the left abdomen(just below the ribs) and left colon with altering bowel habit(alternative constipation and diarrhea).
other symptoms include fatigue, mild fever, weight loss of 10kg in 3 months, recurring of mouth ulcers, head ache, weakness, bloodless XXXXXXX


Stool report says, pus, veg matter, bacilli, occult blood, mucus.

Blood test says; CRP negative, B12 and D3 insufficiency. ESR: 8

X-ray reports; extensive fecal mottling noted in the large bowel. bowel gas pattern is non-specific and chest x-ray shows blunted costophrenic angle

Endoscopy report; H pylori positive but no ulcers

biopsy report; mild chronic duodenitis, h-pylori associated mild chronic gastritis

Ct scan; small specks of calcification found in the right lobe of liver, mild prominence of gastric rugae with e/o subtle submucosal edema in pyloric region

Query:: will please connect these reports and tell me right way to approach the problem
doctor
Answered by Dr. Ratnakar Kini 59 minutes later
Hi,
Thanks for posting your query.
I am Dr.Ratnakar Kini, Gastroenterologist and I am pleased to answer your query.
I would like to know whether colonoscopy was done before I can give my opinion.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ratnakar Kini 19 minutes later
yes colonoscopy was done. it was normal and even multiple biopsies were tested in the lab both collected through endoscopy and colonoscopy.

and here is how my doctor connected the results;
-> stomach pain is due to the fecal matter getting accumulated in large intestine. and the altering bowel habit too.
-> costophrenic angle is because of earlier automatically cured tuberculosis (i never had any tuberculosis, except that i used to cough a lot till 2 yrs back, when i used to smoke)
-> weakness and bloodlessness is due to b12 and d3 insufficiency
-> h pylori was not treated stating that its pretty common in india
-----
i am really worried
its been a week since i started the medicines but the pain is very slowly reducing
still facing multiple motions everyday in the morning (at least 4 times sticky)
n the stomach is very upset in the morning

--------------
here i write the treatment i was given
treatment
t.colospa (retard) --- 1-0-1
t. ciplox (500) 1-0-1
fabolite 2 times a day
inj. vitcofol (5 x 2ml)
calcirol sachets 1 per week -- fir 6 weeks
gemcal d3 - 1 daily for 6 weeks
doctor
Answered by Dr. Ratnakar Kini 18 hours later
Hi,
The pain may be due to constipation. Take high fiber diet and drink plenty of water.
Though H.pylori is common in India, it has to be treated as it can lead to other complications later. So get treated for H.pylori infection.
As your doctor has said, weakness may be due to anemia.

The worrisome factors are anemia, weight loss and positive stool blood test.
I would suggest a repeat upper endoscopy with duodenal biopsy be taken to rule out malabsorption syndrome. A small bowel series test may also be required.

Continue the medications which you have been taking. Take medications for worm infestation also.
I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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