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Have Abdominal Pain, Back Pain And Numbness In Waist Area. Have Prostatitis, Constipation And Loose Motion Alternating.

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Posted on Wed, 7 Aug 2013
Question: I have abdominal pain all over, specifically in the lower left and upper right areas. I also have back pain and numbness in the waist area. I have chronic prostatitis as well. Constipation and loose motion alternating.
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (2 hours later)
Hi XXXXX Thank you for your question and welcome to our site.

Your generalized abdominal pain (with some localization in the upper right and the lower left quadrants), together with the alternating loose bowel movement and constipation, may point to a number of possible conditions which include hypothyroidism, or intestinal obstruction.

If I will base my impression solely on the information you have given, it will quite difficult to say exactly what the problem is. I am also at a disadvantage because I cannot physically examine you as in a true consult. Could you, please, if possible provide me with the following:
1) Is this pain recurrent or recent?
2) Can you describe the pain - dull, sharp, gassy/bloated, crampy (try to use your own words)?
3) When does it occur and how long does the pain last?
4) What triggers the pain and what relieves it (include the things that you do or medications that you take)?
5) Did you notice if your weight changed or if your clothes became tighter or more loose?
6) Any other symptoms - fever, nausea, vomiting, weakness, cold intolerance, sluggishness, and others?

Thank you and I am also very eager to hear from you soon!


Dr. Galera


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rene Gerard Cruz Galera Jr (1 hour later)
1. This pain is recurrent but became more severe about a month ago. I have been having prostate pain for quite some time now; now abdominal pain is added.

2. The pain is generaly dull and crampy (stomach is crampy). When I wear pants and the abdomen gets pressed, the pain is more sharp and difficult to bear.

3. It occurs when I wear pants. With loose clothes it is less painful but it is always there. Only when I lie down it becomes n=bearable.

4. The pain comes as soon as I get up and start my daily chores but becomes more intense when I wear tighter clothes. Eating relieves it somewhat.

5. My weight has gone down recently from 128 to 129 range down to 126 to 127 range.

6. Other symptoms - tired, weakness, cold intolerance, crampiness on the upper back and upper front, numbness in the waist and buttock area, headache occasionally and some shortness of breath which has become better now.

All the symptoms became more intense after I went to an Osteopath to get some help with my prostate condition in February 2013. The practitioner did some manipulations that included placing the hand on the right side of the abdomen and pulling from bottom towards up.
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (25 minutes later)
Hi,

Thank you for getting to me back.

Now, that I have a bit more of information regarding your pain, we can limit ourselves to a shorter list of possible conditions which include lactose intolerance, bacterial imbalance in your gut, abdominal pain with alternating diarrhea and constipation.

I suggest that you see an XXXXXXX medicine specialist or a gastroenterologist who will listen to your abdomen, palpate it, and request for some tests like a fecalysis (to see if there is any blood, fat, predominant bacteria and other parasites in your stool) and some imaging studies like an abdominal ultrasound (to check your small and large intestines and other organs). Only then will we be sure what is ailing you and causing you this pain.

I know that this can be very frustrating now that this abdominal pain is added on top of your chronic prostatitis. Gastrointestinal problems can sometimes be a bit tricky so we really do take time in diagnosing such conditions; so please, try to be a little patient until you and your physicians tackle this problem.

In the meantime, I would suggest that you avoid certain foods that can cause bloating (beans, broccoli, brussel sprouts, cabbage, cauliflower, and carbonated drinks) and constipation (apples, peaches and pears). Also, include yogurt, probiotic milk-like products, and fiber in your diet to help improve your digestion. Wear clothes that are not too tight or choose ones that are stretchable so that you will not trigger the pain.

I hope I was able to address your concerns. If you have further questions, please do not hesitate to ask. Take care!

Dr. Galera
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Rene Gerard Cruz Galera Jr (31 minutes later)
Hi Doctor:

My GP had suggested colonoscopy quite some time back. I had been postponing. I am planning to do this week after next. Will this help? My Gastroenrologist also saw me last week and says he can do a colonoscopy if I want. This same Gastroenrologist did a colonoscopy on me back in Sept 2010 and indicated that he observed some diverticula (pouches) but no infection (no deivertculitis).

Result of a recent MRI of the pelvis April 2013 is as follows - a fat containing left inguinal hernia is observed. There is evidence of sigmoid diverticulosis without evidence of acute diverticulitis. There is no significant abnormality is demonstrated within the musculature of the pelvis. No other significant abnormality is seens. MRI was not conducted on the upper abdomen. CT scan of the abdomen and pelvis was perfored in XXXXXXX 2012 ordered by my Urologist. Nothing abnormal reported in those. Same was done back in XXXXXXX 2010 too.

I am quite worried about cancer because of the long duration of the problem/pain - issue unresolved over a long period. What can be done to rule this out?

I had sought help from a Reflexologist, Chiropractor, Homeopath and an Osteopath for short durations in 2012 and early 2013 in my desperation. Not sure whether any harm has been done by this.

Thanks
XXXXX
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (22 minutes later)
HiXXXXX

Yes, you are correct in saying that the colonoscopy will help. It will provide a more direct and realtime view of your small intestine and bowels. As such, it can also help your gastroenterologist to see if there are any gross masses or lesions (either benign or cancerous) that may cause obstruction or local inflammation.

The sigmoid diverticulosis can also actually be responsible for the generalized pain you are feeling. A bacterial imbalance can cause the diverticulosis to get inflamed or infected (now acute diverticulitis) and also cause pain, bloating, and alternating characteristics of bowel movements.

Manipulations done by reflexologists, chiropractors and others may or may not have placed undue stress or pressure on some sensitive areas of your abdomen. We still have to conduct formal studies to confirm whether their techniques can benefit or harm certain disease conditions.

Do not be too worried about cancer, XXXXXXX As I told you, there is a long list of gastro intestinal problems and they can be tricky to diagnose. But take heart because we now have improved diagnostic tests like colonoscopies and other imaging studies to help us diagnose and visualize diseases. Take it a step at a time and I am sure your very able physicians will clinch the diagnosis. Just be sure to keep sharing with them your thoughts and concerns too so that they can take them into account.

Should you have any further concerns or queries, please do not hesitate to ask them. Otherwise, you may close the discussion and rate it.

Take care, XXXXX! I wish you good health!


Dr. Galera

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Rene Gerard Cruz Galera Jr (2 hours later)
Hi Dr. Galera:

Thanks. Just need a clarification - will colonoscopy cover small intestines as well in addition to the large intestine (i.e., the colon)?

Thanks
XXXXX
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Follow up: Dr. Rene Gerard Cruz Galera Jr (10 minutes later)
Hi Doctor:

Also why am I getting slight headaches and breathing difficuty at times. What could be the cause and how can I get some relief? I have read that if the bowel is not emptying the waste properly it can cause headache too. I do not feel hungry quite lately but am still eating. What I eat has to be digested and the waste get out of the body but that is not happening on its own and regularly. Under my current condition can I do some light exercises and and some short distance walking?

Thanks
XXXXX
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (5 hours later)
Hi XXXXX

My apologies if I was not clear - colonoscopy can allow the visualization and examination of the colon, its junction with the small intestines, and the distal part of the small intestine. It cannot, however, cover the entire small intestines.

Headaches, just like any other symptom, are just a sign that our body is undergoing some kind of stress. The difficulty in breathing may be due to the pain and bloatedness that you feel - the abdomen also has some minor role in respiration - but you have to see the specialists I mentioned above to be sure. Try getting adequate sleep and doing some relaxation exercises whenever you feel headaches. Mention this to your physicians so that they may prescribe some pain medications if necessary.

The bloatedness can decrease your appetite, it is possible that bowel gas is occupying the space that is supposed to be for digested food and somehow functionally blocks or restricts the movement of your bowel. The dietary fiber and probiotics I mentioned before will help you here.

Lastly, light exercises are definitely things you can do. This can improve circulation, breathing and even mental state. Try doing some exercises 15-30mins twice a week and then you may increase either the intensity or frequency after 2-3 weeks when your body gets accustomed to it.


Should you have any further concerns or queries, please do not hesitate to ask them. Otherwise, you may close the discussion and rate it.

Take care, XXXXX! I wish you good health!


Dr. Galera
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Rene Gerard Cruz Galera Jr (13 hours later)
Doctor:

Thanks. My cramps in the upper back and upper front, headache and breathing difficulty have already occurred twice today while I am at work. Do you think I should go to the emergency department at the hospital. Breathing difficulty scares me. Last night while sleeping I did not have much problem.
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (22 minutes later)
Hi XXXXX

Yes, it is advisable to proceed to the emergency department if you have sudden onset of difficulty of breathing especially with your history of diabetes.

Let the doctor-on-duty know your complete history and your medications and tell him everything that you feel/have been feeling.
XXXXXXX fear is a normal reaction especially to the unknown. What is important is that you overcome this fear and act accordingly. If you have unusual symptoms that make you worry, do not hesitate to seek urgent care. I believe that it is better to seek consult for difficulty of breathing that may be due to a minor problem than to be sorry later for not acting on it.

Take care,XXXXX! Let me know if I can help you with anything else.


Dr. Galera
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rene Gerard Cruz Galera Jr (36 hours later)
Doctor:

Thank you for all the answers. I am almost fully constipated now. Very little bowel movement. My breathing discomfort has eased. But I am getting a headache from time to time. I went to see my GP yesterday. Told him about the constipation. He suggested oral fleet. A Gastrolentrologist suggested milk of magnesia last week. I have not tried any. I am afraid of what reaction I will get. I am not getting an urge to do a bowel movement. But the abdominal pain and burning is there when I am wearing clothes (pants). When I sit on the toilet, even with so much effort very little hard stools are coming. Can you please suggest something to relieve this constipation.

XXXXX
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (48 minutes later)
Hi XXXXX

Thank you for coming to me again, I really appreciate the updates you give me.

I am glad that your breathing has improved. Both the treatments that the gastroenterologist and your GP can help with your constipation. They are both safe to take and quite effective in relieving constipation. And it is quite alright to worry about their possible side effects so please allow me to explain some of them to you.

Both Milk of Magnesia and Oral fleet laxative, because of their very nature, can cause abdominal pain or cramping, nausea, diarrhea, and weakness. Rarely, people also reported unique instances of irregular heartbeats and confusion and even allergic reactions. Oral fleet laxative can interact with ranitidine and omeprazole, so if you are taking these drugs, best to choose milk of magnesia. Milk of magnesia, on the other hand, interacts with a longer list of drugs including tetracycline antibiotics, some azole antifungals, digoxin, gabapentin and others.

Again, I reiterate that they are safe to take. It's really up to you. If you are not comfortable with either, a natural alternative would be prune juice. Try drinking half a glass of prune juice in the morning and another in the evening. Remember, because this is also a laxative (albeit a natural one), you may also experience gas and some abdominal pain. It will work in a couple of hours so be sure to have access to toilet facilities. If half the glass doesn't work for you (no bowel movement for two days), try increasing it to one full glass during the morning of the third day.

I hope I was able to address your concerns, XXXXX You may also directly ask me questions from my profile. Let me know if I can help you with anything else.


Take care,

Dr. Galera
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Rene Gerard Cruz Galera Jr (2 hours later)
Is it OK to use a piece of soap inserted in the anal area to get some initiation from the bottom? There seems to be a constriction at the bottom possibly in the last part of the colon (I am not sure). I have never had such a situation in a long time.
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (8 minutes later)
Hi XXXXXXX

Thank you for coming to me again with this question.

I would strongly advise against doing something on your own, especially if you do not know how to do it. Commercial soaps may have antibacterial and other additives that may irritate the lining of your anal area and colon and potentially kill both good and harmful bacteria in your gut. These may cause you more problems.

Please seek a professional to have it done for you so that you are safe and complications, if any, will be kept to a minimal.


Take care!


Dr. Galera
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Rene Gerard Cruz Galera Jr (20 hours later)
Thanks Doctor for warning me against using soap in the anal area. I am getting some light bowel movement by lightlly massaging the left side bottom area. This is some relief but not complete. My headache and breathing discomfort continues intermitently.

I have a new problem which I hope you could help me with. My GP on my visit to him last Monday to talk about my bowel movement problem gave me two shots (needles/injections) quite unrelated to my immediate problem - one for preventing tetanus on one arm and the other for preventing pneumonia on the other arm (I am 58 years old). The right arm where one of the needles was given became lumpy for the past one day and then became itchy and reddish from last evening over a two inch circular area. It is very itchy right now. It is early morning 3 a.m. Thursday here in Toronto. Is there anything that you could suggest for me to do for immediate relief or permanent cure? I know this is not related to my original problem. Hope you would provide me with some advice. Thanks. XXXXX
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (2 hours later)
Hi XXXXX

I am glad that you were given those shots. It will really help you a lot in preventing future pneumonia and tetanus infections.

Could you send me a picture of the area? It may be an allergic reaction or a localized infection. Do you have any fever or chills?

In the meantime, try applying ice on the 2 inch circular area to minimize the inflammation. I will get back to you immediately once I see your picture.

Take care!


Dr. Galera
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Rene Gerard Cruz Galera Jr (37 minutes later)
Thanks Doctor. There is no fever or chills. Severe itching and thickening of the skin. The affected area is slightly bigger now. How can I send a photo through this? Could you advise?

XXXXX
doctor
Answered by Dr. Rene Gerard Cruz Galera Jr (9 minutes later)
No worries, XXXXXXX

It is good that you don't have fever and chills. Monitor yourself if you feel any itching or swelling in other areas of your body and sudden progression of difficulty of breathing.

I believe there should be an option to attach reports with your query. If you can't find it, you may send them to YYYY@YYYY and place this on the Subject line: ATTN 'Dr Rene Gerard Galera'. The XXXXXXX team will make sure to forward the photos to me.

Dr. Galera
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Rene Gerard Cruz Galera Jr

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Practicing since :2009

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Have Abdominal Pain, Back Pain And Numbness In Waist Area. Have Prostatitis, Constipation And Loose Motion Alternating.

Hi XXXXX Thank you for your question and welcome to our site.

Your generalized abdominal pain (with some localization in the upper right and the lower left quadrants), together with the alternating loose bowel movement and constipation, may point to a number of possible conditions which include hypothyroidism, or intestinal obstruction.

If I will base my impression solely on the information you have given, it will quite difficult to say exactly what the problem is. I am also at a disadvantage because I cannot physically examine you as in a true consult. Could you, please, if possible provide me with the following:
1) Is this pain recurrent or recent?
2) Can you describe the pain - dull, sharp, gassy/bloated, crampy (try to use your own words)?
3) When does it occur and how long does the pain last?
4) What triggers the pain and what relieves it (include the things that you do or medications that you take)?
5) Did you notice if your weight changed or if your clothes became tighter or more loose?
6) Any other symptoms - fever, nausea, vomiting, weakness, cold intolerance, sluggishness, and others?

Thank you and I am also very eager to hear from you soon!


Dr. Galera