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Overweight. History of GERD. Have anxiety, diarrhea and abdominal pain. What am I suffering from?

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Practicing since : 1962
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40 year old, 6'3" 325 lb male. No prior surgeries and no chronic health issues beyond those addressed below. No known food allergies or intolerance, but no recent testing. General sedentary lifestyle with poor dietary habits: high fat, low fiber, over-eating. For the past 25 years, stress and anxiety commonly leading to acute cramping, urgency and diarrhea/very loose stool. Past 5 years--history of GERD, occasional to frequent loose, semi-formed tan-colored stools (sometimes pellet-shaped, mostly soft normal shape) fatty residue (floats), maybe also mucous (?) and very, very rarely with a small speck of red. Bloating and gas common. No rectal pain. Dietary habits have deteriorated over past 2-3 years coinciding with increased incidences of cramping (which seems more painful than in the past and more to left lower abdomen) and urgency, etc.. Also in that period, 2 to 3 episodes (lasting 3 to 6 days each) of mild to moderate lower to lower-mid, left-sided or bilateral abdominal pain with pressure, bloating, loose XXXXXXX and fatty stool, mild fever (99.1-99.4). This following bouts of over-consumption of rich/fatty foods over course of several days. Most recent episode is ongoing, now in 6th day. Again, over-consumption led to gradual pressure/bloating over 48 hours, then pain thereafter about 3.5-4 inches below the naval, bilaterally 2-3 inches on either side. Days 1-3: 99.1-99.4 fever with heightened skin sensitivity all over body (mild pain, tingling) and mild chills. Watery stool with bits of floating (about 50 pct of fecal matter), tan-colored whispy fragments. Small volume about 5-6x per day, passing of only minimal gas. Abdominal pain almost constant though seemingly worsened by act of lying down, when sitting whilst hunching over (compressing lower abdomen/pelvis) and when pants/belt pressed tightly against abdomen. No food, only water days 1 and 2. Liquid (chicken soup) diet day 3. Days 4 through 5: Whole wheat bread, fish, cooked veggies, rice, bananas, XXXXXXX chicken, oatmeal...all tolerated well. BMs more solid/formed but still a bit soft and light in color. Abdominal pain subsiding over past 2 days to a general "soreness" (like things are healing?) of a "2" on a 10 scale with 10 being highest pain--and pain only occasional or positional (sitting/hunching). No fever, and gas passage greatly increased both out of rectum and throat. Day 6 and into Day 7: I got over-confident (in retrospect) and ate a meatball sandwich for lunch and 4 slices of pepperoni pizza 8 hours later. Within 1 hour of dinner, developed the same abdominal pain as described above (ranging from 3/10 to a 6/10), moderate abdominal pressure and no gas passage. No BM so far. No fever. Also, the pain is crampy in feel, fairly dull and sometimes it feels like the pain radiates down to my pelvis and occasionally the penis. When I drive, if the car goes over a big bump or I'm thrown a bit side-to-side, the pain increases. Thank you so much for your assistance!
Posted Wed, 5 Dec 2012 in Digestion and Bowels
Answered by Dr. Charles S Narasi 4 hours later
Looks like you have multiple health issues.
Most important of all is, that you are overweight
for sure and you need help with losing weight.
You should have a complete metabolic panel of
blood tests , stool examination for blood.
You do need to see a good nutritionist or a dietician
and get on a proper diet and excercise regimen.
As for your abdominal pain, by the location, I think
you might have diverticulosis or pockets on your
large bowel or colon on the left lower side called
sigmoid area. You may have a low grade infection
causing the low grade fever, abdominal pain, and
change in consistency of stool also.
If you have not seen a gastroenterologist, I suggest
plese do so and have him or her perform a colonoscopy
and determine if you have problems. Before you have
this, you may have your doctor send you for a CT-Scan
of the abdomen.
You must work with your doctor and try to lose weight.
If you have tried different diets unsuccessfully , you may
even need a gastric bypass surgery or other procedures
available. You should look into these as well.
I am concerned about your blood sugar. If you have
Type-2 diabetes , that needs to be treated properly.
Ultrasound examination of your liver and gallbladder
may show fatty liver or gallstones.
I know, you might be alarmed about all the suggestions
that I have outlined, but you are only 40 years young and
I would like you to live to be a healthy and productive
to a ripe old age.
I wish you the very best.
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