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Pain in stomach radiating to back. Had ultrasound done. Is it IBS or something else?

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Hello Doctor! I am 27 years old male. I have been having strange pain sensation (altering from piercing pain to dull pain, sometimes it feels as if it would be a solid rock) in my right side of stomach for 6 years, probably in the ascending colon. (Sometimes below the right rib in the corner, rarely the pain radiates to my back and feel a sudden sharp pain while leaning onwards for instance.) When I touch or push my belly's right side externally, or when the gas moves trough, I can feel that area is very sensitive. There are good and bad periods alternating each other. Bad periods lasts about 2-4 weeks. Pain is also not constant during a bad day. Morning better, later worse. Pain come and go and return during a course of seconds.

I have been scanned by ultrasound multiple times, had 2 colonoscopies, had a contrast-agent x-ray scan. They have found nothing so far. I had my appendix removed but to no avail. Stool content checked against bacteria etc. Got no fever, no diahorrea, only sometimes a sudden surge of bowel movement. Blood tests told nothing particular. No sure sign of blood. No sudden and significant weight-loss. My appetite is good.

My gastroenterologist is inclined to say it is IBS but he is not sure as my symptoms are not typical to any disease. What I see in his eyes that he has no alternative answer to my symptoms so makes this diagnosis.
Do you have any similar experience during your tenure? Something that could serve as an explanation, something could best describe my symptoms? Or any guess? Thank you in advance and Kind Regards from Hungary.
Posted Sat, 27 Apr 2013 in Digestion and Bowels
Answered by Dr. Charles S Narasi 2 hours later

Your location of pain being on the the right side of the abdomen and your description of gas moving through when you press on that area indicates that you have a slow contraction of the colon. Especially, if the gas gets trapped in the part called the "Hepatic Flexure" , you can have intense pain for a few minutes until the gas moves from that area. This part of the colon is close to the liver. I am glad that your doctor has ruled out a lot of conditions including any polyps or colitis or ulcers. The sonograms have been normal too. There has been no blood in the stool. All these are good. Even though you don't mention severe constipation or diarrhea, I agree with your doctor that you have a type of IBS. At this point you may not have all the typical symptoms, but it could be the beginning.

Also, you are young and probably very active and under a lot of stress. This could certainly add to your symptoms. I want you to try and practice relaxation methods, even yoga or meditation. Eat a healthy diet with lots of fresh fruits and vegetables. Avoid excess caffeine, alcohol,tobacco etc.
Regular exercises would also help.

I can assure you that you don't have cancer or anything horrible. Try to have daily fiber supplements like Syllium containing powder, a tablespoon a day with a full glass of water or juice.

Hope this helps you.
I wish you the very best.
Above answer was peer-reviewed by
Follow-up: Pain in stomach radiating to back. Had ultrasound done. Is it IBS or something else? 1 hour later
Thank you Doctor Narasi.

Just one more thing. My sensation is that the pain I feel does not come from inside out, but from the outside rim to inward. But this may only be a sensation and thus false. What is more important is that when I press the area anytime in the 'flare' period I can feel the pain - at different points -, not just when gas moving trough. I usually sense pain, piercing or sharp pain everywhere (i am able to pin-point them sometimes) around the ascending colon area, however not simultaneously. Most of time it is around the Ileum, Caecum and a bit higher toward my liver. (When I wrote the initial mail to you it was around the coecum, now, after having a lunch, I feel it below the right rib and on the right side of the colon, close to my waist. Is this still normal for IBS?

A radiologist once told me after a sonogram that he is on a educated guess that my small intestine may slip into my large intestine or the other way round. Due to this, a valve between the two gets inflamed and spread-out. Although he got no clear vision of that. In addition to that earlier, they seen my appendix at different places whenever they looked on and that my bowels moved relatively free.

Fortunately there is neither sever constipation or diarrhea. My stool most of the time is porridge like (i think that is the term when it is both solid and loose. There are solid parts between looser parts.). Rarely, waterish or constipated.

All things considered, do you think that these indicates no further examinations and my fiancee and me can safely have babies without having gloomy thoughts?
The thought itself drives me crazy sometimes that 'what if this is serious?'.

I don't smoke and drink alcohol once in a blue moon. I eat a lot of veggies, fruits and my diet I think is healthy. I don't exercise or meditate regularly although. I will try your recommendations out, nevertheless.

Thank you so much for your help again!

Best Regards, XXXXXX
Answered by Dr. Charles S Narasi 1 hour later

As for your small intestine going into large intestine, that condition
is called intussuception which can cause obstruction and is serious.
I don't believe that you have it. As for sensation from the skin
outside to inside, sometimes nerve endings can get irritated from
distension and can give you that sensation. I think, you are a thinker
and try to analyze too much. Please try to relax and have good times
with your fiancee.

You can have healthy babies and live to be reaching a ripe old age !

I wish you the very best.
Above answer was peer-reviewed by
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