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Suggest Treatment For Diarrhea, Cramps And Hematochezia While Having Fallopian Tube Obstruction
Question: Over the past year I have had occasional episodes of severe stomach pain that lasts on average 6 hours, I can relate these episodes back to something that I ate an could not digest, cherries and fried chicken, lettuce, bell peppers. a few months ago I started having constant heartburn and stomach pain two finger widths above my belly button. I have also had constipation followed by diarrhea for about a year. In August my general practitioner sent me for a colonoscopy that was normal. About 6 weeks after the colonoscopy I started having constant pain in my lower right abdomen around near where the right ovary would be accompanied my vaginal bleeding when I would have a bowel movement. I went to my gynecologist and she did two ultrasounds and discovered that my right fallopian tube was blocked with inflammation and I had small cysts on the ovary. She took both tubes and ovaries out laporoscopicaly and also did a d&c because the endometrial lining was too thick. She assumed that this was the cause of the lower right side pain. However the pain did not go away. It has been 5 weeks since surgery and the pain has only increased. This past week I had another episode of the stomach hurting with diarrhea and intense stomach cramps. I went to my GP and he said it was probably gastritis. 3 days later on Wednesday I passed a significant amount of bright red blood rectally. I went to the ER and they did a CT and X rays which showed only a small place of enteritis. Blood tests were normal. Stool test showed blood in the stool. Urine test showed blood in the urine. At the same time I started bleeding heavily again vaginally. It had almost stopped. During this time I have had 2 CT scans, xrays and blood tests which show nothing abnormal. I have been on hormone replacements for 4 years because I was peri menopausal prior to the surgery. I take no long term medications other than thyroid replacement hormones, pro-biotics with fish oil, and vitamin D, My gynecologist nor GP have any idea what is wrong with me, nor did the ER doctors. What do you think it is?
Brief Answer:
Please give additional information.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
To recapitulate salient points:
Female/54 - on HRT, Thyroid hormone and others - GP and Gynecologist clueless about the problem - CT, X-ray, blood normal - except small place of enteritis - USG in past showed rt blocked Fallopian tube and small cyst on ovary - Gyne excised both tubes and ovaries by Lap and D&C - 5 weeks and the pain increased - past week > diarrhea and cramps and blood in stool - Stool and urine both showed blood - and vaginal heavy bleeding - Over the year there is severe stomach pain the last for 6 hours - related with particular foods as noted - 3 months > heartburn and pain 2 fingers above belly button - Constipation followed by diarrhea for 1 year and for the last 3 months had pain in the right lower abdomen too.
Read the complete history repeatedly and got some points of note:
- Constipation followed by diarrhea but colonoscopy had ruled out any malignancy in the colon.
- HRT, hormone replacement therapy and thyroid treatment. HRT gives a long term effect on the uterus, and related organs and has direct relation to the hormonal balances and feedback mechanism.
*HRT can have varied complications. Many are known, some unknown.
I would like to know a few details so that we can discuss further:
- What is the type of pain >burning, twisting, throbbing, cutting or so?
- Any reference of pain to the back, legs?
- Any associated nausea, vomiting or bloating? (you have mentioned about bowel habits)
- Has the Gynecologist thought about Endometriosis or stopping HRT and see the results?
- Any other information you would like to share which in your opinion may be or even may not be related to the problems you have noted above?
- What about the histopathological diagnosis of the removed tubes and ovaries, any disease they have told you? Please post the reports of histopathology as it may give me a clue.
Awaiting for your feedback.
Post any positive reports.
Please give additional information.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
To recapitulate salient points:
Female/54 - on HRT, Thyroid hormone and others - GP and Gynecologist clueless about the problem - CT, X-ray, blood normal - except small place of enteritis - USG in past showed rt blocked Fallopian tube and small cyst on ovary - Gyne excised both tubes and ovaries by Lap and D&C - 5 weeks and the pain increased - past week > diarrhea and cramps and blood in stool - Stool and urine both showed blood - and vaginal heavy bleeding - Over the year there is severe stomach pain the last for 6 hours - related with particular foods as noted - 3 months > heartburn and pain 2 fingers above belly button - Constipation followed by diarrhea for 1 year and for the last 3 months had pain in the right lower abdomen too.
Read the complete history repeatedly and got some points of note:
- Constipation followed by diarrhea but colonoscopy had ruled out any malignancy in the colon.
- HRT, hormone replacement therapy and thyroid treatment. HRT gives a long term effect on the uterus, and related organs and has direct relation to the hormonal balances and feedback mechanism.
*HRT can have varied complications. Many are known, some unknown.
I would like to know a few details so that we can discuss further:
- What is the type of pain >burning, twisting, throbbing, cutting or so?
- Any reference of pain to the back, legs?
- Any associated nausea, vomiting or bloating? (you have mentioned about bowel habits)
- Has the Gynecologist thought about Endometriosis or stopping HRT and see the results?
- Any other information you would like to share which in your opinion may be or even may not be related to the problems you have noted above?
- What about the histopathological diagnosis of the removed tubes and ovaries, any disease they have told you? Please post the reports of histopathology as it may give me a clue.
Awaiting for your feedback.
Post any positive reports.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes there has been bloating over the past year. Nausea and vomiting only with this last episode. The pain in the stomach is stabbing/cramping. The pain in the lower right abdomen is steady and constant but not burning or throbbing. There is no pain in the back or the legs. Pathology reports all came back normal. Only showing inflammation in the tubes. There was no endometriosis. Perhaps the gynecology problems are not related to the digestive problems?
Brief Answer:
Enteritis or IBS as discussed below.
Detailed Answer:
Thanks for your feedback.
Noted the history of bloating, stabbing /cramping type pain in abdomen but steady and constant in right lower, Patho showed only inflamed tubes > no specific cause found, no endometriosis.
This indicates that you may be suffering from enteritis of some sort and has been shown on CT scan once, as is mentioned above.
I think this should be investigated by
Enteroclysis under fluoroscopy control to see real-time passage of barium.
If all the investigations are within normal limits, the ultimate diagnosis that remains can be irritable bowel syndrome and a proper medication should solve all the problems.
Please discuss these points with your Doctor or Gastroenterologist and get a reference for Gastro-Surgeon or a General Surgeon. He would definitely help to come to a proper diagnosis and proper treatment.
I hope this answer helps you further.
Enteritis or IBS as discussed below.
Detailed Answer:
Thanks for your feedback.
Noted the history of bloating, stabbing /cramping type pain in abdomen but steady and constant in right lower, Patho showed only inflamed tubes > no specific cause found, no endometriosis.
This indicates that you may be suffering from enteritis of some sort and has been shown on CT scan once, as is mentioned above.
I think this should be investigated by
Enteroclysis under fluoroscopy control to see real-time passage of barium.
If all the investigations are within normal limits, the ultimate diagnosis that remains can be irritable bowel syndrome and a proper medication should solve all the problems.
Please discuss these points with your Doctor or Gastroenterologist and get a reference for Gastro-Surgeon or a General Surgeon. He would definitely help to come to a proper diagnosis and proper treatment.
I hope this answer helps you further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Does IBS cause blood in the stool and in urine? Also, how does IBS affect the stomach to cause stomach pains or do you think that is a different problem?
Brief Answer:
IBS can co-exist with other problems.
Detailed Answer:
There can be co-existing problems. IBS can co-exist many other problems like the conditions causing blood in stool and the urine.
IBS per se may not cause these.
IBS is a syndrome- this is irritable bowel syndrome, irritation can be caused by mere anxiety, stress, thoughts or to some foods, that can cause enhancements at some or the other times and not always. This is in contrast to intolerance to a particular food or beverage wherein the problems will always commence on its consumption.
Hence whenever there is an instigating factor that causes IBS is present, the intestines respond by hypermotility that causes the pains.
To repeat. IBS is thought to be present when all the investigations are necessarily normal and there is a history of instigating or enhancing factors like stress and/or anxiety and so on.
Please take the reference of our previous discussion to get the proper threads of communication.
IBS can co-exist with other problems.
Detailed Answer:
There can be co-existing problems. IBS can co-exist many other problems like the conditions causing blood in stool and the urine.
IBS per se may not cause these.
IBS is a syndrome- this is irritable bowel syndrome, irritation can be caused by mere anxiety, stress, thoughts or to some foods, that can cause enhancements at some or the other times and not always. This is in contrast to intolerance to a particular food or beverage wherein the problems will always commence on its consumption.
Hence whenever there is an instigating factor that causes IBS is present, the intestines respond by hypermotility that causes the pains.
To repeat. IBS is thought to be present when all the investigations are necessarily normal and there is a history of instigating or enhancing factors like stress and/or anxiety and so on.
Please take the reference of our previous discussion to get the proper threads of communication.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
ok thank you!
Brief Answer:
Thanks for your appreciation
Detailed Answer:
You are most welcome!
...
You may please rate this answer before closure of the discussion and can certainly contact me on the bellow link in future, whenever you may need me.
XXXX
Thanks for your appreciation
Detailed Answer:
You are most welcome!
...
You may please rate this answer before closure of the discussion and can certainly contact me on the bellow link in future, whenever you may need me.
XXXX
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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