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What causes abdominal pain and loose black stool?

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General & Family Physician
Practicing since : 2009
Answered : 6181 Questions
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I have had abdominal issues since the end of April. It all started the night of Easter I had a fish dinner. After a month of loose black stools and middle upper abdominal pain I saw my doctor. She checked my blood and saw my lipase level was slightly elevated at 75. 1 week later it went back to normal. At that point (75) it was 2 weeks after my "attack" of severe pain and abnormal stools. So maybe the numbers would have been higher??? Following that blood work I had an ultrasound, CT of the abdomen and pelvis, echocardiogram, MRI of the abdomen and even an endoscopy. ALL CLEAR! No ulcers, Celiac, tumors, cancer, gallstones etc. my pain was always like burning or heaviness in the area one feels indigestion and it would slowly spread throughout my belly. Then one day (3 months in) I only felt pain right at the gallbladder (MRI showed no gallstones). I had two other attacks (severe emergency room worthy pain) and sure enough the lipase was elevated. I know some people just have high lipase levels (my gastro said) but I am dying to know what another medical professional thinks. That pain in the one spot disappeared but I am worried a fourth attack will occur and more importantly want to know what the hek it is. I told my doctor back in April that I thought I had parasites and they all thought I was nuts. A couple of days ago she said "I think even I am convinced it is parasites. Something is causing the duct to be blocked which then inflames your pancreas and it is not gallstones." I am going to start parasite treatment in 2 days just to see if it works. The only other thing besides the weird bowels (microscopic white spots and 1/8 inch clearish brownish wormlike things) and abdominal pain is I feel like my veins are more enlarges than normal. Not saying it is connected but just in case. I also lost 5 lbs (never deviated from 117 in 15 years) in the last 3 months
Posted Sun, 31 Aug 2014 in Abdominal Pain
 
 
Answered by Dr. Chobufo Ditah 2 hours later
Brief Answer:
Resembles bouts of recurrent pancreatitis!

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about these symptoms that you have mentioned. What makes it more concerning is the fact that a definite diagnosis has not been made and thus no treatment with goal to address it once and for all has been proposed.

I beg to differ with what your GI said that some people just have high lipase. Persons who have high lipase would always have high lipase rather than have elevated levels during pain symptoms that return to normal some time later.

I am of the opinion that the pancreas needs to be carefully evaluated. This is very true as the symptoms and lipase levels suggest so. Unfortunate, the possible reason for having attack has not been identified. Some are provoked by fatty meals, alcohol, stress, medications, etc.?have you ever had any such experience? Also, are your stools normal or have you witnessed any changes?

Could it be related to worms? A possibility. Why not do a stool examination before treatment. In any case, treatment for most worms is a single dose and would tell whether that is the cause or not depending on the response to treatment.

In all, symptoms possibly from the pancreas. Cause should be probed into and managed accordingly. Unlikely to be related to gallstones as none were seen on multiple imaging tests.

I hope this helps. I wish you well. Feel free to ask for more information and clarifications if need be.
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