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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest medication for constipation and gastritis

25 yr male, no notable medical history. For the past month, though only occurring maybe once a week, I've been experiencing slight/very dull burning/pressure/gas in lower left stomach, which is somewhat bloated. I have a high-stress job, and for the past month I've increased my drinking of coffee to 2-3 a day (from 1 cup per day), plus roughly two glasses of Kombucha (non-homeade) a day. This past weekend, I noticed the sensation in my lower stomach a bit more stronger, though on a pain scale of 1-10, I'd give it a 2 - it's just annoying and discomforting. It feels like a combination of gas and slight pressure in my lower stomach, and a little bit into the groin. It's lasted for a few days now, mainly flaring up after I eat lunch though the night, though it seems to be gone when I wake. I've tried to remedy it with a few doses of Pepto Bismol, but it didn't seem to work. Couldn't really pass gas, and just now I noticed that my stool is basically black, though soft - almost intestine-shaped, and not tarry/runny. Know Pepto can cause it to be black, but the sensation as described is still present. Haven't felt this really before (prior to a month ago), as when I have gas, it's usually not this low in the body.

Any idea what this might be?

I will be setting an appt with a doctor, but just wanted to get a 2nd opinion, hopefully in the interim.
Sat, 22 Feb 2014
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General Surgeon 's  Response
So to summarize, you've been having "stomach ache" & bloating for about a month or so, made worse by food. +coffee use. If my pt presented with these symptoms I'll find out the following.
- do you smoke?
- any weight loss?
- do you go to bed shortly after you eat, if yes, ever noticed any different when you stay up for at least an hr or 2 before going to bed?
If I were seeing you as a patient, I'll be thinking of possible Gastroesophageal reflux diseases (GERD) or a peptic ulcer or a tumor (less likely).
I'll recommend a trial of H2 blockers such as pepcid or a proton pump inhibitor such as omeprazole. If this doesn't improve within 2 weeks to a month of the above treatment , I'll strongly consider getting an Esophagogastroduodenoscopy (EGD).
As you earlier mentioned, pepto bismol will cause dark stools and even constipation. At your age, except given some familial predisposition, cancer is less likely. Hope this helps.
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