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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Constipation With Chronic Back Pain And Abdominal Pain

I m a 39 yr old, anglo-saxon, female (a out 30 lbs over-weight), and I ve had chronic back pain for over a year (around the centre if my back and the area near the spine and shoulder blade). It aches and feels numb . For just as long, I ve had severe constipation and right upper abdominal pain. Worse when breathing in. Occasionally, I notice bright, red blood on tissue after wiping after BM. In the last 2 months or so I have noticed black/dark spots in my very narrow, pencil-thin, stools (stools have been narrow for over a yr, also) but, now these spots are present. Other symptoms/details are: I m tired all the time, blood work normal (aside from Egrf {renal function} of 56), ct normal of abdomin (found burst ovarian cyst on right side), spinal MRI normal (bulging discs-Dr not concerned), normal ultra-sound, and normal colonoscopy. All these tests were performed in the last 90-120 days. My Dr is at a loss. I am in chronic pain and no relief for a over a year. No change in diet, pills/meds, stress(ers), or anything worth mentioning. I also have difficulty emptying my bladder during this past yr. I ve added flax seed to cereal, increased water, decreased meats, and generally just been trying to eat healthier . No real relief or positive changes. I ve had diarrhea only a handful of times in the past yr.. It is generally bright-yellow, watery, contains a lot of mucous , and burns like I ve just sh*t tobacco sauce. What other direction can I insist my dr take? I live in CAN and switching drs is next to impossible! Thank you in advance!!!
Fri, 22 Feb 2019
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General Surgeon 's  Response
Hi,

Noted the history in details and understood your concerns.
Since you CT scan of abdomen and Colonoscopy are normal there is no cancer of colon that is causing the present symptoms.
The pain in right upper abdomen can be due to colitis and most probably irritable bowel syndrome, IBS in short, as there is no actual obstruction.
The pain in the rib area can be due to costochondritis.
Both the things are related to the stress and anxiety.
The pencil shaped stool indicates anal canal narrowing hence needs review by a Proctologist.
The blood in stool can be due to fissure in ano or hemorrhoid secondary to constipation/ hard stools.
Also get stool tests for 3 days and get treated accordingly.
You will have to try different stool softeners and laxatives to see which suits you and in what dosages thence to continue till you are relieved of symptoms.
As you have mentioned the low back ache over the spine and in cervical area can be due to local causes and an Orthopedic Surgeon or a Neurosurgeon can help you better for proper clinical examination and management.


Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. T Chandrakant, General Surgeon.
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Suggest Treatment For Constipation With Chronic Back Pain And Abdominal Pain

Hi, Noted the history in details and understood your concerns. Since you CT scan of abdomen and Colonoscopy are normal there is no cancer of colon that is causing the present symptoms. The pain in right upper abdomen can be due to colitis and most probably irritable bowel syndrome, IBS in short, as there is no actual obstruction. The pain in the rib area can be due to costochondritis. Both the things are related to the stress and anxiety. The pencil shaped stool indicates anal canal narrowing hence needs review by a Proctologist. The blood in stool can be due to fissure in ano or hemorrhoid secondary to constipation/ hard stools. Also get stool tests for 3 days and get treated accordingly. You will have to try different stool softeners and laxatives to see which suits you and in what dosages thence to continue till you are relieved of symptoms. As you have mentioned the low back ache over the spine and in cervical area can be due to local causes and an Orthopedic Surgeon or a Neurosurgeon can help you better for proper clinical examination and management. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T Chandrakant, General Surgeon.