36, Male, Caucasian. Canada. No Previous Relevant Medical History. No

Posted on Fri, 22 Mar 2019

Question: 36, male, Caucasian. Canada. No previous relevant medical history. No current medications, besides cannabis prescribed for insomnia. Quit smoking cigarettes, two drinks a day. In fall 2017, I began experiencing pain in my lower right abdomen, below and to right of my navel. I attended a family physician about this, and he referred me to a surgeon. This pain is constant, not relieved by anything. The only time it doesn't hurt is first thing in the morning, before I get out of bed, but as soon as I start moving around it begins hurting and does not stop. Sometimes it radiates to the centre of my abdomen, or up under my ribs on the right side, but the main pain centre is directly where my appendix is. I've had ultrasounds all over my lower abdomen, x-rays of same, a CT scan, and an MRI. The CT scan revealed a somewhat enlarged appendix. No other tests revealed anything abnormal. I was then referred for a colonoscopy about 8 Mo's ago (mother had colorectal cancer), which found a benign polyp which was removed and tested. They also sent a sample of my appendix for testing, which revealed no unusual pathology. In other words, I passed the colonoscopy and have to assume (and hope!) that colon cancer is not a culprit based on this result. I should mention, most bowel movements that I have are generally flattened in shape. This pain remains intense and is drastically interfering with my day to day life, as well as the apprehension surrounding not knowing what this is. Two weeks ago I had an episode of extreme stomach cramps, which was followed by a bout of diarrhea. Since then, I have had issues with constipation. I'm not sure if it's related to my abdominal pain, but it seems too coincidental. This episode has been accompanied by lots of gurgling sounds from all over my abdomen, for a couple weeks now. I will be happy to respond to any further queries on this matter.

Answered by Dr. Ramesh Kumar (5 hours later)

Brief Answer:
A case of dyspepsia very likely as all scans are normal.

Detailed Answer:
Hello and Thanks for being on 'Ask A Doctor' service.
I have gone through your query.

As almost all your scans are normal the problem seems to be physiological and not pathological.

To understand the mechanism-
Our gastrointestinal tract has a forward movement (peristalsis). If somehow this movement gets hampered, food along with the digestive juices would stagnate, stomach acid will reflux into the food pipe causing pain and inflammation which may radiate under your ribs.

In order to relieve yourself, please do the following:

* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Avoid alcohol intake (if at all do).
* Take Omeprazole 40mg once daily before breakfast. It's over the counter.
* Take plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like ispaghula/psyllium husk or senna.

* Regular morning walk and exercise to keep the bowel movements proper.
* Take curd or yogurt on daily basis. It contains beneficial bacteria and should help.
* Stress reduction has a very important role to play. Yoga and meditation should help.

*Take a probiotic daily. Take probiotic containing yeast like Saccharomyces as they remain unexpected by antibiotics. The best one is Econorn one XXXXXXX a day.

*Gurgling sound is suggestive of formation of a lot of gases. Take activated charcoal tablets to get rid of gases. It's over the counter.

Hopefully, that should help.

Let me know if I could help further.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ramesh Kumar (14 hours later)

Thank you so much! I will submit two more related questions, and then be done and offer my sincere appreciation. First question: Does it make sense that a condition such as you've described above can last constant for almost two years, every day?

Answered by Dr. Ramesh Kumar (14 hours later)

Brief Answer:
follow up.

Detailed Answer:
Hello again my dear patient,
Yes off course if not diagnosed and treated properly then this problem could be there for decades.Dyspepsia is an umbrella term which covers multiple symptoms and require proper treatment and timely diagnosis.Earlier it is diagnosed the better for the patient otherwise the symptoms become chronic and treatment may take months.
Just for e.g suppose you have a blockage in your heart initially it would be less but if its not diagnosed and treated properly then symptoms would keep on increasing every year and so would be the intensity of problem.
Hope i was easy to understand and clear,
Let me know if i can help you,
Thanks and do rate the answer.

Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng