Been Having Nonstop Intestinal Noises (around Bellow Button Area )

Posted on Sat, 13 Jun 2020

Question: Been having nonstop intestinal noises (around bellow button area ) , mostly lower right quadrant, every day since December (not a day without them ). Sometimes noises are felt in upper quadrant too but most times it’s lower. Often accompanied by gas after meals. Seem worse after eating but present even before eating. Accompanied Symptoms : Single episode of diarrhea once every week or two, stools are lighter brown in bowl but yellowish on wipe , stools are a bit looser but most of the time intact (sometimes they are like shredded wheat), time to time I feel a pressure type feeling in lower left quadrant (like you’d feel after sit ups ). Had a very mild nauseous feeling for a few months (never close to throwing up. Very subtle ) as well as not on the mood for breakfast or lunch.

Medical history : 32M. Had CT scan with contrast of entire abdominal (no abnormalities noted), colonoscopy ( random biopsies normal ) , EGD (Mild stomach inflammation attributed to gastritis shown on biopsy ), blood work (lipase was 2x normal limit on 10/31. Tested again 12/1 and 2/3: normal. CBC normal ), FIT tests normal , stool samples all negeative for inflammatory markers. Gained 24 pounds from Oct 19- March 20 )

Any advice or recommendations for what I should do next ? Is it safe to rule out life threatening issues with pancreas after CT scan ? The persistence of the noises are the most concerning to me . Thank you

Follow up: Dr. Ramesh Kumar (0 minute later)

Been having nonstop intestinal noises (around bellow button area ) , mostly lower right quadrant, every day since December (not a day without them ). Sometimes noises are felt in upper quadrant too but most times it’s lower. Often accompanied by gas after meals. Seem worse after eating but present even before eating. Accompanied Symptoms : Single episode of diarrhea once every week or two, stools are lighter brown in bowl but yellowish on wipe , stools are a bit looser but most of the time intact (sometimes they are like shredded wheat), time to time I feel a pressure type feeling in lower left quadrant (like you’d feel after sit ups ). Had a very mild nauseous feeling for a few months (never close to throwing up. Very subtle ) as well as not on the mood for breakfast or lunch.

Medical history : 32M. Had CT scan with contrast of entire abdominal (no abnormalities noted), colonoscopy ( random biopsies normal ) , EGD (Mild stomach inflammation attributed to gastritis shown on biopsy ), blood work (lipase was 2x normal limit on 10/31. Tested again 12/1 and 2/3: normal. CBC normal ), FIT tests normal , stool samples all negeative for inflammatory markers. Gained 24 pounds from Oct 19- March 20 )

Any advice or recommendations for what I should do next ? Is it safe to rule out life threatening issues with pancreas after CT scan ? The persistence of the noises are the most concerning to me . Thank you

Answered by Dr. Ramesh Kumar (33 minutes later)

Brief Answer:
Right now no need for further investigations.

Detailed Answer:
Hi,
Thanks for asking on HealthcareMagic.

I have gone very carefully through your query. Your problem seems to be due to gastritis or gastroesophageal reflux. Our gastrointestinal tract has a forward propulsive movement (peristalsis) that moves the food material forward as it is digested, absorbed and finally expelled as feces. If somehow this movement gets hampered, food along with the digestive juices would stagnate, stomach acid will reflux into the food pipe and on the other hand the bowel habits would not be proper. Degradation of undigested food in the intestines by the intestinal bacteria would lead to the excess gas formation.This is the cause of excessive bowel sounds.

In order to relieve yourself, you need to do the following:
* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Avoid alcohol intake (if it a part of your habit).
* Continue to take omeprazole once daily before breakfast.
* Take plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like isabgol/psyllium husk or senna. I would insist you to increase your dietary fiber intake.
* Regular morning walk and exercise to keep the bowel movements proper.
* If I had a patient like you I would perhaps have suggested Prodep (fluoxetine) 20 mg tablet (long term anxiolytic and a prescription drug) once daily for at least 2 months (it may take time for the action to set in). Discuss about this with your treating physician.
* 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.

You have already been tested a lot.No further test is recommended.
Follow the advice for 2 weeks and revert back.

Hopefully that should help.

Let me know if I could help further.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Ramesh Kumar (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Ramesh Kumar (22 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi there,
Ranitidine is one of the safest drug in medical history.Even I am on Ranitidine from last 10 years and I don't think it has caused any side effect.The side effects mentioned on Google are not usually seen practically.
Omeprazole and pepcid belongs to the same class of medication.Its just like saying whether window seat or aisle seat of a craft is better.....I mean both are same just having a slight different orientation of molecules you can take any one you want.
For issue regarding pancreas best sure shot test is CT pancreas.
Just elevated level of lipase don't signify any thing.
Hope this answers your query well.
Feel free to follow up on direct link.
http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660
Regards.

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Ramesh Kumar (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ramesh Kumar (2 minutes later)

Thank you, Dr. XXXXXXX I have stated on your recommendations and am looking forward to improvements. I have an appointment with my treating physician next week so I will definitely ask about the anxiety medication. If I could please ask a follow-up question:

In 2014, I was prescribed 150mg daily ranitidine to treat heartburn/GERD. Took it everyday since until last year (government recall). Is there any concern any of these symptoms could be caused by a complication from that medication? Is a high lipase level on that blood draw in October of any significance to these symptoms (only reason I was concerned for pancreas)? Is omeprazole better than Pepcid (both OTC here and I have both) for these issues (such as yellow stool color on tissue )?

Thank you kindly.

Follow up: Dr. Ramesh Kumar (0 minute later)

Answered by Dr. Ramesh Kumar (32 minutes later)

Brief Answer:
Follow up.

Detailed Answer:
Hi again,
Yes it's the same and of it's normal calm down sleep tight your pancreas is working perfect.
Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Ramesh Kumar (0 minute later)

Brief Answer:
Follow up.

Detailed Answer:
Hi again,
Yes it's the same and of it's normal calm down sleep tight your pancreas is working perfect.
Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ramesh Kumar (4 minutes later)

Thanks, doctor. The CT test you mentioned ... is that the same thing as CT with contrast that included pancreas that the ER did on me ? (It also covered stomach , lymph nodes , lower lungs , etc ).

Follow up: Dr. Ramesh Kumar (0 minute later)

Thanks, doctor. The CT test you mentioned ... is that the same thing as CT with contrast that included pancreas that the ER did on me ? (It also covered stomach , lymph nodes , lower lungs , etc ).

Follow up: Dr. Ramesh Kumar (2 days later)

Thanks, doctor. In closing could i trouble you with just a couple last questions ?

The lighter brown stool which looks yellow on the tissue when I wipe (about 6 weeks now), is that any cause for concern ? (HIDA scan normal for gallbladder )

I notice in addition to the intestinal noises I mentioned in original post, it also looks like my
Lower gut (around belly button) is pulsating. (I can see it ... almost like a slight persistent spasm) Enough to notice it. Normal symptom with the previously discussed ?

You’ve been most helpful. Thank you so much.

Follow up: Dr. Ramesh Kumar (0 minute later)

Answered by Dr. Ramesh Kumar (2 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi again my dear,

Please feel free to ask as many queries you want to I would be glad to answer.

All colors of stools from yellow(Different shades) to black to green are normal(except white and tarry black).

Just try to get some tablets of activated charcoal from the nearest pharmacy. It absorbs extra intestinal gas.
Take 2-3 tablets 4 times a day.
Eat Very light food preferably home-cooked.
If the problem of the sensation of pulse continues even after taking it for 3-5 days revert back.

Hope I was helpful.
Follow-ups are welcome.
Thank you and get well soon

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

Answered by Dr. Ramesh Kumar (0 minute later)

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

Follow up: Dr. Ramesh Kumar (2 days later)

Thank you, doctor. I really appreciate your replies. Another thing ive noticed with the stool is for the last 6-7 weeks, my stools have pieces of undigested foods in them. Is it normal for this to be happening every day? Prior to 6-7 weeks ago, my stool was always the typical brown look. As mentioned, the stool looks lighter brown but on the wipe it appears yellow.

Follow up: Dr. Ramesh Kumar (0 minute later)

Answered by Dr. Ramesh Kumar (22 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hey there,
For that I would suggest you to take light home cooked food for few days. meat and fats.
Eat vegetable fruits and salads.
Take lots of yoghurt.
You could also take few enzyme to aid digestion available over the counter.
Regards!

Above answer was peer-reviewed by : Dr. Yogesh D

Answered by Dr. Ramesh Kumar (0 minute later)

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ramesh Kumar (7 days later)

Hi, Dr. just wanted to follow up after your suggestions of charcoal and light meals and ask another question. So the appetite is still iffy but Slowly coming back. The noises have significantly decreased. I had a few more tests come back and was hoping to get your thoughts :

Stool tests for fecal fat and pancreatic elastase were normal. However , lactoferrin was 9.14 which says high ( normal reference range of 0- 7.24). With all we’ve discussed , Is this high result of any concern ?

Follow up: Dr. Ramesh Kumar (0 minute later)

Answered by Dr. Ramesh Kumar (29 minutes later)

Brief Answer:
No significance.

Detailed Answer:
Hi again,
No significance.
There are millions of parameters in our body and every thing could not be perfect at all times.
A famous saying is that a doctor treats symptoms and not numbers.
So just follow the things suggested for few more days and you would be fine.
Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Answered by Dr. Ramesh Kumar (0 minute later)

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ramesh Kumar (30 hours later)

Thank you, doctor. I really appreciate you being so kind to answer so many questions. My appetite through all this just hasn't been the same ... little interest in eating, some days no interest at all.... is this consistent with the other symptoms?

Follow up: Dr. Ramesh Kumar (0 minute later)

Answered by Dr. Ramesh Kumar (4 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi there,
In my initial answer I have given you some recommendations.
Have you started following them.
You need to follow them.
Take a probiotic daily.
You could add few digestive enzymes capsule to your diet.
Eat a soft diet consisting of apple,banana,toast etc for 3-5 days.
Avoid any spicy food for few days.
Take yoghurt in morning and evening.
No junk.
Your appetite would be back in 5 days.
What is your diet right now?
waiting for answer.

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Ramesh Kumar (0 minute later)

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ramesh Kumar (2 days later)

Thank you, doctor. I’ve been following the recommendations of course. Been eating a lot of leafy greens such as cabbage with beef or chicken , peanut butter in the morning with yogurt. Noodles. Mostly a Chinese diet — vegetables. Noodles. Rice. walnuts. Had vanilla ice cream a couple times. No spicy food — don’t like the taste anyway. Appetite starting to feel a little better ... hopeful it will come back to normal soon. Your recommendations have been great.

I did get back another test result B12 is on the lower end of normal (for my anxiety, I’m not googling) so will be adding an OTC supplement for 6 months. I’m assuming no concern with that being anything GI serious ? That B12 liquid is the only change from your recommendations (start tomorrow )— still doing IB guard, husk fiber , and charcoal.

Follow up: Dr. Ramesh Kumar (0 minute later)

Answered by Dr. Ramesh Kumar (36 hours later)

Brief Answer:
Follow up.

Detailed Answer:

Hi there,
Yes definitely things would improve but would take some time.
However few suggestion are try to avoid too much meat or peanut butter(both are heavy to digest for few weeks).
You can take lentils or soy for protein.They are easy to digest and would give time to rest to intestines.
Add a probiotic like VSL#3 to increase concentration of good bacterias in intestine.
This would make recover very fast.
Add a table spoon of wild honey raw to yoghurt..Honey being a good culture media for bacterias would increase the number of bacteria in yoghurt(good one) hence would itself act as a potent probiotic.
Noodles should not be made of fine flour as it sticks to intestine.Use wheat flour instead.
Soy sauce should be limited.
The complete idea is to help your intestines to recover by giving rest to them(taking soft easily digestible food) coupled with helping agents like probiotic etc.
The more you would adhere to this the better would be the recovery.
Now you could directly follow up on the link given in case you need any advice.
Get well soon dear.
http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Ramesh Kumar (0 minute later)