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Have Pain In Lower Right Side After Loose Bowel Movement. Taking Rymicin. Have Back Damage. What Else Can I Do?

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Posted on Sun, 9 Sep 2012
Question: Yes, having sever pain in lower right side, now on Rymicin, Entecort and Dopson. Pain occurs now once a week, after spasitic bowl movement, very loose, uncontroallable.

Also, raditing from back damage to L4-5 disck, pain down the left thigh and down the fron of my leg, taking 300mg Neurtointin 3x daily. What else can I do?
doctor
Answered by Dr. Shanthi E (3 hours later)
Hi,

Thanks for posting your query.

You seem to be suffering from two ailments here.

1. The pain in your lower right side of the abdomen.

2. The radiating pain from the back, down to left thigh and leg.

I also understand that you have undergone quite a few surgeries as well. It must have been difficult for you to bear these and I appreciate your efforts to go through them.

The pain in the lower right side of the abdomen is worrying me. You have had a surgery for twisted caecum earlier. I am unsure if it is a recurrence of it or if it is non-specific colitis now. In both cases, it would be ideal to do an ultrasound scan of the whole abdomen to conclude on the cause. It has to be managed accordingly. "Wait and watch" policy may not work here. I do not wish you to suffer the pain longer.

The pain from the back and leg is again worrisome as it has been for some time now and it is due to damage to the L4-5 discs. Did your treating doctor consider a surgery for this? In most of the cases, physiotherapy is sufficient to relieve the pain.

Neurontin is a very effective drug for management of this. You should continue taking it.

My suggestions to you:

1. Please get back to your take a calcium supplement on a daily basis as well.

5. Daily walking for about 20 to 30 mins is a good measure, if you are comfortable doing it.

I did not get the reasons for which you are on Rymicin, entecort and Dopson. Please let me know about it.

Do write back for further discussion on this.

I wish you get well soon and lead a healthy life again.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanthi E (18 hours later)
Rymicin, entecort and Dopson These were given for the pain in the abdomen. The specialist I have been seeing is a gastoentrist, who recently told me it would be called, Thyilistist, an ongoing inflamation of the bowel. Recently, the pain has been occuring once a week approx, after a spasm and large uncontrollable bowel movement. I cannot make it to the toliet sometimes. At least the pain is not constant anymore. Sometimes I have even used a cortisone supporitory to see if I can get any relief. But, the pain is quite sever, so I try to relieve it by taking anagelisics and even Disapaen 2mg. After my last colonsospy, it was advise the bowel areas were red and inflamed, with an ulcer on the illium. As the illum was cut, there was a tumor on it ffound on the cecumn surgery. So, I feel we are getting somewhere.
The back problem, I have consulted a suregon, but, in the meantime I also see a pain specialist that gives me injections, and uses the rhyazialize treatment to control the pain. After the last treatment one month ago, the pain down the leg returned, and I will see the pain speciallist soon to discuss it further.

doctor
Answered by Dr. Shanthi E (9 hours later)
Hi,

Thanks for writing the further details.

I agree with your Gastroenterologist's conclusion on Typhlitis. It is an aggressive disease with poor prognosis. It is commonly seen with reduced neutrophil count in the blood test.

Going by the details, I feel your general immunity has dropped down to a considerable level. It is not a good idea to use cortisone suppository as it further decreases your immunity. Please consider stopping its use.

You may take simple analgesics like Tylenol for pain. Typhlitis is commonly seen in patients who are receiving chemotherapeutic agents for tumours. I suppose there was a tumour on the ileum and it was excised, as you said.

There is a probability of recurrence of the same now. It is always better to do a prophylactic surgery to be on the safer side. I am not sure if the Surgeon did an elective right Hemicolectomy in you or not. I strongly feel the need for this surgery in you to get prompt relief from your symptoms. Please fix an appointment with your Gastroenterologist again and discuss about this option before complications arise.

I am sorry, but you need to act quickly here to get back things to normal. A CT scan of the whole abdomen is required to come to the conclusion and to decide upon the management plan.

Please work in close connection with your gastroenterologist regarding this and let me know the progress.

Your back problem seems a less severe problem for now. You may see the pain specialist as required.

Let me know if you have more concerns.

I wish you get well soon and lead a healthy life again.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanthi E (10 hours later)
Typhlitis
Hi, can you please explain what the Typhlitis is? As I have had no explaination from my gastro. Also, when I was asking for the colonospy, he would not do it, so, I had to go to someone else for one. It was at that point that it was found I had the ulcer on the illiumn. Also the original surgery for the tumor on the illiumn was in 1986, so, the ulcer must have been coming and going.

doctor
Answered by Dr. Shanthi E (4 hours later)
Hi,

Thanks for writing back.

Typhlitis is a condition where there is inflammation of the whole caecum. It is commonly seen in patients receiving chemotherapy for tumours. In almost all of the cases it is associated with low counts of blood neutrophils, also called Neutropenia.

It is also seen in patients on chronic therapy with antibiotics and steroids which alter the bacterial flora in the colon. You are on Rifampicin, dapsone and entecort which are antibiotics and steroids. You must speak about tapering the doses and stopping these drugs with your gastroenterologist.

Uncontrollable diarrhoea is a common feature in more than 50% of patients with Typhlitis.

Colonoscopy is usually not done in Typhlitis in view of risk of colonic perforation.

At the present moment, it is wise for you to get a CT scan of the abdomen done, look for any residual ilial tumour and consider elective Hemicolectomy, if need be.

Hope this helps you.

Regards,


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanthi E (2 hours later)
Hi, apparently the cemumn was removed in 1986, at the time the illumn had the tumor. When I was younger I had endometrosis, which had apparently caused the tumor on the illiumn. So, presently, no cecumn, a reduced illumn, and bowel problems. Because I had the gall bladder removed, the consequences as well were diareha. So, Questran Light 4mg are taken daily.

In the meantime we have to rush off to the uSA, as my husbands 96 year old mother is in a coma from a fall.

I will have to take my medications with me and hope all goes well. The Typhitis affecting the cecumn would be out of the question then, as there is no cecumn. Further suggestions? The gastro I do see, did not explain just gave me this name as I was leaving his office last vist, I turned to him and asked, is there a name to this condid, and that is what he said.
doctor
Answered by Dr. Shanthi E (5 hours later)
Hi,

I am sorry about the condition of your husband's mother.

I understand your point about Caecum removal, the ileal resection. I was explaining you what could have occurred then and what it could cause now.

Again, part of the ileum is still left out, so there may be recurrence of the tumour in the ileum.

After you come back from the US, please do a CT scan of the whole abdomen and things will be sorted out.

I wish you quick recovery.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanthi E (17 minutes later)
Hi, abour 6 weeks ago, if not less, I was bleeding from the bladder. Unine tests initally confirmed blood in the bladder, then after a week, blood still bleeding from the bladder, with no blode in the urine. A CT scan was done, showing no abonormalities in the bladder, or abdomen, bumt, they did comment on my back! The back is under contral, it is the bowel, and posissible bladder problem. I was diagonised with autoamunine problems several years back, recently about two years ago put on Plaquinial, 100, 2 daily. So, the bladder could be from that. Now the bowel problem, I will see a bowel surgeon, same one for the 3rd time in the last several years.

I hate all this runaround.

My initial colonsoscopy, the doctor in the hospital corridor, advised me the bowel was red and inflammed. But, a letter went out to local GP, stating all was fine. I continued to experience sever pain, I would be sent to other specialists who would all refer to the first report. Five years larter I went to a local surgon who did the colonoscopy when he reported the ulcer and inflamation in the bowel. Since that time it has taken two years for the Gastro, to finally put me on all the current medication which I believe is helping. He also has me taking 5mg of cortisone, which I find helps with the energery levels. I double up on calicumn, and such.

So, it has taken so long to untangle this medical history.

So, current CT done
Bowel Surgeon will be seen with new repdorts
additional follow up with the Gastro.

We also live 150 miles from the largest city where the specialist are located. It takes us 1.45 hr to get to the doctors.

Sometimes too ill to travel that far.
Many thanks
doctor
Answered by Dr. Shanthi E (1 hour later)
Hi,

I understand your pain. Sometimes, it is too much to take - so many medications, so many doctor visits, long distance travel. It is such a pain.

I appreciate your efforts and patience to bear all of these. If it is an auto-immune disorder that is confirmed, then Plaquenil and steroids will help you. The picture is confusing with so many drugs and remissions and relapses in you.

If you are feeling better with your current medications, you may continue to take them.

It's been 2 days now since we started the discussion. How is your pain abdomen now? Has it decreased without you seeing your doctor? How are you generally feeling? Feeling better now? If things have subsided then I am happy and glad.

I sincerely appreciate your patience in life and the courage to move on.

I wish all will be fine soon.

One last suggestion - Speak only to your CT scan would not be much useful. I strongly feel symptomatic treatment would do much good to you now, than anything else.

Please take care of yourself.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanthi E (8 hours later)
The local GP when told of the diagoinse, is not able to help as he advised me that he knows nothing about this condition. As we are in a small country town in Australia, it might be different for GP in larger cities. That is why we have to seek the advise of the specialists.
Take care, many thanks
doctor
Answered by Dr. Shanthi E (17 hours later)
Hi,

Thanks for writing back.

You should take care of yourself too.

If you have no more queries, please accept my answer and write a review.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shanthi E

General & Family Physician

Practicing since :2005

Answered : 2483 Questions

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Have Pain In Lower Right Side After Loose Bowel Movement. Taking Rymicin. Have Back Damage. What Else Can I Do?

Hi,

Thanks for posting your query.

You seem to be suffering from two ailments here.

1. The pain in your lower right side of the abdomen.

2. The radiating pain from the back, down to left thigh and leg.

I also understand that you have undergone quite a few surgeries as well. It must have been difficult for you to bear these and I appreciate your efforts to go through them.

The pain in the lower right side of the abdomen is worrying me. You have had a surgery for twisted caecum earlier. I am unsure if it is a recurrence of it or if it is non-specific colitis now. In both cases, it would be ideal to do an ultrasound scan of the whole abdomen to conclude on the cause. It has to be managed accordingly. "Wait and watch" policy may not work here. I do not wish you to suffer the pain longer.

The pain from the back and leg is again worrisome as it has been for some time now and it is due to damage to the L4-5 discs. Did your treating doctor consider a surgery for this? In most of the cases, physiotherapy is sufficient to relieve the pain.

Neurontin is a very effective drug for management of this. You should continue taking it.

My suggestions to you:

1. Please get back to your take a calcium supplement on a daily basis as well.

5. Daily walking for about 20 to 30 mins is a good measure, if you are comfortable doing it.

I did not get the reasons for which you are on Rymicin, entecort and Dopson. Please let me know about it.

Do write back for further discussion on this.

I wish you get well soon and lead a healthy life again.

Regards,