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Suggest Treatment For Constipation And Fever When Diagnosed With Anal Fissure

Posted on Sat, 30 Apr 2016

Question: Hello,

I am not sure if it is a co-incidence or something to do with bed-lifting I did around 3 weeks ago. (I did lift a wooden bed stretching my front abdominal portion, again not sure if this is a cause to the problem) Apparently, I have been having a sharp pain just below my left rib (beneath). The first week it was immense when I drank or ate anything, the week later it settled and I didn't experience much signs of this pain. However again starting this week I have been feeling this pain when-ever I drink water, it remains till the water gets below my stomach (something like a burp) and then gets better later on.
This has been causing some discomfort and I am unable to eat properly considering the pain it might cause just after eating it. (The pain only remains just behind the lowest rib(left side) and is not experienced any where else including right abdomen or back, also no pain during the night time while sleeping)
I don't have any fever associated and also am passing the urine fine.

I have in general constipation and was diagnosed with Anal Fissure in the US. That is now better after I have made changes to my diet.

Please suggest me if there is something which could help in relieving the pain.

Answered by Dr. Dr. Yogesh D (59 minutes later)

Brief Answer:
Does not sound like a strained muscle, could be due to acidity.

Detailed Answer:
Hello Mr XXXXXXX

Thank you for posting your question here.

I have gone through your question carefully and I understand your concern.

The way you describe it makes me suspect a probable acidity or gastric ulcer.

If you had strained (pulled a muscle), the pain would be felt while bending front or back, this would be a typical symptom of a muscle injury, but your description is quite unlike that which makes me doubt that cause.

However, it is possible that due to the lifting you did 3 weeks ago, a small part of intestine or stomach might have slipped through some naturally present openings in the diaphragm and that could be causing the pain, this needs to be ruled out through proper imaging tests.

Another important cause is, acidity, the way your describe your pain, immediately after meals or during drinking some water is quite suggestive of acidity and ulceration in the stomach due to acidity.

You will need to consult a general surgeon and get yourself examined properly to identify the exact cause and the treatment will depend on the exact cause.

Acidity can be easily treated with antacids and proton pump inhibitors like omeprazole.

I suggest you to kindly consult a general surgeon as soon as possible and get treated appropriately.

Wishing you speedy recovery and good health.

Warm regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Yogesh D (2 days later)

Dear Dr.,

Thanks for your advice and suggestions. I got myself examined by a gastroenterologist and he suggested for an ultrasound.

Along with that he has put me on Razo 20mg., looks the same class of drug you had suggested. I have a followup appointment scheduled with him in the coming week. The pain is much better then was earlier.

I have uploaded the ultra sound report and everything looks normal. There is one concern which I noticed in the report regarding the gallblader which is already highlighed in the report (Gallblader polyp - 2.7 mm). Can you please shed some light on it ? I am getting a little worried about this and any precautions i need to take for this going forward.

Any suggestions would be greatly helpful.

Answered by Dr. Dr. Yogesh D (14 hours later)

Brief Answer:
Your report is not seen, Gallbladder polyp is not very worrisome.

Detailed Answer:
Hello Mr XXXXXXX

Thank you for writing back to me with the above details.

It is good that you consulted a gastroenterologist for your problems and it also reassuring that he does not think there is any major issue.

The fact that your symptoms are much relieved with Rabeprazole is suggestive of gastritis as described in my previous answer.

Continue with the medication and you will feel much better.

As for Gallbladder polyp, 95% of them are benign in nature and do not cause any problem, you will need to get an ultrasound done every year or so to see if it is growing in size.

Your gastroenterologist will be able to guide you better in this regard.

I do not see any attached report, looks like there is a technical issue.

You can send the report to YYYY@YYYY with subject line reading "Attn: reports for Dr. Yogesh D's perusal". Customer care team will ensure that the reports reach me.

As for suggestions:

1. Eat a balanced diet.
2. Do not eat oily and fried foods.
3. Eat at regular and fixed times.
4. Do not drink too much of coffee or tea.
5. Drink plenty of water.
6. Exercise regularly.
7. Do not drink alcohol.
8. Do not smoke.

I hope this answers your question, if you have any additional concerns, I will be happy to help you.

Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Yogesh D (3 minutes later)

Dear Dr.

Thanks for your reply. I have re-attached the same again.

Please let me know if it is still not visible.

Thanks,
XXXXXXXXXX

Answered by Dr. Dr. Yogesh D (20 minutes later)

Brief Answer:
A tiny polyp, nothing to worry.

Detailed Answer:
Hello again Mr XXXXXXX

Yes, I can see the report now.

And the report is very clear and does mention a very tiny polyp.

I do not think it is significant.

Do another USG after 3 months and see if it has increased in size. Other than that there is nothing that needs to be done at this moment.

Consult your gastroenterologist as scheduled and follow his advise.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar