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What Causes Lower Abdominal Pain With Night Sweats?
Question: 'm a 47 yr old male. About a year and a 1/2 ago I had terrible lower abdominal pain - It started with night sweats. Then bloody gas diarrhea with no pain. This bloody gas diarrhea suddenly stopped after about 4 weeks. Then a week later I began to have extremely extremely foul smelling BM's that were loose and I had constant lower pelvic pain and gas that would not seem to come out along with left side pain. I could not eat and lost 20+ pounds. This lasted for weeks until I saw a doctor who thought it was probably diverticulitis and gave me Flagyl. The Flagyl worked right away and I got better really quickly.
I was never tested to see what it actually was but I added fiber to my diet, ate more veggies, got exercise and have been well over a year.
Over time I forgot about the whole incident - dropped the fiber, and began to eat more like I used to, stopped going to the gym, drank beer again, gained weight etc. - back to the old me - feeling fine and living the good life.
However, 6 weeks ago I started to get night sweats again - then 3 weeks ago I have had some more lower pelvic pain and left side pain - similar to a year and 1/2 ago along with the bad gas cramps - then a bad UTI started along with gas and poop in the urine and I am a bit swollen in the left pelvis area just above the penis (I think this is where the fistula must be as I feel the gas move there).
The doctor gave me CIPRO for 3 weeks which took away all the pain and the UTI. I feel fine now except for the gas and poop in urine. My doctor sent me for a CT scan and it confirmed a Colovesical fistula and now I've been referred to a surgeon (in 2 months as I'm in Canada and have to wait in line).
I asked the doctor what caused the fistula - he said nothing on the CT scan gives any clue as to the cause.
I am wonder what your opinion might be - do you think infection or Diverticulosis or a cancer caused this fistula? I assume if Cancer the antibiotics would not have been so effective however.
Your opinion would be much appreciated,
Thanks
I was never tested to see what it actually was but I added fiber to my diet, ate more veggies, got exercise and have been well over a year.
Over time I forgot about the whole incident - dropped the fiber, and began to eat more like I used to, stopped going to the gym, drank beer again, gained weight etc. - back to the old me - feeling fine and living the good life.
However, 6 weeks ago I started to get night sweats again - then 3 weeks ago I have had some more lower pelvic pain and left side pain - similar to a year and 1/2 ago along with the bad gas cramps - then a bad UTI started along with gas and poop in the urine and I am a bit swollen in the left pelvis area just above the penis (I think this is where the fistula must be as I feel the gas move there).
The doctor gave me CIPRO for 3 weeks which took away all the pain and the UTI. I feel fine now except for the gas and poop in urine. My doctor sent me for a CT scan and it confirmed a Colovesical fistula and now I've been referred to a surgeon (in 2 months as I'm in Canada and have to wait in line).
I asked the doctor what caused the fistula - he said nothing on the CT scan gives any clue as to the cause.
I am wonder what your opinion might be - do you think infection or Diverticulosis or a cancer caused this fistula? I assume if Cancer the antibiotics would not have been so effective however.
Your opinion would be much appreciated,
Thanks
Brief Answer:
It would probably be Diverticulitis.
Detailed Answer:
Hi XXXX,
After hearing the sequence of events it is most likely that this Enterovesical fistula would probably be due to Diverticulosis of the Colon. It is by far the commonest cause for these fistulas and your history and age is also in favour of the same. But you should not worry. These fistulas can be cured easily.
Most fistulas require surgical management and the surgery is not all that complicated, its quite straight forward. However, some patients choose to continue non operative management and some of them also get relieved over time in most cases.
You will need to choose what you need to do. CT Scan usually shows the fistula and the management can usually be planned with the help of a CT scan. You do not require any other detailed investigations since a CT has already been done.
You should see a good Surgeon and get it over with if you decide Surgery as the treatment for you. After surgery, when they send the specimen for Histopathology, then only would you come to know what had caused the fistula. This is the only definite test to know what it was.
Take care and feel free to ask any queries that might come to your mind.
Dr Rishi, New XXXXXXX XXXXXXX
It would probably be Diverticulitis.
Detailed Answer:
Hi XXXX,
After hearing the sequence of events it is most likely that this Enterovesical fistula would probably be due to Diverticulosis of the Colon. It is by far the commonest cause for these fistulas and your history and age is also in favour of the same. But you should not worry. These fistulas can be cured easily.
Most fistulas require surgical management and the surgery is not all that complicated, its quite straight forward. However, some patients choose to continue non operative management and some of them also get relieved over time in most cases.
You will need to choose what you need to do. CT Scan usually shows the fistula and the management can usually be planned with the help of a CT scan. You do not require any other detailed investigations since a CT has already been done.
You should see a good Surgeon and get it over with if you decide Surgery as the treatment for you. After surgery, when they send the specimen for Histopathology, then only would you come to know what had caused the fistula. This is the only definite test to know what it was.
Take care and feel free to ask any queries that might come to your mind.
Dr Rishi, New XXXXXXX XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your answer.
Do you think i will need a cathater after the operation and for how long. Are they painful for a man or are they ok.
I am quite scared but i will select surgery. Is there a lot of needles invilved in the pricess?
How long after till i cam eat.
Does the pain medication take away mist if the pain?
Except for the peeing poop and gas i am on perfect health I am young and strong. I hope to recover with out too much suffering
Do you think i will need a cathater after the operation and for how long. Are they painful for a man or are they ok.
I am quite scared but i will select surgery. Is there a lot of needles invilved in the pricess?
How long after till i cam eat.
Does the pain medication take away mist if the pain?
Except for the peeing poop and gas i am on perfect health I am young and strong. I hope to recover with out too much suffering
Brief Answer:
The pain would be minimal and there should be no problem.
Detailed Answer:
Hi,
Good to hear from you.
Yes a catheter would be required. This is essential for the defect in the Urinary bladder to heal. Catheters are not painful at all. They just lead to strange sensation when they are inserted. It is like a foreign body sensation and we all get used to it. You need not fear the catheter at all. They are made of soft silicon or rubber and do not usually cause any trouble. It is usually required for a week to 2 weeks and then removed.
There would be a lot of needles but they would put intracaths so you would feel the prick only in the first time and thereafter it would be relatively painless.
Eating would depend upon how low or high is the defect in the bowel(Colon) and what kind of repair is required. It might entail fasting for a week or a little longer but it will be all worth it to get rid of the troublesome fistula.
The pain medications nowadays are very effective and give you an almost pain free experience. There is nothing to worry about or be afraid of. Try and relax and get into the surgery with an open mind and you should be fine.
You will recover very well, I assure you. Just have confidence in your Surgeon and ask him whatever doubts or queries you might have so that you both are on the same grid.
Take care and all the best.
Dr Rishi, New XXXXXXX XXXXXXX
The pain would be minimal and there should be no problem.
Detailed Answer:
Hi,
Good to hear from you.
Yes a catheter would be required. This is essential for the defect in the Urinary bladder to heal. Catheters are not painful at all. They just lead to strange sensation when they are inserted. It is like a foreign body sensation and we all get used to it. You need not fear the catheter at all. They are made of soft silicon or rubber and do not usually cause any trouble. It is usually required for a week to 2 weeks and then removed.
There would be a lot of needles but they would put intracaths so you would feel the prick only in the first time and thereafter it would be relatively painless.
Eating would depend upon how low or high is the defect in the bowel(Colon) and what kind of repair is required. It might entail fasting for a week or a little longer but it will be all worth it to get rid of the troublesome fistula.
The pain medications nowadays are very effective and give you an almost pain free experience. There is nothing to worry about or be afraid of. Try and relax and get into the surgery with an open mind and you should be fine.
You will recover very well, I assure you. Just have confidence in your Surgeon and ask him whatever doubts or queries you might have so that you both are on the same grid.
Take care and all the best.
Dr Rishi, New XXXXXXX XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you
Brief Answer:
Wish you a safe Surgery & rapid recovery.
Detailed Answer:
Hi,
Hope you have a safe surgery and a fast expeditious recovery to health.
All my good wishes to you.
Take care,
Dr Rishi, New XXXXXXX XXXXXXX
Wish you a safe Surgery & rapid recovery.
Detailed Answer:
Hi,
Hope you have a safe surgery and a fast expeditious recovery to health.
All my good wishes to you.
Take care,
Dr Rishi, New XXXXXXX XXXXXXX
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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