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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Abdominal Pain,bloating And Nausea With History Of Diverticulitis With Perforation Of Small Bowel And Resection?

Have history of Diverticulitis with perforation of small bowel 4 1/2 yrs ago. Had 10 inches removed and surgeon told me that from what he saw the rest of small bowel had diverticulosis. I was hospitalized for a week on IV antibiotics. This followed vague traveling abdominal pain for 4 yrs and being told after CT scans and multiple blood test that everything was normal . Since then no problems until about 3 months ago. Started with some abdominal bloating, increased gas, cramping, some nausea and just feeling not right . Have seen Family Dr and was told that how am I supposed to know, it s a closed area. This past Sun ,(3 days ago), had cramping which increased. Felt like someone was wringing my bowels. Finally as the pain was increasing and because this was similar to what it felt like just before perforation, a friend took me to the emergency room. A CT scan was done which was normal , blood count showed WBC of 13,000. UA was normal, temp was 98.9 altho my normal temp is around 96.8-97. I was given one cap of Bactrim (in case it was diverticulitis) and a Rx for Donnatal and was dischared with instructions of Clear Liquid Diet for 2 days and avoid dairy for a week. Diagnosis, Abd pain, Undetermined. Also was instructed to follow up by family Dr. I feel this is a waste of his time as well as mine. I know because of the location that this is difficult to diagnose. The cramping has subsided, but still tender and feels like pressure. BM s were normal, a little on the loose side. Is there any way of determining this before it becomes serious again. Would a Gastroenterologist be able to find out what was going on. I did have a Colonoscopy last fall which did show for the first time that colon also had diverticulosis. I am a 76 year old woman in relatively good health. What ever information you could give me would be greatly appreciated! Thank you
Wed, 5 Feb 2014
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General & Family Physician 's  Response
Hello,

Thanks for posting on HCM,

I am so sorry for your troubles and hope you get well soon.
There is one thing you should understand about the abdomen. When it comes to it, everything is possible especially when confronted with a non-specific (region) abdominal pain. Sometimes, we are faced with embarrassing situations whereby we are unable to determine the exact cause of abdominal pain especially with a previous history of laparotomy.
You may simply be suffering from functional colopathy or irritable bowel syndrome (IBS) or maybe suffering from something worst such as intestinal adhesions (bowel obstruction- which is a more serious condition).
That is why, a careful evaluation of your situation is necessary.
Ruling out bowel infection is the first step to take and a simple stool analysis +/- culture will reveal a lot. Doing some other tests such as widal test, complete blood count, urinalysis (to rule out UTI) and a abdominal ultrasound will prove to provide some good information about the situation of your bowel. I would not want to start name all the most likely cause of your abdominal colic as they are a wide range of them (only laboratory investigations may prove useful).
Yes, at this point, I will recommend you either see a gastroenterologist or a visceral or general surgeon who can actually get to the bottom of your situation.
Feel free to send any more queries regarding your situation, if you wish for further assistance.

Hope this helps and wish you the best
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How To Treat Abdominal Pain,bloating And Nausea With History Of Diverticulitis With Perforation Of Small Bowel And Resection?

Hello, Thanks for posting on HCM, I am so sorry for your troubles and hope you get well soon. There is one thing you should understand about the abdomen. When it comes to it, everything is possible especially when confronted with a non-specific (region) abdominal pain. Sometimes, we are faced with embarrassing situations whereby we are unable to determine the exact cause of abdominal pain especially with a previous history of laparotomy. You may simply be suffering from functional colopathy or irritable bowel syndrome (IBS) or maybe suffering from something worst such as intestinal adhesions (bowel obstruction- which is a more serious condition). That is why, a careful evaluation of your situation is necessary. Ruling out bowel infection is the first step to take and a simple stool analysis +/- culture will reveal a lot. Doing some other tests such as widal test, complete blood count, urinalysis (to rule out UTI) and a abdominal ultrasound will prove to provide some good information about the situation of your bowel. I would not want to start name all the most likely cause of your abdominal colic as they are a wide range of them (only laboratory investigations may prove useful). Yes, at this point, I will recommend you either see a gastroenterologist or a visceral or general surgeon who can actually get to the bottom of your situation. Feel free to send any more queries regarding your situation, if you wish for further assistance. Hope this helps and wish you the best