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Hello! I Have Had A History Of Spastic Colon For
Posted on
Thu, 1 Aug 2019
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Fri, 2 Aug 2019
Answered on
Last reviewed on
Question : Hello!
I have had a history of Spastic colon for over 35 years but well controlled with fiber only.
Recently, my GI dr ordered a series of tests because I have had RUQ pain/discomfort for 4 months. He ordered a ultrasound, and an abdominal MRI, as well as a Endocope and Colonoscopy. He found one polyp which he removed and mild gastritis. He also found mild fatty liver and ran blood test which shows it to be very mild. I have upped my dose of Cymbalta to 2x daily 60 mg. And I’m taking Hysclsomine as needed and IB Gard. I also started Nexium 2 weeks ago. I’ve been on this regimen for one month and RUQ discomfort is only very slightly improved. Is it IBS or mild gastritis? Should I have any other tests or meds? It’s not high level of pain 3 out of 10 but is there much of the day
I have had a history of Spastic colon for over 35 years but well controlled with fiber only.
Recently, my GI dr ordered a series of tests because I have had RUQ pain/discomfort for 4 months. He ordered a ultrasound, and an abdominal MRI, as well as a Endocope and Colonoscopy. He found one polyp which he removed and mild gastritis. He also found mild fatty liver and ran blood test which shows it to be very mild. I have upped my dose of Cymbalta to 2x daily 60 mg. And I’m taking Hysclsomine as needed and IB Gard. I also started Nexium 2 weeks ago. I’ve been on this regimen for one month and RUQ discomfort is only very slightly improved. Is it IBS or mild gastritis? Should I have any other tests or meds? It’s not high level of pain 3 out of 10 but is there much of the day
Also, virtually no heartburn but some belching and passing gas
Brief Answer:
Proper medication with follow-ups is a must for you.
Detailed Answer:
Hello Duke and thanks for choosing 'Ask A Doctor' service for your query,
I have gone through your details and I appreciate your concerns.
When it comes to Right upper quadrant pain two differential diagnosis are:
1) Gall bladder pathology-Ruled out by MRI.
2) Gastritis
NEXIUM 40mg twice daily is just a baseline dose for gastritis. Secondly, keep in mind that it is effective only when taken empty stomach. You should not eat anything 30 minutes before and after taking NEXIUM otherwise it will have minimal effect. Doses can be increased to 40 mg twice.
Secondly, if relief is not adequate you could ask your gastro to add Acotiamide 100mg thrice daily for 21 days followed by twice daily for the next 3 month. It plays wonderfully and is a very safe drug. If not available in the USA you can get it from Mexico easily or Europe (can get online).
One test that I would recommend you to go for is fecal calprotectin. It reflects the amount of inflammation in your intestines. If inflammation is high levels would be grossly deranged. Usually, levels are very high in a patient with IBS.
IBS being a diagnosis of exclusion has completely different treatment from Gastritis. However, usually, the pain is there in areas of intestines like the lower abdomen or left lower and middle zones rather than right upper quadrant (specific for gastritis pain)
Bloating and belching is a result of fermentation of food inside the gut which releases a large number of toxic gases which causes local inflammation in intestines causing spasmodic pain.
I would suggest you take tablets of activated charcoal 2 tablets thrice daily to absorb these gases along with fiber supplement Psyllium husk 10 gram three times a day soaked in lukewarm water.
Add a quality probiotic like Econorm three times a day.
All these are over the counter.
Do get the test done.
Follow the medicines and tell me how you feel in a week.
You need proper medication and follow up.
The pain would go away once medicines are taken as scheduled.
I hope I was helpful and wish that you recover soon.
Follow-ups are welcome.
Continue the medications your primary have suggested you.
Follow up with the report.
Thanks
Get well soon.
Proper medication with follow-ups is a must for you.
Detailed Answer:
Hello Duke and thanks for choosing 'Ask A Doctor' service for your query,
I have gone through your details and I appreciate your concerns.
When it comes to Right upper quadrant pain two differential diagnosis are:
1) Gall bladder pathology-Ruled out by MRI.
2) Gastritis
NEXIUM 40mg twice daily is just a baseline dose for gastritis. Secondly, keep in mind that it is effective only when taken empty stomach. You should not eat anything 30 minutes before and after taking NEXIUM otherwise it will have minimal effect. Doses can be increased to 40 mg twice.
Secondly, if relief is not adequate you could ask your gastro to add Acotiamide 100mg thrice daily for 21 days followed by twice daily for the next 3 month. It plays wonderfully and is a very safe drug. If not available in the USA you can get it from Mexico easily or Europe (can get online).
One test that I would recommend you to go for is fecal calprotectin. It reflects the amount of inflammation in your intestines. If inflammation is high levels would be grossly deranged. Usually, levels are very high in a patient with IBS.
IBS being a diagnosis of exclusion has completely different treatment from Gastritis. However, usually, the pain is there in areas of intestines like the lower abdomen or left lower and middle zones rather than right upper quadrant (specific for gastritis pain)
Bloating and belching is a result of fermentation of food inside the gut which releases a large number of toxic gases which causes local inflammation in intestines causing spasmodic pain.
I would suggest you take tablets of activated charcoal 2 tablets thrice daily to absorb these gases along with fiber supplement Psyllium husk 10 gram three times a day soaked in lukewarm water.
Add a quality probiotic like Econorm three times a day.
All these are over the counter.
Do get the test done.
Follow the medicines and tell me how you feel in a week.
You need proper medication and follow up.
The pain would go away once medicines are taken as scheduled.
I hope I was helpful and wish that you recover soon.
Follow-ups are welcome.
Continue the medications your primary have suggested you.
Follow up with the report.
Thanks
Get well soon.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thanks for your through answer. So do you think my discomfort is more likely the mild gastritis or IBS?
And last question is it very unlikely that any truly very serious problem like cancer or something else would have not been found with all of the tests I had done, abdominal mri, ultrasound, endoscopy, and colonoscopy?
Thanks again! I’m a worrier
And last question is it very unlikely that any truly very serious problem like cancer or something else would have not been found with all of the tests I had done, abdominal mri, ultrasound, endoscopy, and colonoscopy?
Thanks again! I’m a worrier
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
See IBS as explained earlier is a diagnosis of exclusion. In simple language I don't know what's wrong with you sir so I would sum up all your symptoms and cover them inside an umbrella term called IBS.
No one till date knows what's the exact cause and presentation of IBS.
All we know is that when all reports are normal and patient is having abdominal discomfort of any form we label him as having IBS.
After that starts trial and hit phase in which a number of medications which I had explained earlier are tried and if patient is relieved we say yes it's IBS.
So please try to understand IBS is not a disease rather it's a collection of symptoms in a patient with no physiological abnormality.
In your case as your pain is towards right upper quadrant I would definitely like to treat you on guidelines of moderate gastritis(Full throttle treatment) and if despite of every medicine if not relieved then I would think about IBS.
IBS is a bag in which doctors dump their patients to find an easy way out.
Secondly anxiety increases gastritis by many folds it stimulates your autonomous nerves and causes secretion of large amount of acid in stomach.
Though not asked yet
Tab Nexium 80 mg twice daily
Tab Domperidome 10 mg thrice daily
Tab Acotiamide 100 mg thrice daily
After treating you on this regimen for 3 month if pain still persists then I would think of IBS.
No MRI can't miss a growth even as little as pea.
All tests have been done chances of missing a tumour is clinically zero.
Hope I was easy to understand and was helpful to you.
Any suggestions to make answer better are welcome.
Feel free to follow up and do rate the answer.
Wish you a quick recovery.
Regards.
Follow up.
Detailed Answer:
Hi again,
See IBS as explained earlier is a diagnosis of exclusion. In simple language I don't know what's wrong with you sir so I would sum up all your symptoms and cover them inside an umbrella term called IBS.
No one till date knows what's the exact cause and presentation of IBS.
All we know is that when all reports are normal and patient is having abdominal discomfort of any form we label him as having IBS.
After that starts trial and hit phase in which a number of medications which I had explained earlier are tried and if patient is relieved we say yes it's IBS.
So please try to understand IBS is not a disease rather it's a collection of symptoms in a patient with no physiological abnormality.
In your case as your pain is towards right upper quadrant I would definitely like to treat you on guidelines of moderate gastritis(Full throttle treatment) and if despite of every medicine if not relieved then I would think about IBS.
IBS is a bag in which doctors dump their patients to find an easy way out.
Secondly anxiety increases gastritis by many folds it stimulates your autonomous nerves and causes secretion of large amount of acid in stomach.
Though not asked yet
Tab Nexium 80 mg twice daily
Tab Domperidome 10 mg thrice daily
Tab Acotiamide 100 mg thrice daily
After treating you on this regimen for 3 month if pain still persists then I would think of IBS.
No MRI can't miss a growth even as little as pea.
All tests have been done chances of missing a tumour is clinically zero.
Hope I was easy to understand and was helpful to you.
Any suggestions to make answer better are welcome.
Feel free to follow up and do rate the answer.
Wish you a quick recovery.
Regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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