What Causes Abdominal Distention And Pain?

Posted on Sat, 20 Sep 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 20 Sep 2014 Answered on

Wed, 8 Oct 2014 Last reviewed on

Question : yes my husband had double hernia surgery in 7-29 and has been very sick since then. Immediately after the surgery he could not pee for 2 weeks and had to be catherized. He could do a BM at that time. On 8-20 we went to the ER because he had extreme abdominal pain. They said he has a urinary tract infection and put him on Levaquin and anti biotic until 9-3. From then on he could not poop. He has been admitted to hospital once since and they gave him a citric magniusm dose to clean him out. That was on 8-30. Since then he has seen a GI doctor and they cant seem to find anything wrong. All tests CT, blood, xray and ultrasound covering all abdominal organs are negative and show nothing. He still has extreme abdominal pains in both sides and lots of distention and bloating. He is now on Miralax 2 times a day and is just now getting back to normal bowel movements and he now can pee, but the abdominal pain is still there. We are thinking of going back to the ER this weekend if things don't improve. Could this be Intestinal ileus or IBS? He has lost 20 lbs since his surgery on 7-29. Please help. No doctors have come up with any diagnosis. We appreciate any information you can give us.Need to add some info regarding surgery. Surgery was at 8:30 and finished by 10:15 . At noon I got a call from post surgery that XXXXXXX was not coming out of the anesthisia very quickly. At about 3:00 they moved him to recovery and I joined him there. We had to wait until 6:00 for him to wake up enough to go home. Is this normal? Do you think his current medical problem is due to the length of time he was under anesthesia?

Answered by Dr. Deepak Kishore Kaltari (4 hours later)

Brief Answer:
Kindly provide the password

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Ms

Apologies for late reply.

The likely cause for distension of abdomen and pain is due to loaded colon which could be secondary to impacted faecal matter in rectum. It is unlikely to be illeus , as it does not persist for so long.
Following surgery there is a duration of hypo motility of intestine which predisposes to such occurrence.
Do let me know the website of Spectrum health, username and password, will have a look at reports and get back to you.

Awaiting your response

Take Care

Best Regards
Dr Deepak Kishore
Consultant Surgeon

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

Follow up: Dr. Deepak Kishore Kaltari (10 hours later)

XXXX records can be seen at YYYY
his user name is YYYY@YYYY
passord is XXXX

Please let us know what you think after your review. Do you think the platelet count of 118,000 could be an issue or should we be concerned? Do you think diet,exercise, rest and twice a day miralax will eventually resolve the issue? We are looking for any treatment ideas from you to relieve the pain in his abdomen and the bloating, etc. XXXXXXX had a complete bowel cleanout on 8-20-14 at the hospital using citric magnisium and again last weekend using 7 full cups of miralax. Do you think his colon and bowels may still be compacted?
We appreciate your advise.

Answered by Dr. Deepak Kishore Kaltari (2 hours later)

Brief Answer:
Enema will be helpful

Detailed Answer:
Dear Madam,

My apologies for not being able to access the account online: On trying to log in this is the error message displayed

404 - File or directory not found.
The resource you are looking for might have been removed, had its name changed, or is temporarily unavailable.

Platelet Count greater than 70000 is acceptable and there is nothing to be worried about. It is unlikely to result in any bleeding tendency.

The cause of stomach pain is likely to be due to

1. Impacted stools in rectum: Leading to colonic distension
2. Lazy colon syndrome: Lack of physical activity predisposes to reduced peristaltic activity of gut.

Miralax may wash off the gastrointestinal tract, but in presence of impacted stools it does produce cramps and abdominal pain. I would suggest you not to repeat Miralax again.

Following are my recommendation

1. Ensure good intake of water: 3 litre a day
2. High fiber diet
3. Laxative: Lactulose will be very much helpful
4. Retention enema: Retention enema with Saline and Glycerine in consultation with your physician will be very helpful( doing a OPD per rectal examination will confirm the decal impaction)
5. Avoid Caffeine/Alcohol/Carbonated beverages
6. Semithicone containing antacid will be very helpful in relieving the bloating sensation

Do keep me updated about progress.

Wishing you and your family a very happy and healthy life

Regards
Deepak

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

Follow up: Dr. Deepak Kishore Kaltari (22 minutes later)

We did the enema last Sat along with the miralax cleanout. We dont think he has impacted stools in the rectum since he has had 3 bowel movements recently. 2 on 9/19 and 1 so far today at 9:30am. He is drinking lots of water and on a high fiber diet and does not drink coffee or pop. What product is semithicone? Can i buy it over the counter?
We think the bowels are moving now but the problem is the intense pain in the center of his abdomen about 2 inches above his belly button and just under the diaphram. We are walking 3 times per day around the block. If you goggle Spectrum XXXXXXX Grand Rapids, MI and then go into my health at Spectrum you should be able to see his records. So are you saying not to use Miralax again today or in the future and to use Lactulose instead? Please explain your recommendation here.

Answered by Dr. Deepak Kishore Kaltari (7 hours later)

Brief Answer:
Lactulose is over the counter laxative

Detailed Answer:
Dear Ms,

I have gone through the reports, everything looks fine.
Miralax is Polyethylene Glycol. It is known to cause cramps and intestinal colic on frequent intake. So it is to be avoided in individuals who experience symptoms of pain in abdomen. Lactulose is osmotic laxative and less likely to cause such symptoms. It is over counter laxative. Simethicone is defaming antiflatulent agent , it is too available as over the counter medication.

Pain in upper abdomen just below the rib cage would most likely be due to Acid peptic disease.

I would suggest you the following which will definitely help.
1. Taking Combination Of Pantoprozole with Domperidone will definitely provide you the much needed relief.
2. Avoid Spicy and oily foods
3. Eat small quantity frequent meals
4. Avoid tea/coffee/alcohol/carbonated beverages
5. Consume high fiber diet
6. Consume plenty of oral fluids

If the symptoms persists would suggest you to see a Surgeon for further assessment and UPPER GASTROINTESTINAL ENDOSCOPY:

Take Care

Best Regards
Dr Deepak

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