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IBS and gastritis

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#1 Guest_ldk_*

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Posted 14 January 2000 - 09:56 AM

For the past 6 months I've had chronic abdominal pain, mostly in the middle upper and middle right areas of the abdomen.I have had every GI test in the books done (too long to list). Only one test, endoscopy, revealed any disease: Gastritis.For months I struggled with IBS symptoms such as pain in the left side, partially digested food, and severe constipation. However, several things about my case are unusual:The symptoms started suddenly, without any emotional stress factors to account for it. (We all have stressful events in life, and I no doubt have had them too, but I was not under constant "stress" from my job, with my family, or anything. If stress triggered it, I don't know how or when.)At first I thought it was food poisoning, because the symptoms started right after I ate greasy food at a restaurant and became nauseous.My normal diet does not consist of fatty foods, nor is it low in fiber. In fact, eating fatty food at that restaurant at about the time the symptoms first started, was an indulgence I rarely succumbed to. I normally eat a lot of beans (e.g. lentils), long grain rice, seafood, low-fat lunchmeat, vegetable soup, mushrooms, etc. So a bad diet alone can't account for my IBS, certainly not when it is of sudden onset like this.Ingestion of fat started causing severe constipation as my illness progressed. Before this illness, I had never before had constipation in my life (I'm a 29-year old male in otherwise good health). But after this chronic illness started, the ingestion of fat in almost any amount (even just one hot dog in an entire day), caused my bowel to become blocked within 48 hours. It was blocked not at the anal area, and there was no urge to evacuate, but there was extreme pressure and pain in the left abdomen. Laxatives (which I took only as directed by a doctor), usually took over 4 hours to loosen it up and restore motility. After I noticed the fat-constipation connection (strange!), I stopped eating fat entirely, avoiding it like some people avoid gluten. This eliminated all of the constipation, and all of the pain in the left abdomen. However, my stools were very soft, foul-smelling, and tended to float or bubble in water. There was no incontinence, diarrhea, or flatulence -- just partially digested food and loose stools.I went to one gastroenterologist throughout most of this fiasco, and she did most of the tests (gallbladder, pancreas, liver, colon, etc.), but all of them came out negative, and by the time of my last visit to her, she was convinced I was a psychiatric nutcase with IBS. She refused to prescribe medicine for the pain, which became acute at times, and her nurse provided interference for her, preventing me from seeing her again or setting up an appointment. On my last visit, I had to practically beg the nurse to get the doctor to prescribe pain medicine for the abdominal pain, which was acute. After some angry words with the nurse, she capitulated, and the doctor prescribed Bentyl. This provided some temporary relief, but it had too many unwanted side effects, and it wasn't a long-term solution. At my insistence, a CT scan was taken to rule out pancreatitis (my paternal grandfather died in his early 50s from pancreatic cancer). This was a fee-for-service doctor, by the way. I looked for another doctor, after 5 months of agony: No positive diagnosis, or even pain relief, after almost a dozen GI tests.My second gastroenterologist did an endoscopy, and immediately found gastritis and inflammation in the abdominal wall. Biopsies were negative, however, for H. Pylori, microscopic parasites, etc. Apparently IBS was a preexisting condition I've had all my life, and never realized until now. The gastritis merely acted as the trigger. IBS was the secondary diagnosis, after gastritis.For the past two weeks, I've been taking Levsin (4-hour dosage) for the spasms, and Sucralfate for the gastritis. I had been taking Levsin off and on for three months prior to the diagnosis of gastritis and the prescription of Sucralfate, but it didn't help much (the first doctor prescribed 12-hour doses of Levsin, which were less effective for me than the 4-hour doses my second doctor prescribed). After I started taking the Sucralfate, I felt some relief from the gastritis, and I had my first normal bowel movement in 6 months!!!I would never wish it on anyone, to go through what I did: 6 months of painful gastritis which didn't show up on barium series, only endoscopy, and which was complicated by a preexisting condition similar to, if not the same as, IBS, but which I had never experienced before. The IBS symptoms are initially worse than the gastritis, which delays getting the correct diagnosis.And the attitude of some doctors towards patients with unexplained GI symptoms, such as refusing to give pain relief, or jumping to psychiatric diagnoses, is appalling. If you have these symptoms, and have felt like you've reached a dead end with your doctor, I recommend an endoscopy ASAP, to check for gastritis. IBS may just be another symptom (or a preexisting condition you never knew you had before), instead of the primary cause:
  • Partially digested food in the stool
  • Constipation after fatty meals (important!)
  • Left abdominal pain, after large or fatty meals
  • Constant burning in the upper middle or upper right abdomen
  • Loose stool
  • No blood in stool
  • Tenderness in the right abdomen
  • Muscle spasms and tension in middle and lower abdomen
  • Palpitations
  • Weight lossOf course, these symptoms might also indicate gallbladder or pancreas problems, and the colon should be checked for IBD, but if those are ruled out, strongly consider that you may have gastritis, with IBS as a dual diagnosis!!!It doesn't have to all be caused by your head, or your lifestyle, either!!! Don't take Rome as the definitive guide to IBS, anymore than DSM-IV is the definitive guide to anxiety. They are just guidebooks, not substitutes for proper medical diagnosis. My second doctor even admitted this himself, during our initial visit. The first doctor was one of the ones who is quick to tack on labels like IBS and anxiety, but without getting to the root cause(s).If you're prone to IBS, then gastritis might be just enough to upset normal digestion and motility, even if you've never had IBS before. That is the literal definition of IBS: Your bowel is irritable, and gastritis is one possible irritant. My story isn't over yet: The abdominal pain in the middle and right side is still noticable (but less severe), even after starting Sucralfate, but we'll see how it goes. At least now that the gastritis is being treated, I can go back to a regular diet (small amounts of fat, more solid foods), without getting severe IBS symptoms.[This message has been edited by ldk (edited 01-15-2000).]

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