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Regarding diagnosis of digestive disorder

IBS IBD Cancer Digestive Digestion Belly Abdomen Piles Fissure Irritable

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#1 Aryan111

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Posted 10 June 2018 - 01:54 AM

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I am 27 years old male.

I have been suffering from digestion related issues since last 3 years.

Some key points that I would like to mention about my daily routine:

1.         I work on laptop from my home (highly inactive lifestyle).

2.         Have to take rest (sleep) 2-3 times in daytime as I feel tired, sluggish & lethargic till the sun sets. I feel quite fresh, active & energetic in evening & night.

I consulted with 3 doctors (Allopathic, Homeopathic & Ayurvedic) regarding the issue & all of them told me that it is IBS. But I suspect that it isn’t IBS & might be something more serious.

            So, I researched about digestive disorders/diseases, went through their symptoms & made a list of symptoms that I have, I don’t have & I have no idea about. One thing I have observed that most of these symptoms are short lived. They appear for few days or weeks, then disappear & some other symptoms appear in their place.

There are almost 50 digestive diseases/disorders, all have nearly same symptoms & I think that accurate diagnosis is must in order to get right treatment & that’s why I have made a detailed list of symptoms.

 

I HAVE FOLLOWING SYMPTOMS:

 

1.Usually I have to go to the loo 3-4 times in the morning. Mostly I don’t feel need to defecate after morning but sometimes have to go in afternoon, evening or night as well.

 

Stool types & consistency:-

 

First time in the morning:

The faeces are sausage shaped, smooth & soft. Mostly brownish-yellow in color. Since I drink lukewarm water before going to the loo, some mushy stool also appears.

 

Second time in the morning:

Mostly loose motions. Sometimes stools have some form & are not too loose but sometimes it is watery.

 

Third time in the morning:

Usually I have to sit for long as I don’t get pressure to empty the bowels. Sometimes I have to put pressure to get the stools passed or defecation happens on its own after sitting for long time. This time usually defecation happens in the form of blobs & sometimes mucus or candida (some white stuff) appears with stools. Sometimes when I feel that I have passed stools & when I look into the bowl only mucus appears over there.

 

After meal or in evening:

Brown colored sticky stools which doesn’t float on water

2          Feeling of incomplete evacuation after defecating in the morning. (Usually I have to go to the loo 2-3 times in the morning to get the bowels completely emptied. But sometimes even after passing stools for 3-4 times, I just can’t clear the bowels completely)

3          Difficult & painful bowel movements (sometimes I have to sit for long to empty the bowels & sometimes even after sitting for long time if I am unable to pass stools, I have to put pressure to empty the bowels forcefully & this causes pain while passing stools. This happens usually 3rd or 4th time I go to the loo in the morning)

4          Change in frequency (ranging from 2-7 times a day) & consistency (sometimes a little bit watery stools, sometimes solid etc.) of bowel movements

5          Sometimes stools are narrow (not pencil width though)

6          Bright red blood in the stools (sometimes; it is occult  or hidden blood sometimes)

7      Fat in stools (Sometimes I get to see faeces floating on water. Sometimes they seem to be greasy & sometimes drops of oil also are seen in the water inside the bowl. Though the faeces aren’t that pale or foul smelling.)

8          Some symptoms are alleviated by defecation

9          Dark urine (rarely). Its usually white when I drink enough of water

10        Abdominal pain (I feel some mild pain very rarely in the upper left abdomen at the place of spleen, usually for few seconds.

Had extremely severe abdominal pain one morning a few months back where I had eaten more than my capacity last night. I feel it happened because of trapped gas.)

11        Abdominal swelling/bloating (only if the bowels don’t get emptied completely.

A few months back used to suffer from bloating after sunset without eating anything or even after drinking small amounts of water. It doesn’t appear anymore.)

12        Used to feel full even after eating a fruit or drinking a glass of water at evening, a few months back. The situation has improved much now. But still at night I feel full earlier than I should be.

13        Sometimes I feel my abdomen to be stiff (not sensitive at all) on the left side of lower abdomen. I think this is what is called as abdominal rigidity or abdominal guarding

14        Growling stomach (very rarely; mostly at afternoon after lunch)

15        Very mild burning in stomach (very rarely)

16        Belching (used to belch a lot a few days back, now since I have reduced my meals, the situation has come under control, I belch but not that much)

17        Wind/gas. (Used to pass a lot of gas for a period of few days, a few weeks back. Now the situation has become normal.)

18        Mild pain in the rectum while passing gas (very rarely)

19        Poor appetite (might be because of my inactive lifestyle & sometimes incomplete evacuation)

20        Enlarged spleen (I feel so because of some symptoms)

21        Fatigue, Sluggishness & Lethargy (I don’t feel the same though when I am outing or at a function etc.). I feel completely fresh only when I take a lot of rest, say 4-5 hours in daytime.

22        I feel hungry & the food consumed gets digested properly when I am travelling or am outdoors. Inactive lifestyle worsens the symptoms.

23        Weight loss (I have lost weight but I think it is because I have reduced my diet.)

24        Presence of excess saliva or some bitter liquid in mouth (this might be acid reflux), usually at daytime (I think that is what causes bad breath)

25        Heartburn or acidity (only when sometimes I get up at mid night at around 2-3 AM)

26        Regurgitation of food (very rarely)

27        Headaches (very rarely; usually when I am not able to empty the bowels completely)

28        Joint pain (very rarely get pain in the wrist. I feel it happens because of trapped gas.

Used to have feeling of uneasiness in the ankle joints for a long period, don’t have any more.)

29        Neck & back pain (rarely; I feel it happens because of trapped gas)

30        Cramping (had experienced only for a period of a couple of days, a few weeks back & that too I felt was happening because of trapped gas in scrotum or area between anus & scrotum. I used to feel pain in the scrotum & it was little difficult for me to sit)

31        Mouth sores (mild)

32        Mild chills (sometimes)

33        Low-grade fever (very rarely)

34        Mimicking heart attack (had a couple of attacks like this which were not that severe. Might have happened because of gas)

35        Itchy, red hives on skin (occur rarely; it seems like they occur because of biting from insects.)

36        Lactose intolerance (experience symptoms sometimes after consuming milk based products)

37        Stress & worries to some extent

38        Stress causes aggravation of symptoms

39        Sensitivity to light and sound (to some extent)

 

I “DON’T” HAVE FOLLOWING SYMPTOMS:

 

1          Clay colored or tarry stools

2          Bloody diarrhoea

3          Bleeding during or after bowel movements 

4          Pus drainage near the anal opening

5          Urgent need to defecate

6          Itchiness in the anal area

7          Discomfort while sitting

8          Rectal spasm

9          Pain or discomfort near the anus or buttocks

10        Feeling a bulge after coughing, sneezing or lifting

11        Feeling pressure in the rectum

12        Rectal fullness

13        Rectal prolapse

14        Redness, soreness of the skin around the anal opening

15        Rectal tenderness

16        Swelling around anus

17        Lump or painful hardened tissue or mass protruding near the anus

18        Visible tear or cut in the anus area

19        Levator ani syndrome

20        Passing excessive amounts of gas 

(Used to suffer from this a few days back for a period of few days. The condition is normal now.)

21        Trouble passing gas

22        Incontinence

23        Inability to pass wind (Used to suffer from this a few weeks back, where the gas was moving from here & there inside body but wasn’t getting out. Not anymore.)

24        Abdominal tenderness

25        Abdominal cramps

26        Abdominal bleeding

27        Abdominal discomfort

28        Full, round abdomen

29        Increased abdominal size.

30        Lump or protrusion in the abdomen

31        Mass in the belly

32        Changes to the belly button

33        Difficulty belching

34        Less urine than normal

35        Inability to urinate

36        Urinary tract Infections

37        Kidney stones

38        Malaise

39        Swelling on any other body part than abdomen

40        Dizziness

41        Migraine

42        Fainting        

43        Light-headedness

44        Used to get itchy red small boils on hand fingers, every summer a few years back. No more have these symptoms.

45        Vomiting

46        Fever

47        Feeling sick

48        Jaundice

49        Muscle pain (pain used to be there in the lats muscles. But disappeared after getting massage & taking rest.)

50        Fibromyalgia

51        Arthritis

52        Chest or shoulder pain

53        Pelvic pain

54        Lump or protrusion in the groin or scrotum

55        Groin discomfort or pain

56        Pain while coughing, bending or lifting a heavy object

57        Sleep disturbance

58        Night sweats

59        Cough

60        Feeling that something is stuck in your throat or chest

61        Choking during swallowing

62        Pain in the throat or chest during swallowing

63        Coughing during or after the swallow

64        Difficulty swallowing (suffered from little bit difficulty while swallowing for a period of few of days, felt it happened because of swollen tonsils.)

65        Trouble forming food and liquid into a soft ball in the mouth

66        Trouble pushing food or liquid to the back of the mouth

67        Throat irritation

68        Sore throat

69        Throat clearing

70        Hoarseness

71        Nasal regurgitation

72        Runny nose

73        Hiccups

74        Swelling or puffiness of the tissue directly under skin, especially in legs or arms.

75        Bone pain

76        Dehydration

77        Dry mouth, nostrils or skin

78        Not urinating as often

79        Fast heart rate

80        Shortness of breath

81        Difficulty breathing

82        Anorexia

83        Spider-like blood vessels

84        Bruising

85        Pain aggravated or relieved by meals

86        Burning or gnawing feeling similar to hunger pains

87        Red, purple, dark or discolored bulge

88        Stretched skin (but do have some strechmarks on some parts of the body)

89        Shiny skin (Used to be oily at teenage but became normal after taking treatment)

90        Skin that retains a dimple (pits), after being pressed for several seconds.

91        Weight gain

92        Increased salivation

 

I DON'T HAVE IDEA ABOUT FOLLOWING SYMPTOMS:

 

1          Decrease in caliber of stool

2          Osteoporosis (I feel my bones to be weak though & my posture is usually little bit stooped.)

3          Bumps or lumps on bones of legs, arms, skull and jaw

4          Infertility

5          Colitic arthritis, an arthritis that migrates along the body and affects knees, ankles, hips, wrists and elbows

6          Low blood count (anaemia) that makes you feel tired

7          Low blood pressure

8          Pericholangitis, inflammation of the tissues around the bile ducts

9          Malnutrition

10        Severe air swallowing

11        An enlarged bubble of gas in the stomach following heavy meals

12        Water-electrolyte imbalance

13        Teeth changing color or losing their enamel (My teeth always seem to be a little bit yellowish, no matter how properly I brush them.)

 

I consulted with doctor a couple of days back & he has advised me to get some blood tests (CBC, LFT, Creatinine, Vitamin D3 & B12, TSH & RBS), Stool test & Anal manometry to get done. 

 

What should I do? Shall I go with his advise or seek for second opinion?



#2 TarunSareen

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Posted 15 June 2018 - 10:49 AM

I would suggest you to leave the diagnosis to the doctor, from your end make sure you select a good specialist.

I had almost the same symptoms (regarding bowel frequency and form) initially and is changing with time, I also have 14 kg weight loss.
With such a drastic weight loss its hard to believe its ibs.
However the reality is that its nothing else but ibs, have been diagnosed by the TOP most institution (AIIMS) in India after running all the possible tests including capsule endoscopy.
All my tests are normal...

Sometime I feel that such severe ibs is even worse that ibd...
You got the result of your tests?
  • Aryan111 likes this

#3 Aryan111

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Posted 08 July 2018 - 01:34 AM

I would suggest you to leave the diagnosis to the doctor, from your end make sure you select a good specialist.

I had almost the same symptoms (regarding bowel frequency and form) initially and is changing with time, I also have 14 kg weight loss.
With such a drastic weight loss its hard to believe its ibs.
However the reality is that its nothing else but ibs, have been diagnosed by the TOP most institution (AIIMS) in India after running all the possible tests including capsule endoscopy.
All my tests are normal...

Sometime I feel that such severe ibs is even worse that ibd...
You got the result of your tests?

Hey buddy! First of all thanks a lot for replyingsmile.png & secondly I didn't get the notification of your reply. I just came to this forum again to post update of reports I have got.

 

Yes, I have consulted with one of the most renowned gastroenterologists of Mumbai.

 

I also have lost considerable amount of weight but I think the reason behind it is my reduced diet (its not unexplained).

 

If you are sure that your diagnosis is IBS then I would suggest you to look for homeopathic medicines. I have googled a bit & found that homeopathy is quite effective in treating IBS.

 

BTW here are the details of the tests & reports:

 

CBC, LFT, Creatinine, Vitamin B12 & D3, TSH, Fasting glucose & stool r/m 

There is a deficiency in Vitamin B12 & insufficiency in D3. 

The stool r/m shows presence of mucus, occult blood & RBC (1-2). Though it shows absence of blood (non-occult) & fat, I have observed blood to be there & feces floating in the bowl several times. 

I also got Colonoscopy done day before yesterday. Below are the verbatim findings & impression of the report: 

Findings - "There were presence of multiple patchy areas of ulceration seen in the colonic mucosa from rectum to hepatic flexure. The ulcers size ranged from 3 to 7 mm with surrounding erythema. The ascending colon, caecum, IC valve and 10 cm of the terminal ileum were normal. 

Impression - Infective colitis. 

The doctor also did biopsy & sent the sample to histopathology department for further analysis. Will get the reports in 4-5 working days. Once I get it, will update. 

Would like to know your opinion on the impression of the report as I don't think that it is infectious colitis because the symptoms just don't match to the symptoms I have. 



#4 Aryan111

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Posted 11 July 2018 - 05:05 AM

Hi guys! Received the biopsy report a few hours back. Have an appointment with Gastroenterologist after two days. Was eager to get to know what is mentioned in the report. I could not understand the meaning of "GROSS" & "MICROSCOPY" section of the report. If anybody understands it, please comment. Here is the report:

 

DIAGNOSIS :

Moderate colitis; likely infective origin.

 

CLINICAL DETAILS :

Increased stool frequency with fecal red blood cells.

Colonoscopy - Multiple patchy ulcers from rectum to hepatic flexure.

Impression : Infective colitis.

 

GROSS :

Received multiple grey-white mucosal tissue bits aggregating to 1.0 x 0.7 x 0.2 cm; Colonic ulcer biopsy.

Sections : A to D.

 

MICROSCOPY :

Sections show ulcerated colonic mucosa with presence of neutrophils in the lining epithelium. Lamina propria shows

moderate mixed inflammatory infiltrate consisting of neutrophils, lymphocytes, plasma cells, and a few eosinophils.

There is no cryptitis, crypt abscess or crypt distortion seen. There is no evidence of granulomas or dysplasia seen. No

parasites evident.



#5 Aryan111

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Posted 15 July 2018 - 04:00 AM

Hi guys! I consulted with the gastroenterologist yesterday. After reading the report he said that infection is most likely the reason for ulcerations seen in the colonic mucosa. He said that he can't tell how long will it take to get cured. He also thought depression or my too much of thinking might be the reason behind my stomach not getting emptied properly or it might be a component of IBS & prescribed me an anti-depressant. He told me to not even think about the issue I am suffering from. He advised me to continue with normal diet and also advised to do some Yoga & exercise. He told me not to have protein powder as well as mass gainer as of now.

I am thinking of taking second opinion. I request you to guide me whether I should continue with his advise or go for second opinion.



#6 Aryan111

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Posted 10 September 2018 - 11:16 AM

Guys, I got stool test done twice. First time I had given reddish sample for test but it didn't show presence of any blood in the report. So I got it done again. This time as well the report stated no presence of blood (though I still get to see bright red blood stuck to the stool sometimes). The only abnormal thing was that it showed the stool be acidic to which the doctor said that it doesn't matter much. 

 

Mentioning my current symptoms below:

 

1.   I don’t feel fresh & energetic when I wake up even though I sleep for 8+ hours.

 

2.   I have to go to the loo at least 3 times a day & sometimes even after passing stools for 3-4 times in the morning itself, I don’t get the feeling of completion. It feels like I empty the bowels in parts (I mean it doesn’t get emptied in single attempt). Usually third time onwards, I have to sit for long as I don’t get pressure to empty the bowels. Sometimes I have to put pressure to get the stools passed or defecation happens on its own after sitting for long time.

 

3.   The stool is mushy almost all the times. As far as I know mushy stool suggests mild diarrhoea & I think because of this dehydration happens which makes me feel exhausted (tired & sluggish). I have to sleep then as I don’t feel fresh & can’t concentrate on work. It takes me around 4 hours to get ready to kick start the day.

 

4.   I get to see small amount of bright red blood stuck to the stool sometimes.

 

5.   A lot of belching happens when I do simple exercise like warm up.

 

6.   I have to go to the loo when I wake up if I sleep after lunch in afternoon.

 

7.   I mostly feel full in the evening time even if I haven’t eaten/drunk anything or eat/drink only in small amounts. So I mostly skip snacks.

 

8.   Have got 2 attacks of severe abdominal pain in the lower left abdomen till now.

 

9.   Mouth sores (mild)

 

10. I feel hungry & the food consumed gets digested properly when I am travelling or am outdoors. 

 

The doctor has prescribed me to get anal manometry done now. I would like to have your opinion on whether should I get manometry done or seek for second opinion.

 

Thanks in advance



#7 mellosphere

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Posted 11 September 2018 - 01:04 PM

If there is a test they are willing to do, I always recommend doing it so you know what it says. That being said, from what youve described here, it sounds like it could totally be IBS.

#8 Aryan111

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Posted 15 September 2018 - 05:21 AM

If there is a test they are willing to do, I always recommend doing it so you know what it says. That being said, from what youve described here, it sounds like it could totally be IBS.

Hey! Sorry for late reply buddy. Was little busy in festival celebrations. 

 

I also think that I should get the test done now. BTW do you have any idea what is anal manometry for? I googled it but didn't find much information about it. I think its all about the contractility of the muscles in anus. Kindly let me know if you know anything about it & how it can help in confirming whether I suffer from IBS or something else.

 

Thanks in advancesmile.png



#9 Aryan111

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Posted 20 October 2018 - 10:44 PM

Hi guys! As advised by the gastroenterologist, I got anorectal manometry done. The doctor who did the procedure told me that I contract the anal muscles instead of relaxing while having bowel movement, this causes incomplete evacuation & that is why I have to pass the stools several (usually 4-5) times a day.

Below are the findings of the report:

1. Anal sphincter length is approximately 4 cm (shorter than the normal length I guess)

2. Rectoanal inhibitory reflex [RAIR] is present.

3. On bearing down he paradoxically contracts his anal sphincter instead of relaxing it and has poor rectal propulsive forces [<40mmHg] which is suggestive of "Dyssynergic defecation". He is unable to expel a 50cc balloon in 60 secs. Biofeedback sessions for anal sphincter relaxation exercises maybe beneficial.

The doctor has advised me to go for biofeedback. I googled a bit & found that biofeedback is the most effective treatment method for dyssynergic defecation but from a survey on patientslikeme I found that this treatment method isn't that effective instead people got benefited from a method like physical therapy.

Have got a few questions now:

I. Is it only the dyssynergic defecation which causes me to have 4-5 bowel movements daily, poor apetite etc or something else like IBS as well is present (I don't have symptoms of any kind of pain)?

II. What is the reason of blood being seen stuck to the stool (sometimes)? Is it Infectious colitis or dyssynergic defection or something mild like anal fissure?

III. Shall I go for biofeedback or try something else like physical therapy?

Kindly guide me. Thanks in advance.

 

 

 

 

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