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I am a 40 year old woman, and I have been a high anxiety type all my life. I was "diagnosed" with IBS about 12 years ago because I was having a lot of diarrhea. My doctor didn't do any testing, just said it was probably IBS. I have always had diarrhea when I am nervous or stressed out since then, and I've learned to deal with it.About 9 months ago, at the beginning of the school year, I start having constipation and bloating, with a weird uncomfortable lump like sensation on my right side, low near my hip, so that I couldn't sleep on my right side. After 2-3 months, I went to the doctor. My doctor sent me for a CT scan and did a bunch of blood work. The CT scan showed a nodule on my adrenal gland, which, with a follow up MRI was shown to be harmless. Otherwise, the CT scan and blood work was normal. This was taking place between November/December 2009.She recommended dietary changes and I started feeling better through the winter.In April, it returned with a vengeance, severe constipation, bloating, nausea and the strange sensation in my lower right abdomen, which then morphed into a grinding or burning kind of pain that came and went. I went back to my doctor, and they recommended Miralax, up to 4 caps per day, but also to see a gynecologist. I did see the gynecologist, and when she examined me, my right ovary was very tender, but when she sent me for a pelvic ultrasound, it came back completely normal. The GYN referred me to a GI doctor. I saw the GI's P.A. on June 1, and she scheduled me for a colonoscopy and sent me for blood work. The blood work came back showing me as anemic, so they added an upper endoscopy to rule out any GI bleeding. During these weeks I have been managing the constipation with A LOT of Miralax.The colonoscopy was on June 18th, and both the upper and lower endoscopy were normal. He did take some biopsies, which he told me were meaningless, he does biopsies for anyone with anemia, but there were no polyps or signs of cancer. He said the constipation was functional, and I could continue with Miralax. He said he's concerned about the lower right quadrant pain, and maybe I need more follow-up, but since there's no colon cancer he's happy. He gave me a prescription for a month's worth of Bentyl and no instructions for follow up. Now, I was completely loopy from the sedation, but my husband was here and heard all of this. The only follow up I have is to have another blood test to check on the anemia.Strangely, the Bentyl seems to be helping with the constipation, but that could just be residual from the colonoscopy, and the right lower quadrant pain is still there. I am so confused and feeling disheartened. My primary care doctor washed her hands when the CT scan came back normal six months ago. The GYN said it wasn't her problem when the pelvic ultrasound was clear. The GI doc says there's no GI cancer, so he's done. I don't know what to do. If it was just diarrhea and cramping, I'd go on with dealing with it, since those are familiar to me. The constipation and steady, gnawing pain is different and doesn't feel like IBS to me. Should I insist on another CT scan? The only other weird thing is that I suddenly have a swollen lymph node in my neck. The doctor attributes it to either dermatitis from some irritated skin on my neck or from the fluid in my ears that I've had for weeks now due to allergies. She insists it can't be connected to the abdominal problems I've been having.The only good thing is that I haven't lost a lot of weight. Initially when I was very constipated and nauseated I couldn't eat and dropped a bunch of weight, but managing it with Miralax helped with that. I don't want to take 4 caps of Miralax every day and I would really like to not have any more pain.Any suggestions on which doctor to get more insistent with?
 

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It sounds like you have had a very thorough work-up. Personally, I would not undergo any further diagnostic testing involving x-rays. The radiation from CT scans is quite significant. If you are not completely satisfied with the diagnosis, which it sounds like you are not, there is a new procedure offered by some gastroenterologists and radiologists called MRI Enterography which is primarily used to examine the small intestine. There is a prep involved with the procedure, but is it nothing like a colonoscopy. MRI's do not expose you to any x-rays. If you are fearful of small spaces then you should let them know this ahead of time so that they can give you something to calm you down.If you do not want to do any further diagnostics then you could borrow all your diagnostic images and take them to another gastroenterologist for a consultation. It may be reassuring to get another opinion.Since you mentioned being anxious, you may also want to investigate medication and/or cognitive behavior therapy (CBT). Both may help with that.I hope this is helpful to you.Jeff
 
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