“What is causing this abdominal pain?”
H/O total gastrectomy 2008. I had a small surgical hernia afterward, of no concern to my physicians. In 2019, I developed pain, ending in the local ER. The CT showed "bowel in hernia", small dose Fentanyl (25 mg) stopped the pain, transferred to the inpatient facility, pain remained OK, discharged the next day. An appointment with a hernia surgeon was scheduled. Back in the ER with severe pain before my appt. Not told the results of CT. Exploratory lap, then hernia repair soon after. Was told by the surgeon and hernia surgeon to stay on a low residue diet. No GI follow-up was suggested. About 2 years of abdominal pain and erratic bowel movements. The best self-treatment has been a strain Lactic b. probiotic and magnesium supplement. It seems if I stay on my back to sleep, I sleep better. If I turn on either side I feel my abdominal contents shift, sometimes a sharp pain involved and after that bloating, small pencil stool, explosive diarrhea episode, feeling of a baseball in my abdomen, and more. Thank you for any suggestions you have.
Female | 77 years old
Complaint duration: 18 months
Medications: Vitamin B12 injection 2xmonth
Conditions: h/o total gastrectomy for Ca. Ca has not returned
4 Answers
You need a colonscopy and repeat CT scan of the abdomen and pelvis.
You might have small intestinal bacterial overgrowth, given the history of surgery and the nature of the symptoms. A trial of antibiotics might help. A GI doctor can evaluate you to try to ascertain the cause.
You may have an "internal hernia" that comes and goes based on your position. If you think of a telescope, how it opens and closes on itself, that's basically the idea of what an internal hernia is. So laying flat keeps everything nice and straight but when you move your side you close the telescope, and this bunching up causes a bowel obstruction. The explosive diarrhea is a result of your bowel muscles trying to move the obstruction.... That's kinda what it sounds like to me. Low residue diet, the magnesium all that keeps the system moving right along without slowdowns to reduce the chances of it happening... That's what it sounds like but I'd talk to a surgeon
Get results of ct scan and give to oncologist surgeon
