Cyclical pain in flank, chest, bloated stomach. Alcohol intolerance.

Resolved question:
Hello. My symptoms include side/flank pain, lower rib pain (both sides) chest wall pain, narrow bowel, changes in bowel color (green when feeling worst, light brown when feeling better), always bloated/burping/belching, alcohol intolerance (not vomiting, but easily intoxicated). I'm sure there are more. In general, my abdominal health has deteriorated rapidly over the past two years. My symptoms seem to come and go, which is hopefully an indication that cancer is not a cause. The 'flares' of symptoms last no less than a few days and up to a few weeks. The only medical procedures I have had in this timeframe are full blood work and an ultrasound of my gallbladder which came back clean. Any ideas? And, more importantly, is the cyclical nature of the symptoms, in fact, an indication that cancer is less likely? I'm only 29 years old patientold.

Submitted: 4 Days
Category: Gastroenterologist, Medical

Expert:  Dr. Ratnakar Kini replied 4 Days.

Hello.
Thank you for your query at DoctorSpring.com.

I am Dr.R.K and I am pleased to assist you.

Looking at the description of your symptoms, cancer is unlikely. So please do not worry in that regard.
I would like some additional information before I can give my opinion.

1. Do you get nocturnal symptoms, i.e., any symptoms at night?
2. Is there any weight loss?
3. Have you been tested for Coeliac disease?
4. Any other medical illness?
5. What medications are you taking for relief of your symptoms?

Please revert back to me with this information and I would be better able to give my opinion.

Regards,
Dr.R.K.

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Patient replied :

1. As far as nocturnal symptoms, nothing typically wakes me up. I may wake up naturally and still feel bloated or general discomfort, but I rarely wake up due to pain. 2. I have not had any weight loss; in fact, the opposite. My symptoms actually began after a period of significant weight gain. During my fiance's pregnancy, I went from about 205 to nearly 230. It was near the end of the pregnancy that I began experiencing more severe symptoms, and thus it was after the weight gain. I now find weight difficult to drop, and if I do lose 5 or 10 pounds it quickly comes back, even with generally healthy eating. Honestly I feel as though I'm carrying around excessive feces, and most of this weight is carried in my stomach and upper abdomen; an uncomfortable feeling of distention. 3. I have not been tested for coeliac disease. After recieving your reply, I took a screening quiz at a .org regarding gluten sensitivity. I identified 26 symptoms that I experience regularly, and probably 5-10 of those I experience constantly. Upon completion, the result read something to the effect of "you present more than 4 symptoms and likely have some level of gluten allergy". 4. I have no other medical illness that I am aware of. Over the timeframe of this off-and-on illness, and general feeling of unhealthyness, I have on two occasions presented yellow in the whites of my eyes. It was faint, but was noticed and brought to my attention by others. For this reason, I worry about my liver. I've also read that constipation and any of these bowel and bile duct related issues can cause this, so I suppose that's not necessarily the case. 5. I am not taking daily medication of any kind. I will take gas pills or tums on occasion in hopes of bloating relief, but generally this is to no avail. I will take the occasional vitamin, but by no means do I remember to take it daily. I have not noticed a difference in abdomen health while taking the vitamins. In fact, I remember a particular instance where I feared it was contributing to the problem as I was remembering to take them and feeling worse and worse.... Likely a coincidence, I suppose. In addition, I wanted to point out that I experience skin sensitivity. By that I mean tenderness to touch. If I scratch, particularly around the abdomen (both sides, front and back) I have a feeling of a bruise being pushed on for about 20 to 30 seconds afterwards. I believe this is a symptom that comes and goes, but honestly I only notice it being there, and don't notice it not being a symptom, if that makes sense. Other symptoms I may have forgotten include: excessive sweating (seriously more than anyone I've ever known; this is not always the case, but when I'm feeling bad it's worse... Not typically cold sweats, but sweating in general). I will sweat to the point of soaked hair with relative easy activity such as golfing --- by the second hole. I had a light gluten free dinner tonight, but understand that the possitive affects this could have, if in fact I have a gluten allergy, will take time. I will hope to see quick changes regarding the bloating, reflux etc. even if the overall pain and, I assume, inflamation takes time to alleviate itself. I am certainly interested in more of your thoughts and opinions on this. In particular, for piece of mind, I was wondering what about my case leads you away from cancer. I should tell you, another symptom is general anxiety.. Ha, can you tell? That said, I assure you that my symptoms are VERY real, and are slowly taking over my life.
AH! One last thing that I wanted to mention. One thing that has typically steered me away from IBS type conditions is that I do not experience an unusual amount of diarrhea. To the contrary, I have more issues with constipation and hemmorrhoids. That said, I would never call my movements 'solid' by any means. On the bristol scale I am consistently at a type 6; fluffy in appearance, almost mossy, soft appearance, but formed. Sorry if this is not pertinent.

Thanks for your help!


Expert:  Dr. Ratnakar Kini replied 3 Days.

Hello.
Thanks for the additional information.
You do not have any alarm symptoms which are suggestive of cancer. So cancer is unlikely.
Going by the description you have given and that you do not have any alarm symptoms and the recurrent nature of your symptoms point towards functional bowel disease. You are having functional dyspepsia and irritable bowel syndrome. You need not have unusual amount of diarrhea to call it IBS. You probably have a mixed type of IBS.
You need to get the following tests done before calling it functional.
1.Complete blood count.
2. Stool analysis
3. Thyroid function test
4. Test for celiac disease
5. Test for H.pylori
6. Blood glucose
You can take antispasmodics and antidepressants for relief.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.

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