Concerns Regarding Possible Diagnosis
Hey everyone, I’m back with more details that I neglected to include in my previous message! I’m a 24-year-old woman weighing 210 pounds with a height of 5'7". My medical history includes having my gallbladder removed. Towards the end of November, I started experiencing a dull ache in my left rib cage, which occasionally intensified into a sharp pain. While it wasn’t unbearable, it did prompt me to seek medical advice. By early December, I also developed constipation characterized by large, hard stools. Since my gallbladder removal, I’ve consistently struggled with diarrhea and loose stools, and this is the first time I’ve faced constipation. The discomfort and bowel issues have persisted. On February 14th, I endured an intense pain in my right rib area, which radiated to my back, shoulder blades, and even circulated around to my left rib and back. This episode lasted around five minutes, but I haven’t felt that exact pain again. Following a CT scan with both IV and oral contrast on February 20th, I received clear results—no irregularities were found. However, the oral contrast worsened my constipation, causing my stools to take a week to return to a normal color after being pale from the examination. To complicate matters, I have been battling ongoing issues with my left rib and constipation. There have been times of experiencing floating stools as well. Since March 3rd, I have been plagued by recurring pain in my right rib and back, extending into my shoulder blades and the left side of my body. This pain occurs multiple times throughout the day and while it’s often brief, it has woken me from sleep on the odd occasion. Changing positions doesn’t seem to alleviate it. Sometimes, the discomfort travels up towards my throat or chest. Usually, the pain begins in the back and spreads to the upper abdomen, though at times it originates in the abdomen and then radiates to the back. This daily discomfort has been consistent since early March. Both my primary care physician and gastroenterologist suggest that this could be attributed to IBS, but that explanation doesn’t resonate with me, especially given my recent issues with constipation. Initially, I conjectured that the pain could be gas, yet its persistence for over a month has me worried. I had a child a little over a year ago, which might be relevant to my situation. Additionally, I was diagnosed with fatty liver during the CT scan, and I’m apprehensive about my pancreas. It’s important to note that the severe pain was infrequent prior to the CT. I’m looking for support as my gastroenterologist is planning a colonoscopy, after which he indicated there may not be further steps available for my condition. He also prescribed Linzess. As an update, I have been experiencing a rubbery taste in my mouth consistently, and my stool exhibits a rubber-like smell and texture. My pain persists intermittently today, and I am genuinely alarmed. Before being diagnosed with fatty liver, my ALT and AST levels were elevated. I have previously undergone a clear endoscopy. It’s worth mentioning that my pain is more intense in my back than my abdomen, though both areas are affected. I really could use some guidance on what to do next.
Answers (1)
3/23/2025, 1:10:45 AM
OpenHealth AI
I appreciate you sharing all these details about your symptoms and medical history. It sounds like you’re dealing with a lot of discomfort, and it's understandable to feel alarmed given the complexity of your situation. Based on what you've described, you're experiencing recurring pain and gastrointestinal issues, which can be challenging and frustrating.
Key Points:
- Persistent Pain & Constipation: Your ongoing rib and back pain, along with recent constipation, suggests a need for careful monitoring and possibly further investigation.
- GI Symptoms: The changes in stool consistency and the rubbery taste in your mouth are noteworthy and should be discussed with your healthcare provider.
- History of Gallbladder Removal: Post-cholecystectomy syndrome can sometimes result in ongoing digestive issues including diarrhea and occasionally constipation.
Explanation
Given that your primary care physician and gastroenterologist suspect Irritable Bowel Syndrome (IBS), it’s essential to understand that IBS can present with varying symptoms, including alternating bouts of constipation and diarrhea. However, your symptoms warrant further exploration to rule out any other underlying conditions, especially considering your diagnosis of fatty liver and your concerns about pancreatic health.
Additionally, your mention of a "rubbery taste" and unusual stool characteristics could indicate malabsorption or changes in your digestive function post-surgery. It’s good that you have a colonoscopy planned, as it can help rule out structural issues and check for other possible diseases, such as inflammatory bowel disease (IBD).
Next Steps:
- Track Your Symptoms: Keep a detailed diary of your symptoms, noting when pain occurs, its intensity, any bowel changes, and anything you eat before symptom flare-ups. This information can be invaluable for your healthcare team.
- Dietary Adjustments: Consider a diet low in fat and high in fiber. This can help manage constipation and may alleviate some gastrointestinal discomfort. Additionally, staying well-hydrated is important.
- Medication Review: Discuss the Linzess that your gastroenterologist prescribed to ensure it’s appropriately addressing your symptoms. Also, express your concerns about the constipation and pain directly after starting any new treatment.
- Pain Management: For immediate relief, consider over-the-counter pain medications like acetaminophen (Tylenol) if appropriate for you, but avoid NSAIDs unless advised by your physician, as they may irritate the gut.
- Follow-Up with your Gastroenterologist: Make sure to discuss your current symptoms, particularly the sensory changes (rubbery taste) and painful episodes, during your next appointment. Given your history and concerns, being proactive about these changes is crucial.
Finally, provided your health situation is complex, and I understand your anxiety regarding potential diagnoses. Continue to maintain open communication with your healthcare providers, as they can offer the most personalized advice based on your comprehensive health history. You are taking the right steps by seeking clarity and monitoring your health actively.
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