Is it Diverticulitis or IBS?

@elle1233 , Diverticulitis is the word for when the pouches become inflamed and infected. I have had so many times I cannot count.. diet doesn't keep it from happening. Since the bad bout I had a couple of years ago.. which I did not have the classic symptom that time of left side pain; it was throughout my lower abdomen... I have been tender in my lower abdomen. The pain gets very bad when I get a gassy stomach. Nothing helps the gas and I was told after my last surgery at the Mayo in Jacksonville that no medication will help rid me of the gas.. but I still try the meds for it. Sometimes it helps a little. Walking, heating pad and massages help. With me pressing on any part of my lower abdomen hurts.

I actually thought when I had the bout of diverticulitis it maybe was adhesions from my hysterectomy or maybe a fissure. I had a pelvic exam to make sure and then a MRI... which the pockets showed up and inflammation. So yes it clearly shows on an MRI. Thickening also showed and I had a colonoscopy to check that out and there was no cancer. Instead of the couple of pockets I now have them throughout my colon and more likely to get diverticulitis. Thankfully I have not had another bout for a while.

So far no SIBO or auto immune disease. I have to go to the Mayo for all my upper abdomen, stomach, and esophagus issues. My local GI doctor is very good, but he says they changed me so much during the last surgery that he is not comfortable handling it. He still looks after my lower abdomen. I think soon he will retire.. he is in he mid or late 50s, but I think he will retire early and I will probably have the Mayo handle it all if they will. I am only 5 hours away, but hate the drive.

Hi TennisGolf

I just wrote a reply to your first comment.. and again I'm excited to hear you describe your problems, because I have experienced the same thing .. and still am after GB surgery, and have felt so alone. However, sad; because it has been 11 years, and I have no answer yet. FYI, I am 58 now, and was 47 when I had my gallbladder surgery. I had no prior abdominal surgeries, and have not had children.

What really strikes me is the kind of pain you are describing. Mine is a little higher than yours, but very similar.. just to the left of my naval is the center (although now it spreads out to general lower abdominal pain, and also upper left quadrant. But there is that sharp, localized area. Also interesting, is that the biggest aggravating factor for my pain is having a bowel movement. On the rare occasions that I have a "normal" or larger BM (sorry, GI discussions get graphic 🙂 ), it really flares up that pain. The pain is always there, has been for 11 years, it varies in intensity from level 2 (rare) to level 9. I have spent as much as a week in bed/on the couch. Like you, I was very active prior to this, and don't consider myself a "wimp". This pain is bad. I tore my rotator cuff, had that repaired, went through all the rehab - nothing compared to this. And - at least there was an end.

Like you, it feels like there is something "restricting" things, or being pushed, pressed on. I also find pressure on the abdomen helps me "go". In fact, I feel better wearing tight "girdle" support undergarments, and even will take a large ace wrap and wrap it real tight around my abdomen. It feels like I'm supporting my colon.. so I know what you mean. I don't know if I am. I am 5'5" and weigh 95 lbs now, so I am very thin. I've bought various back support things that I wrap really tightly around my abdomen, and that helps. In fact, as I type, I have a heating pad on, over which I wrap this 6" wide velcro strap as tight as I can, because this feels good. This is how I spend all my evenings.

I think ruling out diverticulitis can't hurt, although FYI, diverticulitis isn't supposed to cause pain, only when they get infected and become diverticulosis (I think that is what that other person is talking about). I have significant diverticulitis in my sigmoid colon but Dr. says that is not cause of my pain. I've thought about adhesions like you, but my pain, like yours, started right after the surgery, I think adhesions might take awhile to form. Although you could have some from the past that got aggravated.

Don't feel bad about the reaction you've been getting from the medical community.. I've been getting it for 11 years. I'm a little depressed b/c I just finished up with another round of testing/consults at Mayo, and Dr. is saying it is irritable bowel syndrome. I still think something is wrong. If it is IBS, my bowel has been irritable for 11 years. I've done all the meditation, yoga, deep breathing, all that business. I don't know, maybe if you get really good at meditation it can help, but IMO, it doesn't really help pain that much.

Interesting you bring up the small intestine.I had a motility test, and my small intestine is very slow. Dr. Said , doesn't matter. My colon is supposedly normal. However, I also have SIBO, which according to the literature, is common with slow sm intestine motility, so seems like it does matter! Then he says, well, he doesn't think the SIBO is my problem, because I should have diarrhea. But, according to other centers, and the literature, people with SIBO can have constipation. I'm so frustrated that I came to this supposed #1 GI center in the country and the Dr. doesn't seem to understand this issues more than I do. I think these younger Drs. just learn some "rules" and then can't think outside the box, like you do sometimes. After 11 years, I've done a lot of research (I don't mean to sound like a snob -but I have learned quite a lot.

Like you, initially they kept giving me all kinds of laxatives, blaming everything on constipation. I don't think I was constipated initially, but I do seem to have developed a problem with it. I think all the laxatives made me dependent on them. Geez, one Doc had me doing colonoscopy preps a couple times a month. It didn't change my pain one bit. Just made me miserable and lose more weight.

The only thing that seems different with you, is having the bowel changes before. I would think a doc would find that significant. I agree, it's scary - the medical system these days.
And you do need a patient advocate.. sadly, no such thing exists. you have to be your own. Don't feel bad about being a "problem" patient! I'm sure I'm viewed that way, but it's the only way you'll get help! Turns out, by "problems" are in my small intestine and stomach (I mean the abnormal things on tests), found by endoscopy, and the only reason I had one was b/c I asked for it! The Dr. wasn't even going to do that, and I would have missed the only thing he's treating me for.

So, I know now not to waste my time with a Dr. that doesn't have anything to offer me, or who doesn't know more than me. I do have another idea based on a CT abnormality that the Dr also said "isn't a problem", but fits in with my symptoms, so I'll be taking it to another Dr.

I figure, I have no life anymore b/c of this pain (and now constipation/accidents), so I might as well spend it trying to find a solution. I'm eager to hear what, if anything you find, b/c it might help give me some clues.

It really drives me crazy that they blame so much on constipation. I always knew my pain wasn't related to that, and it isn't now. Being constipated makes me or anyone more uncomfortable, but I have pain when I've had diarrhea for a week. For some reason, they keep giving me that diagnosis. So.. you hang in there.. keep asking for tests and answers.. and if you don't get any... go elsewhere. And, if laxatives help you, take them, but if they don't, throw them out, because like me, it's crazy to think pain that starts immediately after a surgery is caused by constipation. And if you keep taking all that stuff, eventually you will become constipated without it. I know that's what happened to me. Look forward to hearing your progress.

I have pancreatitis and diverticulitis. I know the difference with pain. Pancreatic pain is on the left side next to the navel, or lower left side. I have diarrhea....lost 20 lbs in the past 4 months. Had a stool test and found my pancreatic enzyme result was less that 15mcg. Should be 200mcg. Going on pancreatic enzymes tomorrow. Gallbladder surgery can cause pancreatitis, since they are closely related.
This probably won't help you, must maybe it will. You never know. Good luck!

No, hearing about all these problems really helps, even if it rules out things. Interesting, b/c that is where my pain is to left of navel. In fact, I've thought about pancreatitis because its about the only thing located where my pain is. I know you can have acute or chronic pancreatitis. I don't have diarrhea though, don't know if that's a requirement. I feel nervous about asking my Dr. for more tests, because I pretty sure he thinks I'm crazy and has decided except for the SIBO and bile reflux, everything else is IBS and I should be to pain management group therapy 🙂 I still think something is 'wrong' and not ready to give up.

Do you just need stool test for pancreatitis? That wouldn't be too hard.

EUS is the best diagnostic tool. Also, MRI and CT scan of pancreas. Also bloodwork for pancreatic enzymes, amylase and lipase. If just one of these suggest pancreatitis, doctors will continue with the testing. I had it all, and they all suggested pancreatitis. Reason for the stool test was because I was having so many stools a day, not necessarily diarrhea. Doc tested me for parasites, Ulcerative Colitis, Crohns, and pancreatic enzymes because I was losing so much weight and had so many stools.

All your responses to my mystery have been so thoughtful and helpful. I went to my GB surgeon 3 times and he seems almost clueless and keeps saying "You are fine". He says not hernia after a 2-second check. My internist says not diverticular., but it seems like a muscular problem. They both suggest colonoscopy. But now that I think I may have discovered problem (abdominal adhesions) myself, I think that needs to be addressed before a colonoscopy? Would that make sense? I have not had one in 10 years. Age 70+. Physically very active (when normal). Busy lifestyle. Interestingly, Cleveland Clinic's website says "Listen to your body." Seems so important.

@tennisgolf , @courtneyt , hi to both of you. I have been reading through this thread and agree with everything I have been seeing. I just wanted to add to if a future olonoscopy rules out other things, and leaves you with a diagnosis of IBS, that you might also want to have a pelvic floor exam done by a pelvic floor therapist or a specialist who deals with pelvic floor dysfunction. I was having similar pain in same abdominal area for years after several surgeries in that general area, which eventually became worse throughout the years. It all came to an excruciating painful climax last March. Eventually, after having test after tests and exam after exam, which ruled everything else out, I was told by both my Internist and my GI, that I have IBS-C&D, pelvic floor dysfunction, interstitial cystitis, fibromyalgia, and BE. I have also had a whole year and a half to do all of my research and everything seems to be flowing with what my team of specialists are telling me (I have a GI for ibs, and BE, a rheumatologist for the fibromyalgia and chronic pain with relation to my CNS [nerves], a pelvic floor physical therapist [in relation to not being able to relax my muscles due to adhesions from surgical scar tissue as well as from stress], and a Urogynocologist for my IC [painful bladder spasms]. Sometimes poop and gas backs up in the intestinal track right where your pain is that you're describing is and there's a physical manipulation you can do that my therapist taught me in order to get it flowing again. Obviously, it's also extremely important and most beneficial to follow a restricted diet for this as well. Since my IBS is both constipation and diarrhea, but more so constipation, I follow the Low FODMAP diet, which you can Google. But, also, in addition to this physical manipulation I'm talking about, the muscle/fascia tissue needs some kind of consistent therapy to loosen up to where those tight restricted muscles and nerves can learn to relax again and push out whatever waste needs to be pushed out, without the pain. They can do surgical procedures to remove some of the scarring, but it's usually not recommended (unless your case is severe and nothing else has worked) since this will be yet another surgery, with more possible scarring. I am not completely better, but I am making much progress from where I first started. In addition to the helps I've mentioned already, I do physical therapy stretches and now as of recent, strengthening stretches at home, daily, which my therapist taught me. I am also having to take a nerve relaxer as well as a muscle relaxer daily to help while I am still a work in progress but my rheumatologist is hopeful that I will be able to only take as needed in the near future as I continue to get better, from time to time, whenever I get a flare up. He has put me on the lowest dosage for both of those meds, and neither of them are habit forming, thank God for that, bc they really have helped relax me as well as keep the chronic pain that I used to feel, at bay. I don't know if any of this will help you, but I just wanted to share a little bit of my journey with you. And, if you have any questions about anything that I said here, please let me know here in the thread, or feel free to send me a private message. Keep us posted on whatever you find out and on how you're doing!