Diverticulitis? Diverticulosis? IBS? Muscle tear?

Posted by tennisgolf @tennisgolf, Wed, Aug 7 7:54pm

I had gallbladder surgery 6 WEEKS ago. Things seem OK. But my stool has totally changed in past 6 MONTHS. Have been extremely regular always – for decades. Now stools are a little ragged, always have "little bullets" either separately or inbedded in a larger stool. No blood. Color is normal. Consistency is a little soft but they are formed and no diarrhea. A little constipation sometimes (NEVER before happened in my lifetime!). Stools always has a little skinny "tail" on ends (I KNOW THIS SOUNDS RIDICULOUS). I feel FINE. ALWAYS HAVE. QUITE HEALTHY. But since gallbladder surgery I have a rather sore spot in bottom left side (colon). GB surgeon says I may have Divertic. I feel like it is a deep muscle tear deep inside. I will get a colonoscopy (have not had one for 10 years). But one more thing: sorry to mention this, but all stools have the oder of a "chemical". Like iron?? It is not a bad odor, but it is always the SAME. WEIRD/WEIRD/WEIRD situation. Urine has been quite yellow since before the GB surgery. It still is usually yellow. Should I go to gastroenterologist? Get a colonoscopy? I FEEL FINE EXCEPT THE SORENESS IN LOWER LEFT ABDOMAN. I am not a crybabiy – but suddensly I seem to have conditions that I never had before. Am very active physically and mentally. Sounds weird, don't you think?

I would go to a GI doctor just because of the lower left abdomen pain. It can be diverticulitis… which can be very painful. Gallbladder problems and removal can cause you not to digest some things as you did before so that may be the stool problem. .. of course many other things could be the cause.

Liked by graceandpeace

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Thank you for your response! I have been calling all morning to get appt. for Colonoscopy in a large medical group I go to in NY. So far, everyone is booked. Will keep trying. Tried to go directly to Memorial Sloan Kettering – but they seem to want to know if I have been diagnosed with cancer. Certainly hope not – but some symptoms seem to possibly suggest that.

Liked by graceandpeace

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@tennisgolf

Thank you for your response! I have been calling all morning to get appt. for Colonoscopy in a large medical group I go to in NY. So far, everyone is booked. Will keep trying. Tried to go directly to Memorial Sloan Kettering – but they seem to want to know if I have been diagnosed with cancer. Certainly hope not – but some symptoms seem to possibly suggest that.

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You do not need a colonoscopy for diagnosis of diverticulitis. Sometimes just a physical exam and other times a ct scan.

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By a gastroenterologist? My general surgeon for gallbladder suggested colonoscopy (with a Dr. he knows). He specializes in hernia and ruled that out.
My long-time internist also suggests colonoscopy.

Liked by graceandpeace

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@tennisgolf

By a gastroenterologist? My general surgeon for gallbladder suggested colonoscopy (with a Dr. he knows). He specializes in hernia and ruled that out.
My long-time internist also suggests colonoscopy.

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Usually you meet with the gastroenterologist and he/she decides what test you need. If your surgeon referred you to one he knows that is just fine. If you have a general practitioner or family doctor they may be able to take care of it. Usually diverticulitis is treated with two antibiotics. It is basically an infection in a diverticula… pocket in the colon. It should be taken care of soon as possible being it is an infection.

Liked by graceandpeace

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Thanks. I have been reading too. I have had 2 TKR – the last knee was 7 months ago – so infections can be serious.

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I am replying to my own post! I think I have figured out the problem (NO thanks to doctors who DO NOT LISTEN TO THE PATIENT. Unprofessional).
Based on my research, I think I have abdominal adhesions/scar tissue after gallbladder surgery June 2019. And now reading Mayo Posts, I am encouraged that I may be right and can seek new doctors. Surgery was OK. Except went to ER 4 days later because I could not move bowels. All along I have had a pain on left – 3 inches left of navel and 2 inches down. It is always sore; pulses a little and it is like a muscle tear – that is why I think adhesions. Painful: having BM, sneezing, major difficulty getting in and out of bed. Sitting is fine. Standing is not too bad. But cannot really exercise.
Surgeon did Lap. surgery and also worked on naval hernia (that I had no clue I had!). I also had former abdominal surgeries (hysterectomy, oopherectomy, pregnancies, etc. – which he knew). Here's the thing: I told him it is hard to "push" (I think this is part of bathroom problems). He keeps saying "You are fine."
Went to my internist who thinks it is muscular – not diverticular. Have appt. for colonoscopy. However, I do not think it is a good move until I have a new GI Dr. or surgeon examine me. And I want to find a very experienced one.
Oh, I discovered when I do go to bathroom, if I push my hand against my abdomen, it is less painful. As if I am supporting the colon or something?
Is there any reason I should stay with my Gall. surgeon? I have had 3 post op visits and he is not attentive to what I say. Last time he said maybe "diverticular and get a colonoscopy". I think I should leave local hospital and go to the best Drs. I can find in N.Y. City which is nearby. How does anyone suggest I get them to see me asap since time seems to be an issue with adhesions or organs that are stuck(?) or compromised by same? It hurts every day. I do think after a bowel movement there seems to be less pressure for a while, but still sore. Sorry, I am disappointed with the medical profession. Noen of the doctors mentioned adhesions or scar tissue which I find astounding. Thanks for thoughts.

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@fourof5zs

I would go to a GI doctor just because of the lower left abdomen pain. It can be diverticulitis… which can be very painful. Gallbladder problems and removal can cause you not to digest some things as you did before so that may be the stool problem. .. of course many other things could be the cause.

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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.

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@tennisgolf

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.

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Hi tennisgolf: You sound kind of like me, even your age, 70+. My complaint is somewhat different but I see similarities.
Many years ago I had hysterectomy, 1988, and then gallbladder removal in 2005. At time of GB surgery I was told I'd had loads of adhesions to get through, and I assume that was due to the earlier hysterectomy.

Now I was recently diagnosed, after several years of reflux and other digestive complaints, with Barrett's esophagus. It has no symptoms in itself, but was found during endoscopy and typical symptoms of GERD are what I feel. Along the way to this diagnosis I had many medical tests because I began unintentionally losing a lot of weight and internist and an ENT got concerned. I also have a raspy voice that comes from GERD often, and one vocal cord is messed up so ENT wanted to be sure nothing bad was pressing on it; hence another scan.

I had no appetite to speak of and those reflux symptoms and had just slowed my eating way down. I also became depressed/anxious about all things medical..

Anyway, re the pain you feel in left side since your GB surgery. I get it, an the way you describe it. I have always had typical digestive pains, suggestive of IBS, but this colonoscopy, which was my first recent test, revealed nothing except for newly found redundant (too long) colon. It is also called 'tortuous.' Never knew about that before and it 'can' be acquired over time, they say. I did not hear 'redundant/tortuous colon' when having my first colonoscopy many years ago and I was not 'sore' for weeks after that one but I am much older now.

A routine pelvic exam I had last year just about killed me, too. I was sore from that experience for weeks and in years past (numerous years ago and many pelvic exams), I never had that reaction. They say older people tend to feel pain LESS but you and I seem to be exceptions to that and are encountering pain now.

Within a week of that recent colonoscopy, leaving my insides extremely sore I found that I had a searing pain just above the navel and across upper abdomen in a straight line when 'pushing' (NOT straining) during a bowel movement, most of the time, not all. Afterwards, I would feel no pain. If I sat back on toilet and pushed again, when NOT having a BM, I would not feel the pain at all. I asked the GI doc about it but he brushed me off, said it could be due to constipation, and with all other scans (due to weight loss) showing nothing in any of the abdominal organs, he seems to think I'm nuts. He is a good and well respected doctor but can be less than personable and is dismissive.

This was all several months ago now and the pains when, not before, not really after, but right during the act of pushing (sorry about the TMI) itself brings on this searing pain that now covers entire upper abdomen. I have no idea if it's from any adhesions, as you are wondering about in your case, or if during colonoscopy the doc 'did something' to the colon when manipulating that scope around, or the loops and twists in extended colon worsened and that's what I'm feeling.

I finally got another appt. with this doc since a GI seems to be the right specialty to address this, but it's not for three weeks. Like I said, he is well known, considered excellent, and even other docs go to him. So every time I need to have a BM I know I will have this tearing/searing pain across upper abdomen . It seems odd that nothing showed up on any of the CT scans I've had. I dread the doc's reaction when I see him again in three weeks. Wondering if I should change doctors or see some other type of specialist or what.

Believe me, I feel your pain and understand your dilemma re who to see and where to go! I do know that gall bladder and any other abdominal surgeries leave us, most of us, with adhesions that can be extremely painful. In fact, doesn't even have to be surgery. Any trauma to an abdominal area can cause adhesions to form. I just didn't think the pain of adhesions would occur or worsen during something 'mechanical,' like having a BM. You mentioned something similar on your left side that sounded similar.

I look forward to hearing your next report. I'm about to throw myself on the mercy of UCLA here in L.A. and try to get a diagnosis. With you near NYC and great facilities and me near UCLA we both SHOULD be able to get the attention and care we need. I hate to say this but I hope we aren't being brushed off due to being over 70! My best to you.

Liked by graceandpeace

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@tennisgolf

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.

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In 2017 I had diverticulitis. It was not my normal pain with it. It started lower on my left side. My first thoughts were I had pulled a muscle from coughing. Second thought with more pain was adhesions from the hysterectomy I had in 1997… then the pain moved more centered in the lowest part of my abdomen. I start thinking a vaginal fistula. So I saw a gynecologist All was fine there. He ordered a ct scan. Somewhere in all this I had short bout of diarrhea and then constipation. Diagnosis was diverticulitis and the doctor did not put me on antibiotics. It was a few days after getting results I had an appointment with my gastro doctor.. I had scheduled it months before as a regular check up. He was surprised that the gynecologist had not started me on antibiotics. By this time my whole lower abdomen was hurting. I did the round of antibiotics and had a colonoscopy about 6 weeks later… doctor wanted time for it to heal. I did not clean out well, but he was able to see the one section that concerned him most.. Instead of the couple of diverticulum I had a colon full. I another colonoscopy a few months later. One polyp… pathology was fine on it. Now since I have more of the pockets I will be more susceptible to diverticulitis.

My point is… just because it feels muscular it may not be. It could be a blockage or diverticulitis or something else causing your symptoms. I think you should see a good gastroenterologist.

Your doctor may want you to have a ct scan, ultra sound, and or a colonoscopy or other test. Yes, Know your body and find the words to express what your body is saying. Write down your symptoms so you do not leave anything out as you talk with your doctor. Write down questions.. bring something to write on and with to your appointment. Take someone with you. Two sets of ears are better than one. Sometimes the other person can think of questions that you have not.

I don't know what I would do without my husband going through all of this with me… fortunate to still have him. We just celebrated our 50th wedding anniversary.. taking care of my 91 year old mom. No cards… no gifts, no fancy dinner just taking care of each other and now along with my mom.

Liked by courtneyt

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@fourof5zs

You do not need a colonoscopy for diagnosis of diverticulitis. Sometimes just a physical exam and other times a ct scan.

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How do people research doctors anyway? I do it by: Education, Hospital, word of mouth and online articles (such as ProPublica's Surgeon Scorecard). ProPublica is terrific. Provides thorough details on why and how they rate surgeons. The Scorecard is only for MEDICARE PATIENTS FOR about 6 COMMON SURGERIES (KNEE REPLACEMENT, GALLBLADDER, HIP, SPINE etc.). They use Medicare data based on sample size of 17,000 surgeries. This was excellent for my research on TKR. But the data is only for 2009-2013. I do wish they would perform their studies again.

Also when it is said Gallbladder surgery can be affected by prior abdominal surgeries – does that include vaginal child birth (probably not), Hysterectomy/Oopherectomy?, Abdominoplasty? I am interested in scar tissue or adhesions from these former procedures.

And when surgery reports say "No Complications" – what does that include? During gallbladder, if a small intestine is nicked or touched – is that a complication if nothing serious results? I guess we don't discuss ophthalmology in this forum but …. Following Cataract surgery on one eye, if pupil in new eye is a bit larger than the other eye, is that a complication? If the eye lid now has a very slight droop, is that a complication? If there is a tiny indentation (not quite a scar) by the brow where I assume a tool was used, is that one? Surgeons says no. I say yes. What does one do? Call in the FBI? or live with it if it is nominal (which means perfection seems not to be a goal)?
There are no simple answers, are there?

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@tennisgolf

How do people research doctors anyway? I do it by: Education, Hospital, word of mouth and online articles (such as ProPublica's Surgeon Scorecard). ProPublica is terrific. Provides thorough details on why and how they rate surgeons. The Scorecard is only for MEDICARE PATIENTS FOR about 6 COMMON SURGERIES (KNEE REPLACEMENT, GALLBLADDER, HIP, SPINE etc.). They use Medicare data based on sample size of 17,000 surgeries. This was excellent for my research on TKR. But the data is only for 2009-2013. I do wish they would perform their studies again.

Also when it is said Gallbladder surgery can be affected by prior abdominal surgeries – does that include vaginal child birth (probably not), Hysterectomy/Oopherectomy?, Abdominoplasty? I am interested in scar tissue or adhesions from these former procedures.

And when surgery reports say "No Complications" – what does that include? During gallbladder, if a small intestine is nicked or touched – is that a complication if nothing serious results? I guess we don't discuss ophthalmology in this forum but …. Following Cataract surgery on one eye, if pupil in new eye is a bit larger than the other eye, is that a complication? If the eye lid now has a very slight droop, is that a complication? If there is a tiny indentation (not quite a scar) by the brow where I assume a tool was used, is that one? Surgeons says no. I say yes. What does one do? Call in the FBI? or live with it if it is nominal (which means perfection seems not to be a goal)?
There are no simple answers, are there?

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@tennisgolf Thanks for the info on ProPublica, I had not heard of that before. I generally check healthgrades and vitals but only find them credible if there are numerous reviews. Locally there is a yearly edition of a magazine that names doctors that many people have voted best. These days I rarely use local doctors though but I also ask friends and family about doctors in Boston.

You ask some intriguing questions to which I have no answers.
JK

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@tennisgolf

How do people research doctors anyway? I do it by: Education, Hospital, word of mouth and online articles (such as ProPublica's Surgeon Scorecard). ProPublica is terrific. Provides thorough details on why and how they rate surgeons. The Scorecard is only for MEDICARE PATIENTS FOR about 6 COMMON SURGERIES (KNEE REPLACEMENT, GALLBLADDER, HIP, SPINE etc.). They use Medicare data based on sample size of 17,000 surgeries. This was excellent for my research on TKR. But the data is only for 2009-2013. I do wish they would perform their studies again.

Also when it is said Gallbladder surgery can be affected by prior abdominal surgeries – does that include vaginal child birth (probably not), Hysterectomy/Oopherectomy?, Abdominoplasty? I am interested in scar tissue or adhesions from these former procedures.

And when surgery reports say "No Complications" – what does that include? During gallbladder, if a small intestine is nicked or touched – is that a complication if nothing serious results? I guess we don't discuss ophthalmology in this forum but …. Following Cataract surgery on one eye, if pupil in new eye is a bit larger than the other eye, is that a complication? If the eye lid now has a very slight droop, is that a complication? If there is a tiny indentation (not quite a scar) by the brow where I assume a tool was used, is that one? Surgeons says no. I say yes. What does one do? Call in the FBI? or live with it if it is nominal (which means perfection seems not to be a goal)?
There are no simple answers, are there?

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You are correct… there are NO simple answers usually… but second opinions should be a must for almost any surgery, except emergency,….. I live in a University Town in Iowa.. but my background as a professor has taught me that a review of literature (Read a lot from credible sources) and Opinions are part of that review is necessary to find even the way to attack a problem. Science is ever-changing but I believe in Science that has been Peer Reviewed. When I go to my local clinic… which is very large… maybe 75 physicians … I get my second opinion from the Mayo Clinic.. but places like the Cleveland Clinic… or Boston General… or John Hopkins…or M.D. Anderson in Houston…. are certainly credible … I like Mayo (Rochester) because they have a whole different approach to "time spent with the patient"…. Mayo generally pays their physicians in a manner that is not so competitive, it was explained to me…but Mayo has its own Medical School etc… Even when your local doctor suspects something… get a referral to Mayo… that works best initially… Mayo even has an Emergency Room… Good Luck…

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I am replying to my own post. Currently I believe I am considered a problem patient. I have asked several times for a CT Scan and think I am getting it next week. First they need to take (another) blood test. IS THAT A TYPICAL REQUIREMENT? My Laparoscopic Gallbladder surgery was 8 weeks ago and I have complained over and over about pain in lower left abdomen (~ 3 inches left and 1 inch down from belly button). During GB surgery a naval hernia was fixed (although it never bothered me and did not know I had one). My incisions are fine; no fever; no weight loss, so nausea – so my surgeon says "You are fine." BUT I A NOT FINE. Could that surgery have caused problem in small intestine? colon? strangulated organ? could there have been scar tissue from prior surgeries (30 and 35 years ago – total hysterectomy/oopherectomy or abdominoplasty) that suddenly cause a problem? Since surgery I have met with GB surgeon, internist, and gastro. (he wants me to take more laxatives to make passage easier). All have different ideas. But I am thinking Diverticulitis or adhesions. It hurts every day. BMs have been totally unusual in appearance and varied for 7 months. When I strain for BM, I find if I push my hand hard against my belly, it helps relieve pressure and soreness so I can strain effectively. I told my surgeon 1 wk. post op that I could not "push" as well. No comment. Sometimes they do not listen.
I wonder if he has delayed the CT Scan for a reason? Perhaps so more time passes since surgery so it does not reflect on the surgery? As you see, I have become untrusting, disgruntled and am annoying my medical professionals with my questions. I feel disgusted. GB is supposed to be an easy surgery. Overall I am and have been a healthy, active, and engaged "senior". I had TKR 7 months ago (my second one) and that has been quite good – still working a bit on leg exercise.
For a year I have had a dental abscess (not painful or problematic at all – but Prosthodontist wants it fixed) – am in the midst of dental implant – so my poor system is being taxed. Anyway, I just feel medical folks are stalling. I need a patient advocate. Time may be of the essence. Any comments (pro or con) are welcome. Thank you. (Also, if CT scan indicates I need surgery, I do not think I should have the same young surgeon do it. I should go to a BIG hospital in nearby N.Y. City. What do you think?)

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@tennisgolf

I am replying to my own post. Currently I believe I am considered a problem patient. I have asked several times for a CT Scan and think I am getting it next week. First they need to take (another) blood test. IS THAT A TYPICAL REQUIREMENT? My Laparoscopic Gallbladder surgery was 8 weeks ago and I have complained over and over about pain in lower left abdomen (~ 3 inches left and 1 inch down from belly button). During GB surgery a naval hernia was fixed (although it never bothered me and did not know I had one). My incisions are fine; no fever; no weight loss, so nausea – so my surgeon says "You are fine." BUT I A NOT FINE. Could that surgery have caused problem in small intestine? colon? strangulated organ? could there have been scar tissue from prior surgeries (30 and 35 years ago – total hysterectomy/oopherectomy or abdominoplasty) that suddenly cause a problem? Since surgery I have met with GB surgeon, internist, and gastro. (he wants me to take more laxatives to make passage easier). All have different ideas. But I am thinking Diverticulitis or adhesions. It hurts every day. BMs have been totally unusual in appearance and varied for 7 months. When I strain for BM, I find if I push my hand hard against my belly, it helps relieve pressure and soreness so I can strain effectively. I told my surgeon 1 wk. post op that I could not "push" as well. No comment. Sometimes they do not listen.
I wonder if he has delayed the CT Scan for a reason? Perhaps so more time passes since surgery so it does not reflect on the surgery? As you see, I have become untrusting, disgruntled and am annoying my medical professionals with my questions. I feel disgusted. GB is supposed to be an easy surgery. Overall I am and have been a healthy, active, and engaged "senior". I had TKR 7 months ago (my second one) and that has been quite good – still working a bit on leg exercise.
For a year I have had a dental abscess (not painful or problematic at all – but Prosthodontist wants it fixed) – am in the midst of dental implant – so my poor system is being taxed. Anyway, I just feel medical folks are stalling. I need a patient advocate. Time may be of the essence. Any comments (pro or con) are welcome. Thank you. (Also, if CT scan indicates I need surgery, I do not think I should have the same young surgeon do it. I should go to a BIG hospital in nearby N.Y. City. What do you think?)

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@tennisgolf I personally will never again not get a second opinion from a larger medical center. For me that is Mass General Hospital, generally. If you, I would definitely at least get an opinion in NYC. Which specialty would you be looking for? I had a great gastro who is now in NYC at Columbia (Presbyterian?) but they all seem to have specialities within the overall umbrella of Gastrenology so I don’t know if he would be the right doctor for you. I went to him for Barrett’s Esophagus. I had endoscopes with him and colonoscopies. His name is Dr. Chin Hur.
JK

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