Is it Diverticulitis or IBS?

Posted by AmericanPatriot @USA @tennisgolf, Aug 7, 2019

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?

Hello @aliashraf,

Welcome to Connect. I moved your message and combined it with this existing discussion as I thought it would be beneficial for you to be introduced to the many members who are discussing much of what you are experiencing. Simply click VIEW & REPLY in your email notification to find your post.

Diverticulosis occurs when small, bulging pouches (diverticula) develop in your digestive tract. When one or more of these pouches become inflamed or infected, the condition is called diverticulitis. https://www.mayoclinic.org/diseases-conditions/diverticulitis/symptoms-causes/syc-20371758

I’d encourage you to go through this discussion where members are talking about diet suggestions related to diverticulosis:
https://connect.mayoclinic.org/discussion/recommended-fiber-amount-for-diverticulosis-and-tortuous-colon/
I’d also like to invite @nurseheadakes @sandyabbey @virginia44 to join in and share their insights.

@aliashraf, may I ask if you’ve consulted with a gastroenterologist? Or had any further testing to rule out other GI conditions?

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@elle1233

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.

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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.

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@harper7745

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.

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TY Harper. I do have that fairly often – not diarrhea, but many stools, 6 or more in a day. Docs have never been concerned about this. Call everything irritable bowel. I did have a general abdominal CT, don't know if this would be enough to suggest any problem with pancreas. I don't think I've had any testing for pancreatic enzymes.

One thing about chronic pancreatitis is that it doesn't seem like there is much that can be done about it, is there?

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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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@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!

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@graceandpeace

@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!

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Hi @graceandpeace,

I thought you might also be interested in viewing this Connect video on the GI Page, (https://connect.mayoclinic.org/page/gastroenterology-and-gi-surgery/), where Mayo Clinic dietitian, Jacalyn See, offers more insight about the FODMAP diet:
A Map for the FODMAP diet https://connect.mayoclinic.org/page/gastroenterology-and-gi-surgery/newsfeed-post/a-map-for-the-fodmap-diet/

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@kanaazpereira , hi there and thank you so much for sharing the link! All the information we all can have, the better 🙂. Yes, I have read this information bf when trying to figure out what was best for my body. I have been tested for Celiac's as well as many other autoimmune diseases, but so far, all are negative. I have stuck to the FODMAP diet for so long simply bc it is the only diet restriction that works best for me. I am aware that it is mainly a guideline and temporary elimination diet, so from time to time, when my inflammation seems low, I will reintroduce a small amount of restricted food. I am still in the process of reintroducing. It's more of a long term diet for me, simply bc that's how long it is taking me to reintroduce one food item at a time. I am especially thankful, though, that I have found something that seems to be working for me, and has been a huge part in helping me get back the quality of my life. Thank you again!

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It seems I have 2 problems one is the diverticulosis with super added infection ,the second one is recurrent infective diarrhea with any food either solid or liquid that not boiled for sterilization now iam not taking cold water or soft drink or vegetables or fruits or cheese that should be sterilized before eating it , my intestinal immunity against bacteria is nil any one face such problem , my impression it looks intestinal flora disorder any idea .?

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@elle1233

TY Harper. I do have that fairly often – not diarrhea, but many stools, 6 or more in a day. Docs have never been concerned about this. Call everything irritable bowel. I did have a general abdominal CT, don't know if this would be enough to suggest any problem with pancreas. I don't think I've had any testing for pancreatic enzymes.

One thing about chronic pancreatitis is that it doesn't seem like there is much that can be done about it, is there?

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No. They just treat the symptoms. Usually pain, which I don't have. Pancreatic enzymes should take care of the stools and weight loss.

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@harper7745

No. They just treat the symptoms. Usually pain, which I don't have. Pancreatic enzymes should take care of the stools and weight loss.

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Thanks goodness you don't have pain, and if the enzymes can help those other symptoms, that sounds pretty good – i.e it sounds like there is treatment that is effective!

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@elle1233

Thanks goodness you don't have pain, and if the enzymes can help those other symptoms, that sounds pretty good – i.e it sounds like there is treatment that is effective!

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Saw the specialist today and he said my MRI looked like the pancreatitis is resolving. He told me to hold of on the enzymes for now. My stools have been almost normal for a few days now. He seems to think I won't need them. I am confused. I thought chronic pancreatitis doesn't go away, but he said he thought it was from an auto immune disease and steroids will help that. I took steroids for 2 weeks. Don't know. Just confused for now.

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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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Sorry to hear about your problems. You know your body best. They will never admit to a problem having occurred. When I had my gallbladder surgery via laparoscopy they did something around my belly button, as I have scars. Maybe, bc you had issues around the belly button they had to go a little lower to do the tool where it usually goes in at belly button. Something was definitely affected and perhaps a muscle if it's affecting pressure to eliminate. Just a thought. Wish you well in your continued efforts to seek the truth. I'd try an MRI vs CT bc I think it will show more soft tissue damaged if there is some.

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Are you taking iron, or a multivitamin with iron? That could account for the odor. If it has been only 6 weeks since the gall bladder surgery, you may need more time to heal. Your insides are still bruised and sore. And when you have to go, the pressure you use could be pressing up against the area of surgery.
Also be careful what you eat. I knew a lady that had gall bladder surgery and for nearly a month afterwards, everytime she ate any type of protein food (meat, eggs, beans, etc) she would get very sick. Her body wasn't up to heavy foods yet. So that could be a reason that you hurt when you go to the restroom. Heavy foods might not be digesting well and causing soreness down there and could be attributing to constipation. Try eating more fruits and veggies and see if it helps.

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