Is it Diverticulitis or IBS?

Posted by libertyusa @libertyusa, 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?

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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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@libertyusa

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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@elle1233

OH MY... there is someone else!! I really hope you see this as it has been a couple of weeks since your post. Although, you may not be happy hearing from me - I have had a similar experience.. s/p Gallbladder surgery - no, you are not crazy!!!!!!!!!!! (although get ready to be told to see a psychiatrist 🙂 ). There are some things you said that sound very similar to my experience. First, let me say that I think there is a lot that the medical community does not understand, especially in the GI world. If you have a "standard" problem, that goes as it should, you will be okay - gallbladder issue, polyp, Chron's or one of the main diseases, Cancer.. this sounds bad, I'd rather have a diagnosis with an answer! But - anything "off the beaten path", it's very hard to find anyone interested. Tests, surgeries, those make money.

I was healthy and very active - professional career, did triathlons, 1/2 marathons, full life, until the GB issues and what was supposed to be a 'simple' surgery. Right after, I developed severe abdominal pain. Also on my L side - main locus is at umbilical area, it is very localized and sharp. The surgeon was no help. I was fine, according to her. The internist I was seeing said I was constipated, and take Miralax. That didn't help,in fact, in made me feel worse. The only difference with me was that my pain was severe. I would be curled up in a ball and crying. Finally 8 months later she referred me to GI Dr. I had a +hematocrit (blood in stool) and had colonoscopy/endoscopy the next day. Dx was Gastritis, and I was given proton pump inhibitors. I was never really told where the bleeding was from - I suppose the stomach?

11 years later.. the pain is still here. What really strikes me is what you describe for relieving it - pressure/pushing on it! I feel so strange, but this makes it feel better - I actually lie on my stomach on top of towel rolls, tennis balls, foam rolls to put more pressure on it Hasn't made it go away, of course. I totally "get' what you mean about it feeling like a muscle spasm almost, but deeper. I've had multiple diagnoses. For a time, they even tried treating it has a musculoskeletal problem, I've had many trigger point injections, months of physical therapy without relief. I always thought it was "deeper". And I also have GI issues, constipation, diarrhea, nausea. But for a decade, no change in the sharp mid gut pain. I've had hernia surgery/incision repair, a hysterectomy. No change, in fact, it's gotten worse over the years.

I just had a work up at the Mayo Clinic. My colonoscopy was normal (I've had 3). I do have significant diverticulitis, but that is not painful unless they get infected (so they say), otherwise that is normal. I had an endoscopy and have bile refluxing into my stomach, with inflammation; and SIBO. He thinks this is "normal" and sent me to a dietician who didn't even know what SIBO was, let alone the diet one is supposed to be on.

So, I have some more info, and now I will look for a Dr. who specializes in SIBO. So far, there seems to be a center a Johns Hopkins, unless anyone reads this and has any suggestions. I'm also going to pursue what can be done about the reflux, because it hardly seems "normal" to me, and the burning in my stomach area tells me it isn't either.

So, I have no answers, but some unsolicited advice/comments. 1. I was perfectly normal GI-wise (except for gallbladder symptoms) until I had this surgery. 2.Seems clear to me that this is a result of the surgery (not suggesting the surgeon did anything wrong, maybe it was just happens sometimes, but no doctore will ever "go there", they must think you are going to sue or something. 3. You won't get anywhere with the surgeon - not the same one. Once the surgery is done, they are done. 4. You will have to be assertive, seek out and ask for help, and do it. 5. DO NOT accept "you have to live with this", if a doctor can't help you, or doesn't seem interested, or says you have irritable bowel syndrome (i.e. they don't know), move on. I've lost 10 years of my life. Things worsened to the point where I couldn't work. I have trouble eating, lost a lot of weight, and am tired and weak all the time. I've decided I have to keep going on my quest to try to find an answer to what is causing my pain, because living like this sucks.

There must be other people like you and I out there. I don't know. Yes, see a GI doctor, but you'll have to find one who will listen to you and take your problems seriously. I'm wondering, since you say your stool may smell like "iron", have you have it tested for blood? Do you have black , tarry stools? I did, but never saw blood in my stool since my bleeding was from upper GI tract.

Intuitively, it seems to me that when they do these laparoscopic surgeries, who knows what can happen when they put all those cannulas in. On the other hand, if you were having stool changes 6 months ago, maybe something was starting then.

I'm curious to hear about your story and how it unfolds, because you are the first person I've "met" who has described this kind of pain that feels better by putting pressure on it.

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Thank you for saying “or says you have irritable bowel syndrome (i.e. they don't know)” — I’ve thought that for years!

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