Posted by HFHS Md-rf on January 15, 1998 at 09:43:50:

In Reply to: Abdominal pain/cramps posted by David on January 12, 1998 at 19:47:29:

: I had a kidney stone in the late summer. Since then, I have
had some recurrent cramps on the right side (same side as
the kidney stone) between my ribs and navel. At times, it
takes the form of cramps, at other times it seems like there
are creatures in me trying to gnaw their way out. No problems
with diarrhea or constipation. Eating or not eating seems to
not make a difference, nor does what I eat (spicy, bland, etc.)

My doc says right off that it is probably IBS. Isn't that a
diagnosis of last resort though? From what I have read, the
symptoms don't match that of IBS.

Any ideas?

Dear David,

Irritable Bowel Syndrome is a common clinical condition. Individuals can have a variety of symptoms including abdominal pain associated with defecation, constipation alternating with diarrhea or either bowel pattern alone. You are correct that IBS is a diagnosis of exclusion. Physicians, however, can suspect IBS based on the clinical history and the presence of normal physical findings and laboratory tests.

In our practice, we do an evaluation to exclude organic diseases that can cause the symptoms for patients that we are seeing for the first time. The list of possible diagnoses can be quite extensive depending on the nature of the predominant symptom. The patients age, prior medical history, and presenting complaint can affect the diagnostic possibilities.

Abdominal pain alone can be a presenting symptom of IBS, although usually patients will associate the pain to defecation. Gnawing pain in the region between the ribs and navel can result from inflammation, including ulcers, of stomach or duodenum. (Typically, ulcer pain is related to eating although we do not always obtain the textbook symptoms). Pancreatic and colonic diseases tend to be less common causes for this type of pain. Additionally, gallbladder disease due to gallstones must be considered although it would be exceedingly unlikely to produce the pains that you describe. It is unlikely, although not impossible, that your pain is related to gallstones.

If symptoms persist, you may wish to ask your physician about the benefit of doing X-ray studies of the stomach and small intestine as well as an ultrasound of the gallbladder and pancreas. If you are in the Detroit area and wish to be seen, please call (313) 876-2393 and request an appointment with Dr. Fogel, one of our experts in the treatment of intestinal diseases.

This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.

Best of luck.

HFHSMD-rf

keywords: abdominal pain, irritable bowel disease

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