Abdominal Discomfort: Is It IBS or Something More Serious?

Abdominal bloating and feeling a hard mass on the left side of the abdomen?

Hello, doctor! I previously visited the hospital due to a feeling of pressure in my stomach.
I underwent two gastroscopies and one colonoscopy.
The first examination revealed gastroesophageal reflux disease (GERD), the second showed a mild gastric ulcer, and the colonoscopy only indicated hemorrhoids.
However, I still experience bloating after eating or when lying down, and my stomach makes noises while I sleep.
Sometimes, when I press on the middle of my abdomen, I can hear a sloshing sound.
Due to constipation, the doctor prescribed a stool softener, and I have been having daily bowel movements, but some of the stool is green.
Currently, I sometimes feel a hard lump in the upper left part of my abdomen; it can be very hard at times, while at other times it is less noticeable.
Additionally, I have had two or more bowel movements for two consecutive days, and although I thought I had diarrhea, the stools were all formed.
This might be irritable bowel syndrome (IBS), but I would like to know if this is a stomach issue or a gastrointestinal issue.
Could it be stomach cancer?

Ye Junhong, 20~29 year old female. Ask Date: 2020/03/10

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, the gastrointestinal system is interconnected.
Frequent bowel movements that provide relief afterward may indicate intestinal dryness syndrome.
Both gastroscopy and colonoscopy have been performed, and currently, there is no evidence of gastric cancer; however, treatment for gastroesophageal reflux disease and peptic ulcers is still necessary, along with dietary management.
Gastric cancer is associated with diet, Helicobacter pylori infection, and genetics.
It is important to pay attention to dietary habits, consume more fresh foods, limit smoking and alcohol intake, reduce consumption of pickled, fried, and spicy foods, avoid eating too quickly, maintain adequate hydration and exercise, and develop good bowel habits.
Wishing you peace and health.
Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2020/03/10

More Info

Based on your detailed description, it seems that you are experiencing a combination of gastrointestinal symptoms that could be indicative of Irritable Bowel Syndrome (IBS) or other gastrointestinal issues. Your history of gastroesophageal reflux disease (GERD), mild gastric ulcers, and hemorrhoids, along with your current symptoms, suggests a complex interplay of digestive health concerns.

Understanding Your Symptoms
1. Abdominal Discomfort and Bloating: The feeling of pressure or bloating after meals is common in individuals with GERD and can also be associated with IBS. The bloating and the audible sounds from your abdomen (often referred to as borborygmi) can be due to increased gas production or altered gut motility.

2. Changes in Bowel Habits: You mentioned experiencing constipation, which can lead to straining during bowel movements and potentially exacerbate hemorrhoid issues. The fact that you have had some episodes of diarrhea (with stool still being formed) suggests that your bowel habits are fluctuating, which is characteristic of IBS.

3. Hard Lump in the Abdomen: The hard lump you occasionally feel in your left upper abdomen could be related to several factors, including muscle tension, gas buildup, or even stool impaction. However, it is essential to monitor this symptom closely, especially given your family history of colorectal cancer.

4. Green Stool: The presence of green stool can result from various factors, including dietary choices (such as consuming green vegetables or food coloring), rapid transit through the intestines, or changes in gut bacteria. While it is usually not a cause for concern, it is worth mentioning to your healthcare provider.

Recommendations
Given your symptoms and medical history, here are some steps you can take:
1. Follow-Up with a Gastroenterologist: Since you have a history of gastrointestinal issues and a family history of colorectal cancer, it is advisable to have a follow-up appointment with a gastroenterologist. They may recommend further investigations, such as imaging studies or additional endoscopic evaluations, to rule out any serious conditions.

2. Dietary Modifications: Consider keeping a food diary to identify any potential triggers for your symptoms. A diet high in fiber can help manage constipation, but be cautious with certain high-fiber foods that may cause gas. Gradually introduce fiber and ensure adequate hydration.

3. Stress Management: IBS is often exacerbated by stress. Incorporating stress-reduction techniques such as mindfulness, yoga, or regular physical activity can be beneficial.

4. Medication Review: Discuss with your doctor the medications you are currently taking, including any over-the-counter remedies. They may adjust your treatment plan based on your ongoing symptoms.

5. Monitor Symptoms: Keep track of your symptoms, including the frequency and consistency of your bowel movements, any changes in abdominal pain, and the presence of any new symptoms. This information will be valuable for your healthcare provider.

Conclusion
While your symptoms may align with IBS, it is crucial to rule out any serious underlying conditions, especially given your history and family background. Regular follow-ups with your healthcare provider, along with lifestyle and dietary modifications, can significantly improve your quality of life and help manage your symptoms effectively. If you experience any alarming symptoms, such as significant weight loss, blood in your stool, or persistent abdominal pain, seek medical attention promptly.

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