Abdominal Discomfort: Insights on Gastrointestinal Issues

Abdominal discomfort?

Hello, in April, I went to the emergency room due to abdominal pain and underwent a CT scan, which showed edema and inflammation in the colon.
After receiving antibiotics and resting for several days, my condition gradually improved.
In May, I was diagnosed with ankylosing spondylitis and have been taking NSAIDs.
However, since my diagnosis, I frequently experience gurgling sounds in my abdomen, accompanied by discomfort, primarily in the lower left abdomen, which is worse in the morning.
I also experience burping with an unpleasant taste reminiscent of what I ate the previous day, and I often feel the urge to use the restroom but can't distinguish between needing to go and just discomfort.
Each time I go, I don't pass much, and sometimes I go several times without any results.
Occasionally, I have diarrhea, while at other times, my stool is not hard.
After having a bowel movement, I feel slightly better, but my appetite is poor, and I feel bloated and uninterested in eating.
I lost 2.5 kg six days after my diagnosis, and the medication hasn't been effective.
This situation has persisted for a week.
What should I do?

tony, 20~29 year old female. Ask Date: 2022/11/08

Dr. Chen Shidian reply Gastroenterology and Hepatology

Continue to follow up with the physician to monitor changes in symptoms and necessary medications/tests.

Reply Date: 2022/11/08

More Info

It sounds like you're experiencing a complex set of gastrointestinal symptoms that are causing you significant discomfort and concern. Based on your description, you have a history of abdominal pain, recent diagnosis of ankylosing spondylitis, and have been treated with antibiotics for colonic edema and inflammation. Your current symptoms, including left lower abdominal discomfort, frequent burping, changes in bowel habits, and a general feeling of bloating and loss of appetite, warrant a thorough evaluation.

Firstly, the connection between your gastrointestinal symptoms and your diagnosis of ankylosing spondylitis (AS) is important to consider. AS is an inflammatory condition primarily affecting the spine and sacroiliac joints, but it can also have extra-articular manifestations, including gastrointestinal issues. Inflammation in the gut can lead to symptoms such as abdominal pain, diarrhea, and bloating. The fact that you experienced colonic edema and inflammation previously suggests that you may have an underlying inflammatory bowel condition, such as inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis.

Your symptoms of frequent burping and the sensation of food lingering in your throat could indicate gastrointestinal dysmotility, which is not uncommon in individuals with chronic inflammatory conditions. This can lead to feelings of fullness, bloating, and difficulty in bowel movements. The alternating patterns of diarrhea and constipation you describe may also suggest a condition known as irritable bowel syndrome (IBS), which can coexist with other gastrointestinal disorders.

Given that your symptoms have persisted for over a week and have led to weight loss, it is crucial to seek further medical evaluation. Here are some steps you might consider:
1. Consult a Gastroenterologist: Since your symptoms are gastrointestinal in nature, a specialist can provide a more targeted approach to your evaluation and treatment. They may recommend further diagnostic tests, such as a colonoscopy, to assess the health of your colon and rule out conditions like IBD or other structural abnormalities.

2. Dietary Modifications: Keeping a food diary to track what you eat and how it affects your symptoms can be beneficial. Certain foods may exacerbate your symptoms, and identifying these can help in managing your discomfort. A diet low in fermentable carbohydrates (FODMAPs) may be helpful for some individuals with IBS.

3. Medications: While NSAIDs are effective for managing pain associated with AS, they can sometimes exacerbate gastrointestinal symptoms. Discuss with your physician whether your current medication regimen is appropriate or if adjustments are needed. They may consider prescribing medications that target gut motility or address inflammation.

4. Hydration and Electrolyte Balance: If you are experiencing diarrhea, it is essential to stay hydrated and maintain electrolyte balance. Oral rehydration solutions can be beneficial if you are losing fluids.

5. Stress Management: Chronic pain and gastrointestinal issues can lead to increased anxiety and stress, which may further exacerbate your symptoms. Techniques such as mindfulness, yoga, or cognitive-behavioral therapy may help in managing stress and improving your overall well-being.

6. Follow-Up: Regular follow-up with your healthcare provider is essential to monitor your symptoms and adjust your treatment plan as necessary. If your symptoms worsen or new symptoms arise, seek medical attention promptly.

In conclusion, your symptoms are multifaceted and may be related to both your gastrointestinal health and your underlying condition of ankylosing spondylitis. A comprehensive approach that includes further evaluation, dietary changes, medication adjustments, and stress management will be crucial in addressing your discomfort and improving your quality of life. Don't hesitate to reach out to your healthcare provider for further assistance and guidance.

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