Chronic Abdominal Pain: Is It Irritable Bowel Syndrome?

Chronic abdominal discomfort?

Hello Dr.
Yang,
1.
In May, I felt a persistent dull pain around my abdomen (near the navel) that was not localized.
I first visited a family physician, but it was ineffective.
2.
I then went to a larger hospital in Sanxia, where I had an abdominal X-ray and stool tests.
The doctor said there were no issues, and I took some medication for a few days, but it didn’t help.
3.
A few days later, I experienced severe abdominal pain at night and went to the emergency department in Linkou, where I received an injection and medication.
The next day, I visited the gastroenterology department at that large hospital (in July), where I had a colonoscopy.
The doctor said everything was fine and advised me to relax or take a break (no treatment or follow-up was provided).
After returning home, I still felt uncomfortable with persistent dullness.
4.
I forgot to mention that in August, I underwent a full health check-up, and everything was normal.
5.
In early December, a friend referred me to a gastroenterologist in Shulin, who diagnosed me with irritable bowel syndrome (IBS).
I took medication for two weeks, which was effective, but when I stopped, the pain returned.
Last week, I went back for more medication, but this time it was ineffective (the medication was the same as before).
The medication names are as follows: TRANCOLON TAB.
7.5 (2) and ERISPAN TABLET (1).
Dr.
Yang, do you think I have irritable bowel syndrome? Is there medication that can help control it? A friend suggested that installing an electrolyzed water machine to drink electrolyzed water could improve my condition.
Is this correct?
Thank you.

A-Hsien, 40~49 year old female. Ask Date: 2004/01/02

Dr. Yang Peizhen reply Gastroenterology and Hepatology

Hello! Your symptoms appear to be related to gastrointestinal dysmotility, which means there are no pathological changes in the organs themselves (as you have undergone many tests to rule this out), but rather a dysfunction in the nerves controlling intestinal motility.
This can lead to occasional abdominal discomfort or bloating, and sometimes results in loose stools.
The exact causes are not entirely clear, but factors such as emotions, stress, or diet play a significant role.
Treatment options include not only symptomatic medication but also dietary adjustments, such as reducing the intake of irritant foods, increasing fiber and fruit consumption, and trying to relax as much as possible, all of which can be helpful.
Sincerely, Dr.
Yang Pei-Chen, Chief of Gastroenterology, Taoyuan Hospital, Department of Health, Executive Yuan.

Reply Date: 2004/01/02

More Info

Chronic abdominal pain can be a complex and frustrating issue, especially when multiple tests and consultations yield no clear diagnosis. Based on your description, it seems you have undergone a thorough evaluation, including X-rays, stool tests, colonoscopy, and upper endoscopy, all of which returned normal results. This can be disheartening, particularly when you continue to experience discomfort.

Your symptoms, particularly the persistent dull pain around the navel and the episodes of acute pain, could indeed suggest a diagnosis of Irritable Bowel Syndrome (IBS). IBS is a functional gastrointestinal disorder characterized by a combination of abdominal pain and altered bowel habits, which can include diarrhea, constipation, or a mix of both. The exact cause of IBS is not well understood, but it is thought to involve a combination of gut-brain interaction, gut motility issues, and possibly changes in gut microbiota.

The fact that you experienced some relief with medication prescribed for IBS, but then the symptoms returned, aligns with the nature of this condition. IBS can be quite variable, and many patients find that their symptoms can fluctuate based on diet, stress, and other lifestyle factors. The medications you mentioned, such as Trancolontab and Erispan, are often used to manage IBS symptoms, but they may not work for everyone or may require adjustments in dosage or type.

Regarding your question about the effectiveness of drinking electrolyte water, while staying hydrated is essential for overall health and can help with digestion, there is no strong evidence to suggest that electrolyte water specifically will improve IBS symptoms. However, maintaining proper hydration can support bowel function, especially if you are experiencing diarrhea or other gastrointestinal disturbances.

In terms of management, here are some strategies that may help:
1. Dietary Modifications: Many individuals with IBS find relief by adjusting their diet. The low-FODMAP diet, which involves reducing certain fermentable carbohydrates, has been shown to help some patients. Keeping a food diary can help identify potential triggers.

2. Stress Management: Since stress can exacerbate IBS symptoms, incorporating stress-reducing techniques such as mindfulness, yoga, or cognitive behavioral therapy may be beneficial.

3. Regular Follow-ups: Since your symptoms have persisted, it may be worth discussing with your healthcare provider the possibility of trying different medications or therapies. Sometimes, a combination of treatments is necessary to find what works best for you.

4. Probiotics: Some patients find that probiotics can help balance gut bacteria and improve symptoms, although results can vary.

5. Physical Activity: Regular exercise can help improve gut motility and reduce stress, which may alleviate some symptoms.

6. Further Evaluation: If your symptoms continue to be severe or debilitating, consider seeking a second opinion or consulting a gastroenterologist who specializes in functional gastrointestinal disorders.

In conclusion, while your symptoms may align with IBS, it is essential to continue working closely with your healthcare provider to explore all potential avenues for relief. Chronic abdominal pain can be challenging, but with the right approach and support, many patients find ways to manage their symptoms effectively.

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