IBS without C or D?

Hi sylvestergirl,
Have you been put through the testing ringer to rule out anythng else (like gallbladder, appendix, GERD, H.Pylori, etc.)?
IBS does seem like an odd diagnosis for pain & nausea without bowel changes. Change in bowel habits is the #1 symptom of IBS.
Go with your gut, keep pushing your docs. Or, get a 2nd opinion if you can.

Yes, they have done it all--I had two CT scans (including with contrast), bloodwork and urine tests, a complete abdominal ultrasound, a colonoscopy, and a stomach scope--the latter with biopsies that were all fine. I also had a pelvic exam and a vaginal ultrasound. Nothing has shown up yet. Because the symptoms are significantly worse (right upper abdominal pain accompanied by general malaise, nausea, headaches) during my period, the gyn suggested a laparoscopy to rule out endometriosis.

Canyongirl, was your pain in the upper right quadrant or was it lower? I know the laparascopy would be to look for endo but would they see other problems as well, if any were present (such as the appendix)?

Thanks for all the replies--I am really frustrated, especially as I just returned from the gastro dr--he is very competent and nice and I trust him completely, but he still has no idea what is causing this pain and I am at my wit's end.

Thanks for your post, Marey. If you don't mind my asking, did you get a lot of headaches with your abdominal pain? For me this has been the most troubling at times--since it gets hard to focus, function, or be pleasant when my head is pounding. It seems to go in waves along with my side pain.

sylvester,

One thing you might want to look into is a HIDA scan to check your gallbladder's ejection fraction.  This is different from an ultrasound in that it doesn't image the gallbladder, but checks to see how much bile your gallbladder is producing.  If you're producing too little, symptoms like nausea, upper right quadrant pain, etc. can result.  Many people with a low ejection fraction get their gallbladders removed and feel quite a bit better.

Also (this is less likely) you might want to re-check is your thyroid-stimulating hormone (TSH) level.  It's a simple blood test but docs don't always perform it regularly.  Sometimes an overactive thyroid can lead to increased frequency of bowel movements (it's actually one of the hallmark signs).  Or you can look back at the results of your bloodwork and see if they ever did one.

I have heard about pain-predominant IBS.  Although most people do have bowel changes, it's hard to exclude someone from the IBS realm simply in the absence of them (especially since we don't exactly know what IBS is). 

I have had irritable bowel syndrome for many years, but no one has told me which one (pain dominate, etc). In fact, I never knew that IBS had several categories.

In November of 2004 I had a severe gallbladder attack, and when my doctors were trying to diagnose a cause, they found a large mass over my uterus. It turned out to be a borderline ovarian cancer, and the prognosis is excellent. I had an abdominal hysterectomy and several months later, my gallbladder was finally yanked out as well because of stones (no cancer there).

Since my hysterectomy and gallbladder surgery, I seem to have IBS more often. Sometimes, anyway. And I have found that at times I have pain in my upper-right abdomen. Several months ago, it got really bad and I thought maybe my cancer came back? So I had a number of tests, including a xrays, blood work and a CT scan. They all came back normal. Then, I tried to modify my diet not only because of the IBS but also because I don't have a gallbladder any longer. The pain got better, but it still comes back off and on.

Sometimes I get pain in my back and behind both shoulders - whether or not this is related, I couldn't tell you. Sometimes it feels like my upper right side is swollen, sometimes it doesn't. Sometimes I get bowel movements before and after the upper-right hand pain, so I think this may be IBS-related, but I'm not sure.

Btw, during my hysterectomy my oncologist found that I had endometrosis, but I don't think it was widespread, and I don't know if it can recur after surgery. Maybe I have adhesions too?

The pain isn't constant, nor is it getting worse. It just seems to be off and on. Sometimes it gets better after eating, sometimes worse. Recently, I was diagnosed with type-2 diabetes and so far it's under control with diet and excercise. And, I have an underactive thyroid, so every several months I get blood work done. All those tests have come back normal.

Should I be worried? Should I have additional tests? Could this be my IBS getting worse, or what? I would appreciate any advice you guys would have. Thanks!

Diana, if you have D problems, then try Welchol; it's a cholesterol medicine, but it has this funny way of absorbing excess bile in the GI tract which is a real life-saver for those of us with otherwise constant bile D. Also try taking Caltrate 600 w/ vitamin D for D. Not only does the calcium help absorb the water in you intestines, making your poops less liquid, but it also is beneficial to the lining of your intestines. I think I inflamed my intestines with a combination of a bad reaction to sugar alcohols and too much bile (I was off my Welchol). It was the calcium that got rid of my intestinal pain and helped the Welchol get rid of the constant D.

I used to get the same aching pain in my back and especially in my right shoulder, arm and elbow when my gall bladder was acting up. I found that caffeine was causing that. If you ever drink caffeinated drinks (including decaf coffee, which still has a good deal of caffeine in it), stop and see if that helps those aches. Carbonated drinks might also be causing them (gas).