What did your investigations like blood work, colonoscopy, barium meal with follow through, CT scan and ultrasound show?
I agree that your back pain can be due to gut. The large intestine (whole of the colon) lies on the inner portion of the back (retroperitoneum). The movement disorder of the large bowel can be responsible for your symptoms. You should get the following investigations which are the mainstay of the evaluation for your symptoms;
1) Blood investigations do give the clue. A complete blood count, biochemical profile, serum calcium, blood glucose, and thyroid function tests are routinely recommended in the evaluation of patients with these symptoms swollen abdomen (bloating / distension), intense lower back pain and constipation.
2) Depending on these blood results further blood work is done; serum protein electrophoresis, urine porphyrins, serum parathyroid hormone, and serum cortisol levels, may be done to identify or rule out myeloma, porphyria, hyperparathyroidism, and Addison's disease. These causes are not common causes so clinical manifestation and physical examination clues are important.
3) Barium enema or barium meal with follow through study
4) CT scan
6) Colonic transit time; it can provide a better understanding of the rate of stool movement through the colon.
7) Other investigations like Anorectal manometry, balloon expulsion test, Defecography etc.
8) Colonoscopy / sigmoidoscopy
9) Laparoscopy; camera exam of inside of the abdomen.
Your symptoms can be due to;
1) Intestinal motility disorder
2) Irritable bowel syndrome
3) Congenital band or internal hernia of the gut
Please feel free for your follow up questions.
Thank you for your reply. I've had bloodwork, a barium enema, and a colonoscopy, and everything came back normal. It's been about 4 years since I've had these tests done. If I go back to the doctor, what would the next step be? Should I ask for a CT scan or ultrasound? Also, could you tell me more about intestinal motility disorder?
You are welcome.
A CT scan with intravenous and oral contrast would be the better. Intestinal motility disorders may manifest in a variety of ways, including abdominal distension and recurrent obstruction; severe abdominal colicky pain; severe constipation etc. This can be due to;
a) abnormal intestinal contractions, such as spasms and intestinal paralysis.
b) gut looses its ability to coordinate muscular activity because of endogenous or exogenous causes.
So there is an abnormal transition of the food and digestive juices. One of the commonest cause is called as Chronic intestinal pseudo-obstruction. Defecography offers some information about the rectal emptying, though, scintigraphic study of the small bowel or colonic transit time is preferred. Diagnostic laparoscopy or laparotomy, with full-thickness biopsy or resection of the intestine tells about the muscle and nerve problems of the gut. Following medications can be helpful;
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