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Dr. Ravoof
Dr. Ravoof, Doctor
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Experience:  Experienced Physician in the field of Medicine and Surgery.
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Low back pain and IBS symptoms. Sometime it really flares

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Low back pain and IBS symptoms. Sometime it really flares up. After having a bowel movement I feel like I have been kicked in the lower back. Any thoughts/

Thanks for your question.


What symptoms of IBS you are having? What medications you are taking presently? Any other medical condition?

Customer: replied 7 years ago.
Here is the detailed history of the symptoms.

12/10 - Sense of urgency & unease (nervousness) radiating from rectum, down legs. Almost a fear/fight or flight sensation

12/11-12 - Gas, loose stool, ribbon like stool, pebble like stool, normal stool

12/13 - Dull lower back pain

12/14 - Subsided for 48 hours then returned

12/16 - Ate lunch at restaurant and within 4 hours had horrible nausia, acid reflux and almost vomited. Possible food poisoning?

12/17 - Visited doctor – Went on bland diet, stopped drinking coffee (3 – 4 cups a day coffee drinker), started Prilosec, and also was prescribed hyoscyamine

12/18 – 19 - Still going to the gym and running

12/20 - Constipation with normal bowel movement relief eventually

12/21 - Rectum pain, almost like internal hemmoriods

12/22 - Lower back pain, moving from general dull, to specific lower right or upper left pinpoint pain. Pain is sometimes worse sitting or lying down.

NOTE: Taking 1 pill a day now in AM

12/23 - Loose stool, ribbony and normal along with gas. Low back pain, along with shooting perennial pain and rectum pain and itching. Sometimes pain will shoot down legs. Tylenol seemed to reduce pain until the early AM, when there was very specific pain in the upper left buttocks, and constipation.

12/24 – AM passing a lot of gas, but feeling constipated. Lower left of back, pain, overall pressure and dull pain. Constipation gives way to diareeah and ribbony stool. Feeling exhausted by D bout, shooting pain down legs. Lower left back side pain main issue. Pain down left leg. Back pain subsided, now rectal pain and discomfort.

12/25 – Lots of AM gas and some lower pressure. Closer to normal bowel movement my noon. Anal pain and itching. Pelvic pain, right and left hip. Some specific lower back left side pain when lying down. PM – anal discomfort, feeling of discharge, itch. Lower right back pain, specific. Perennial pain. 2 hours post dinner indigestion. (NOTE: Most comfortable, pain free evening in a while)

12/26 – AM some lower back pain, feeling of anal discharge (none present), anal itching, general stomach cramping and belching and gas. Pebble stool, then loose stool. Post BM lower back pain. Lots of air and noise in stomach. Early PM continued loose stool, lots of air, frequent trips to the bathroom, cramping, gas, bloating, nausia, sensation of bad stomach bug. Late PM right leg pain, right hip pain, some lower back pain. Had good sized dinner, chicken, rice, salad, avacado. Gas and some bloating. Specific pain in lower right back, seems different than before.

12/27 – 3AM woke with lower back extreme discomfort, feeling of constipation. Had small bowel movement. Some pebbles then a more normal movement. 8AM, more gas and small bm, darker in color, still lower back discomfort. 11AM large soft, but normal in size movement. Lower back pain pre and post BM.

Later afternoon attack, lower back pain. Going on liquid diet.

8PM lower back pain is a 6 (1-10 scale). Taking Tylenol. Some relief

12/28 – 8AM pebble stool, then mucus gas. Pain radiating to both sides in the lower back. Belching and lots of air.

Dr.s Appointment. Had me increase the motility medication to 4x a day. And taking sucralfate 4x a day one hour before eating.

Driving in car, lower back pain, heated seats on high helped.

Ate at 8:30, groin cramps and pain….

Continued on liquid diet until dinner. Now on BRAT diet

12/29 – Significant improvement. Small but normal BM. Loose ribony stool. Then another normal larger. Back pain reduced by 80%. Lots of gass and air.

12/30 – Small AM BM. Still trying BRAT. Some early evening pain, but continued 80% improvement.

12/31 – AM constipation, some back discomfort and gas during the evening. Fairly normal BM, occasional pain. Lower left shooting to left leg pain.

Late PM BM, large, well formed. Some lower left discomfort and left groin pain after.

1/1 – Woke with lower back pain, constipation type pressure. 2 hours later ribbony and loose BM then post dull back pain. Continued post dull back pain, radiating to perennial region and down back of legs. Took two Ibuprophen at 11:15 to see if it has an impact on the pain. Minimal help, additional strage sensations throughout the day, pain in hips, lower back etc.

Thanks for your reply.


Did your symptoms start from 12/10 and you had no symptoms previously?

Customer: replied 7 years ago.
I seemed to have no symptoms previously, though I have always had bloating, gas and generally a stomach and digestion that is all over the place. But this lower back pain is new. The last time I had similar lower back pain was over 10 years ago (when I was in my late 20s) At the time I thought it was due to a prostate infection but that was never confirmed. It could have been a similar attack then.

At the time I was given a colonoscopy and told I was fine and that I was simply suffering from gastritis. The symptoms eventually went away.

In current case I seemed to get much better after going on sucralfate while being on a bland diet. Last night was the first time I had a non BRAT diet, and drank some beer had some chocolate and had a very bad flairup today. It seems as though the blad food and sucralfate helped. I have also cut my caloric intake in half.

My current general dr. is treating this as if it is an IBS flairup.

I am just very concered this is colon cancer or something. However, the lower back pain seems to take place throughout all areas of my colon, left, right little up, little down, it radiates around and comes and goes.

My bowel movements go from constpated pebbles, to loose ribbony stool, to diarieha etc.

Sorry for the misspellings, I am tying quickly

Thanks for your reply.


Basically reviewing your history I would not attribute low back pain 'shooting down the legs', to IBS. Severe IBS can cause low back pain, but even then, the appropriate workup for low back pain including imaging studies are required before attributing the back pain to be due to IBS. Also rectal and anal pain is rarely caused by IBS, and needs a physical examination by your doctor to diagnose the common causes for rectal pain.



IBS is basically a diagnosis of exclusion. All the other conditions that can cause your symptoms have to excluded through relevant investigations (such as complete blood count, sigmoidoscopic examination, and stool specimen examination), before diagnosing that your symptoms are due to IBS.


Alternate diarrhea and constipation may be seen in IBS. Anxiety disorders are also common in patients having Irritable Bowel Syndrome (IBS), which can cause recurrent abdominal pain.


Increased stress usually causes symptoms of IBS, hence relaxation and hypnotherapy is also used to treat IBS. In fact this is a vicious cycle, with stress causing increased symptoms, and the increased symptoms will in turn cause increased stress and anxiety. Therefore another therapy known as Cognitive behavioural therapy is also beneficial in this condition.



Presently, I would advise you to consult with your doctor about dicyclomine [Bentyl] for the pain and Loperamide (Imodium) for the diarrhea. Supplementation of fiber is also beneficial especially for constipation.



Also you can try out using probiotics, containing Bifidobacterium infantis, like Activia Yogurt.


You need to relax and not be stressed, as the prognosis of IBS is good, with majority of the patients learning to adapt to their symptoms and leading productive lives. In fact, if it is diagnosed as IBS, you should be happy as it is a benign condition and there is no serious underlying disease.


Take care.


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