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911DOC
911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5092
Experience:  Emergency Medicine Physician
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I have PKD. now at 35% function, decline is hastening. I have

Resolved Question:

I have PKD. now at 35% function, decline is hastening. I have been complaining about constipation, slow movement , now virtually none w/o the aid of something, for over 2 years. Sunday went to ER cuz the distention was scary for 6 days, had exray, Dr. said no obstructiuon on x, did not even look at my abs or touch, said to "eat a salad. I am 5'4, 118 lbs, skinny arms and lower legs, extremly distented, especially on left side. Not really pain, but alot of discomfort, a little pain in flank. I have tried probiotics, gas pills, Ducolax, Milk od magnesia, clear lax, etc, prune juice, juice and liquid diet, everything, exercise- power walk in soft sand w/ my Greta Dane on beach 30 -45 minutes each day, yoga, etc. Nothing works w/o aid and even then, only a little moves at a time. I go , I wait 3 days to go , then 3 days before I take something, then 2 days to go. Please help , no one else will, say "drink more water". I drink about 10 gasses a day. What can I do?
Submitted: 1 year ago.
Category: Medical
Expert:  911DOC replied 1 year ago.

911DOC :

Can you tell me please if you have brought your concerns to your primary physician?

911DOC :

Have you had a recent CT scan?

911DOC :

I will check back with you when you get online and can answer the above.

Customer:

I was chasing a pssword...sorry...

Customer:

I have no promary but my nephrologist says to take miralax, gas pills,"just keep it moving"...

Customer:

I have not had CT scan; I do not have insurance , cannot get it, so that is a little tough to do. What would we be looking for? The ER Doc said

911DOC :

Well, this is not constipation, that would show on the Xray.

911DOC :

something is causing the bloating and enlargement on the left side

911DOC :

I'm sorry you do not have insurance, but you need a CT scan probably, and you need, perhaps, to see a GI doctor

911DOC :

The ER is for emergencies, and while you are uncomfortable and are having concerning symptoms

911DOC :

the ER would not do a CT scan if they didn't think you had a condition that might require an emergency intervention like surgery.

911DOC :

standing by

Customer:

Basic blood test looked clear, but he would not send it for further testing. He said xray showed very slight blockage and some air, but he did not look at my belly. This is so bad, I have a ambilical hernia now, on the left side of the belly button . I ma sure it is from straining.

911DOC :

I'm not doubting you.

911DOC :

you need a more thorough evaluation, likely a CT scan. that's the next step.

Customer:

What about an Ultra sound? There is a "Life line Screening" Aug 23, "Abdominal Aortic Aneurysm Sreening". The last time , 5yrs ago, the tech was fascinated by my kidney and liver cysts. Do you think they could see something or be able to tell if something was different, and by the way, what are the diff things they could be looking for?

911DOC :

Yes, they could see many things, but an Ultrasounds is lousy for looking at air filled organs like the intestines... it is only good for liver, gall bladder, OBGyn, and aorta (blood makes a good contrast and the aorta can be clearly seen). Air filled structures do not show, and a CT is the test you likely need.

Customer:

Any ideas about how I might be able to go about getting this is my very middle class, living on extreme budget? Programs? White person w/ home thta has just been restructured?

911DOC :

you do not have a primary care physician, is that correct?

911DOC :

also, are you in contact with your nephrologist?

911DOC :

abdominal distension is a complication, and if you have a very large cyst it could be partially obstructing your intestines.... this is not something to wait on.

Customer:

yes, I have talked to nephrologist many times, and he says my kidneys could be pushing on intestines and creating a bubble and I should eat gas pill befor e eating, and mirilax to keep moving, which I have, but they dont seem to work now.

911DOC : And he is correct, but you need a CT scan. You need to go see him or call him as this is obviously getting worse rather quickly. There is simply no way to know what the problem is without a more comprehensive work up. You need to be persistent, and if you develop vomiting or acutely worse pain you need to go back to the ER so that the scan can be done immediately as that might indicate a surgical emergency.
Customer:

any chance of intestinal ischemia? I have been on Hbp med for 25 yrs, have pkd, distention, constipation? How do you look for this? Any chance of parasites? I do not see anything really

911DOC : This is NOT intestinal ischemia. That is acutely painful with no distension. Parasitic infection is vanishingly unlikely. This is, most likely, a complication of your PKD. You need an imaging study, a contrast CT.
911DOC : Ma'am, I am going to need to finish up soon so as to keep in the good graces of my wife.
Customer:

ok will try to figure out how. will call nephrologist. thank you.

Customer:

thank your wife too

911DOC : You ate welcome. When you call it might prompt him to the CT if you we're to emphasize the following....
911DOC : increased distension and pain
911DOC : nausea
Customer:

ok will tekk him that . thanks again.

911DOC : and some spitting up which feels like you may need to vomit
911DOC : thosevomit those are ba signs.
911DOC : "Those are bad signs"
911DOC : he needs to know this is progressing
911DOC : andprogressing and you should ask for the CT scan
Customer:

ok will do that . Thank you very much.

911DOC : "and you should ask for the CT"
911DOC : sorry, driving now.
911DOC : You are most welcome
911DOC : iwelcomed wish you well and thank you for your question
911DOC : good night.
Customer:

thank you too. no more write, just drive, thank you

911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5092
Experience: Emergency Medicine Physician
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