Pain and swelling of the abdomen

[Accadana]

Hello Doctor.  Several years ago, I ate contaminated food, with e-coli, which gave me problems in the intestine.  I binge drink once every month, sometimes I will go party once every 15 days, when I get bored.  For a few years, I have been experiencing GERD, abdomen swelling, diarreah, and painful cramps in my lower abdomen, symptoms which become more present after drinking.  I get pain about an inch down from my belly button, and to the right.  I also feel pain when I notice transit on my intestine, specifically in that area.  This is incredible pain, ussually minutes before I will go to the bathroom, and have diarreah.  After going to the bathroom, I feel relief and everything calms down, I even feel my colon calmer.  As of late though, I have been experiencing abdomen discomfort even if I don´t drink for a month or so, and I am getting a little bit worried.  What type of exams or routines would you recommend?  Is this serious?  Thank you in advance for your response.

[Dr. Kokil Mathur]

Hi!

I appreciate your concerns and will try my best to guide you. The symptoms could mean a lot of things, and though it may not be serious as in life threatening, prolonged persistence of these symptoms can cause malnutrition due to poor absorption. For these problems, the investigations can be of two types: invasive and non-invasive.

Persisting E coli infection can also cause colitis which can cause lower right abdominal pain. It can even be chronic appendicitis caused by past E coli infection or due to impacted food or any other infection. The other possibility is ulcerative colitis. Hence, a CT of abdomen may help diagnose or rule out all three causes.

Parasitic gut infections like amoebiasis, E coli infection, round worm, giardiasis can also cause similar symptoms. Hence, you must get a stool test. Also, irritable bowel conditions like IBS, Crohn’s ulcerative colitis and celiac disease, which can cause similar symptoms can cause bleeding into the gut which is not visible to naked eye. So, an occult stool test should be done apart from stool routine and microscopic for ova and cysts of parasites.

If these tests are not conclusive, then you may need a colonoscopy to rule out a colon condition like colitis, ulcerative colitis etc.

The doctor may also ask for blood test to look for inflammation, infection, gluten intolerance etc. Alcohol can worsen an existing colitis. Also, chronic appendicitis may or may not be affected by alcohol intake. If you have allergy to certain alcohol ingredients like yeast used or gluten etc, then repeated intake of alcohol can damage the gut.
Please discuss with your doctor. Try and consult a GI specialist. Hope you get well soon! Good Luck and take care!

[Accadana]

Thank you very much DR.  God bless you.