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IBS, is your diagnosis correct?

Author: Scott Best

Some twenty years ago, I developed a pain in the lower right quadrant of my abdomen that seemed to travel up and to the side radiating into my back on the right side.  The pain would come and go, accompanied by minor abdominal bloating constipation and or diarrhea.  My doctor of that time was what you might consider, an old fashioned, tell it like it is country doctor, who though it might be a gallbladder issue.  Over the course of several months several tests were performed including but not limited to an ultra sound, CT scan and a high fat intake study, in an attempt to force the gallbladder to react negatively.  It never did react during the testing.

CT and MRI scanning were in their infancy at the time, and neither showed any abnormalities.  The pain and discomfort continued and in frustration the old doctor told me that regardless of what the tests showed,  he would be willing to remove my gallbladder, because his gut feeling was that it was malfunctioning and the cause of my pain. I have to admit that his offer at first sounded tempting, but once I found out how the procedure would take place, I decided against the doctor’s hunch and avoided the surgery.  There was no laparoscopic procedure at the time for removing the gallbladder.

Time passed, in fact years passed and my pain got a little worse with each year, as did the symptoms that accompanied it.  The old doctor passed away, and I saw several new doctors about my pain and symptoms.  With the new doctors came a battery of new tests over time, none of which could ever find anything wrong.

There is a measure of wisdom in this despite the fact that it may take a while yet to get to it.  Over the progression of years and pain, I had become what might be considered to be desensitized to my level of pain. There were times when it the pain became very acute and I felt it necessary to seek medical attention.  But I believe that the doctors I was seeing for my condition had also become desensitized to my condition as well, having long since labeled my condition with the diagnosis of Irritable Bowel Syndrome.

Because of how my whole case transpired I feel a bit of explanation is in order.  I live in a rural area, and medicine here moves slowly, for several reasons.  One is that most tests that require big fancy machines until quite recently required long distance travel, and usually days advance notice to be able to set these tests up.  Another reason, for me I think medicine moved so slowly was that the IBS diagnosis that had been given me, prompted the doctors to not get excited about my condition, thinking that all that could be done had been done, and that nothing more would return any different results.  I think they got tired of my complaining about my condition and pain, and had become complacent about how they viewed my condition. Sometimes the pain cycle would be a few weeks, sometimes a month or more without an episode, usually lasting from a few days to a week or more.

Even with the advent of a new test called a Hida scan nothing was ever found. A typical episode would go something like this. My pain level would increase or be sustained for several days prompting me to call the doctor’s office to set up an appointment to be seen.  Usually the appointments could never be made for the day I called, and usually never with my preferred physician, only a PA (physician’s Assistant) sometimes days or even a week later.  So by the time I actually did get in to see a doctor or PA, the peak of my crisis passed.  Then I would be scheduled for a test of some sort usually days after that, either by virtue of having to travel to another town or because of the back log of test that needed to be performed locally.  So by the time the tests were actually being conducted, my crisis was usually on the downward side or completely gone.  Pretty much I lived like this for a bit over 20 years.

Then one day, it was on a Sunday, when none of the regular doctors could be reached, I had an episode. I began calling these bouts of pain and abdominal discomfort episodes many years previously because I was under the belief that I was dealing with Irritable Bowel Syndrome or IBS which everyone was referring to in the manner of as having episodes of. This new episode took my pain to new heights.  I had the misfortune a few years prior to have had a kidney stone that got lodged and ended up rupturing a kidney.  I thought then that no physical pain could be worse, I was wrong.

By the time my wife got me to the emergency room, I couldn’t walk, I couldn’t talk, and I could barely gather the presents of mind to even breathe the pain was so intense. Upon arrival, I was in the thought pattern that I was having another issue with a kidney stone, as did the attending physician.  But after the X-rays, blood tests, urine tests, CT scan, MRI scan and several hours of agonizing pain, it was mentioned that I could be having a gallbladder attack.  After several hours and a lot of Demerol and no change in my condition I was finally admitted. The staff surgeon took a look at my case and it was decided to ship me off the next day, 70 miles to the north to a town where a Hida scan could be performed.

If you have ever had a Hida scan then you know that you can actually see the liver and gallbladder function on the overhead monitor in most cases.  I had had several of these over the years and all had the same type setup.  This time the gallbladder did not show normal function, in fact it didn’t show any function at all.  So the test was finally positive for a malfunctioning gallbladder.

The next day I was scheduled for surgery and the gallbladder was removed.  The surgeon that performed the operation told me later that he had never seen a gallbladder with as much scar tissue as mine had.  He also said that the gallbladder had fussed itself to the liver and to the large intestine due to the large amount of scar tissue, and proved to be rather tricky to remove.  He was amazed that it had not become gangrenes.  He stated that he had seen others that had done so with far less scar tissue. The assumption was that the gallbladder had been malfunctioning for a long time to have built up the scar tissue that it did.

Since the removal of my gallbladder, haven’t had any server IBS symptoms. Symptoms that usually occurred very frequently before have now subsided.  My body is adjusting to no longer having a gallbladder and I believe I may be on my way to being IBS symptom free.

I don’t really know how to put all of what happened to me into some kind of perspective, some sort of red flag lecture for those that suffer from a condition known as IBS other then what I already have here in this article.  In previous articles that I have written on the subject I have stated that I had always believed that IBS was a real condition, but that is had an underlying cause, which made it a condition not a syndrome.  There is a difference, a condition has a causation, where as a syndrome has no definable causation or explanation for its causation. Just like in Down syndrome, scientists know that a defect in chromosome 21 is where the condition stems from, but no definite causation for the defect can be pinpointed, thus it is labeled as a syndrome.

Much the same for Irritable Bowel Syndrome, many theories abound about what the causation might be, but none have been positively identified.  It may well be that there are many things that cause IBS, reasons that go far beyond mere dietary intake or stress.  It may be in some cases a combination of factors, no one know thus it remains a classified as a syndrome.

I had one person tell me that because I had a gallbladder condition that caused my symptoms that I never had IBS.  I did get a bit upset as I explained that for over 20 years, no one could ever confirm a gallbladder condition, even though it was targeted for testing numerous times, so I indeed did have IBS.  I suffered from the classic symptoms of Irritable Bowel Syndrome.  I dealt with the bloating, cramping and pain. I had years and years of dealing with bouts of constipation then diarrhea. Symptoms so severe they affected my lifestyle to the point of almost making me a shut-in, afraid to travel any distance because of the embarrassment of what might happen if I were unable to make it to a restroom in time. Likewise I became almost totally socially isolated because I didn’t want to have to go through the embarrassment of explaining to others why I could not attend a function or event, or even accept an invitation to dinner at someone’s house.

The greater tragedy in all this is that with a wife and children, my family suffered my social isolation as well, which is a very hard burden to bear. Mine is not a happy story, nor an easy one to tell.  I still have some lingering conditions that will have to be dealt with because of the IBS/Gallbladder disease. One being the intolerable amount of weight gain I have had over those years of pain and discomfort. Although it is not widely though that IBS causes weight gain, it is known that weight gain can be associated with gallbladder problems. I also suffer from hypothyroidism which I am sure is a contributing factor, one that now that the gallbladder issue is resolved, can be more effectively controlled.

My particular case of IBS poses, or should pose some unique questions in the minds of those that suffer from IBS.  If a gallbladder condition can go undetected for so many years, what else that has the potential to cause the symptoms of IBS, might slip through the cracks of the medical professions battery of tests unnoticed?

If you have a diagnosis of IBS or Irritable Bowel Syndrome, I would recommend that you not give up seeking medical attention, even when the medical community seems to have pushed you aside.  Be adamant in your search for answers.  Because I believe that for every person that has been diagnosed with IBS, there is an underlying causation that is just waiting to be determined.  It may well be that being persistent in your pursuit of finding that underlying causation, can give you your life back. I can only pray that for you it doesn’t take 20 years. If you have thoughts or comments about this article, please send them to scottbest@ibshelpsite.com.  I would love to read them

Copyright 2008 Scott Best

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