Could it be IBS?

[Schwarz]

Almost 3 weeks ago my 15 yr old was involved in a car accident. Even though the car was totalled, all the occupants came away mainly with scapes & bruises (that's our big miracle of our summer). My son needed some stitches where his glasses dug into his eyebrow, other than that, he suffered some whiplash to his back and bruising to his abdomen from where his lap-seatbelt had been.

About 4 days later, we had to take our son to emerg because of severe stomach pain. The dr poked around the stomach area and felt that it was just nerves from having come through the trauma of the accident. He gave our son some Zantac and then sent us home with a prescription for more. For the rest of the night, my son writhed on the floor in pain and continually wretched his way through to daylight. Finally, and 7:30 am, I did my own examinations & found that the appendix area was where the real pain was (the dr hadn't even tried poking that area). Returning back to emerg, the new dr took things a little more seriously (I guess being bent-over, ghastly pale, & wretching helped to draw their attention). She ordered bloodwork & xray. Nothing showed. They called the surgeon & he ordered my kid to be transferred to another hospital for CT scan & ultrasound. Being drugged with Gravol & Demoral, my son was taken via ambulance. After the tests were all done, nothing could be diagnosed other than internal bruising from the seat belt. After a 2 day stay in the hospital, he was discharged & we all expected a speedy recovery from there.

Things were going fine until this past Friday ...the pain returned with a vengence & so did the vomiting. With this being the Civic Holiday weekend the only thing open was emerg & I wasn't interested in more Zantac. With finally being successful in keeping pain killers down (after 5 attempts), I was able to ask my son a bunch of questions ...what have you all eaten lately, when was your last BM, how much have you been drinking. Info was vague but there was no question that this kid was constipated. I also looked into a medical encyclopedia I have and the symptoms sounded like Spasdic Bowel. For the next 24 hr I attempted to get this kid loosened up. Oatmeal porridge with raisins & cooking bran added, LOTS of liquids, a dose of Metimucil later on in the day, more liquids, by nightfall I even resorted to a bit of Exlax (I never used this stuff before ...in my desparation, I remembered that I had a small sample pkg in my 'junk drawer'). The rest of the night consisted of more writhing and wretching again. By morning, my son finally passed a little 'rock'. Occasionally throughout the day he passed more 'rocks', then by nightfall things started to show that the stool softeners had taken effect. With the aid of Gravol, my son was able to put in a whole night's sleep, but by 7:30 am the pain & wretching started again. This time he was able to keep down pain killers on first attempt. He eventually was able to eat some breakfast (oatmeal with added cooking bran). I gave him one dose of Metamucil later on in the day and then made him drink like a madman all day. He was able to keep down a couple soft boiled eggs for both lunch & supper. Tonight, he's more comfortable, yet (upon going to bed he told me this) he was only able to produce one little 'rock' again for a bowel movement. I gave him some Gravol when he went to bed to help him relax so he could sleep.

With all the information I've read, it appears my son may have developed a spastic bowel as a result of his accident. Could that be possible? The surgeon won't be in his office until Tues. morning for me to take my son in for a reassessment. Could anyone offer me some enlightenment or educated questions that I could pass on to this surgeon? It would be nice to get to the bottom of my son's problems. Do you have any other suggestions for me to consider while we wait for Tuesday morning to come (to see the dr)? Foods? Proceedures? (I realize this forum is not a medical cure-all organization, but there sure are excellant ideas that come up that have been as much or more practical than what medical science has come up with.) All your input is appreciated!

[lissylou73]

Schwarz,

I am sorry to hear of the misery your son is going through. I have IBS, but mine is more of the diarrhea predominant type. Please know that I am not an expert! But, here are my thoughts:

1. Make sure he has a colonscopy. IBS can mimick many other problems, which may be more serious.

2. Usually one does not vomit that much with IBS. I am not saying it never happens, but it sounds like he has been at it for days.

3. An endoscopy may be a good idea, too. This may get to the root of the vomiting problem.

4. Keep trying to get him to move his bowels as much as possible. You are doing the right thing by forcing fluids, serving bran, and giving him laxatives.

I have a few questions......Is there blood in his stool (bowel movements that are either black or bright red in color)? Is there blood in his vomit? Does he have a fever? Exactly when was his last normal bowel movement?

I suppose this onset of problems could be a result of the stress of the car accident. But, I am concerned that it is some type of injury, such as a torn bowel, that was not discovered in the CT scan. This is where a colonscopy and endoscopy is also a good idea.

Please let us know how he is doing!

Melissa

[Schwarz]

I will inquire about a colonscopy and an endoscopy. I would have never asked about it if you hadn't suggested it.

My son does not have blood in his stool or vomit. He has no fever and he had his last bowel movement just this morning (I was hoping for it to be softer but it appears to be medium/hard).

Just this afternoon a neighbour spoke to me about how head injuries can cause a multitude of symptoms that seem to have no connection to the head. Our son had suffered a mild concussion from the accident ...he cannot remember anything from the accident -he just tells people what he's been told. I don't know how I can look into this possible connection (the head connected to the bowel --sounds rather crazy :daze: ), but when I asked this neighbour about this concussion thing & possible connection to my son's abdominal pain, she said it's amazing what a head injury can produce. I bet the dr's gonna think I've flipped if I ask him about this possibility ...but I'm trying every angle to get to the bottom of what appears to be a form of IBS.

Right now my son wants to eat things like a hamburger, or hot dog or more 'interesting' things than just the bland / high fibre stuff. Do you think a hamburger patti would aggrivate his digestive system (because of the grease)? Soft boiled eggs go down well but he's starting to loose interest in them. I finally allowed him a small sub ...using meats that were low fat, and no cheese. Do you have any other food suggestions?

Thanks for your interest & concern. I'm hoping the dr will take my son in tomorrow if I call first thing in the morning. At least my son had an undisturbed night's sleep last night. Today he's still sore and draggy but he can keep his food down. It's just too bad he had to pull out of canoe trip that he'd look forward to for the whole summer. 'Fortunately' he's feeling crummy enough that he knows he'd never pull through it if he went.

[lissylou73]

schwarz,

I'm glad my suggestions may help you. The head injury may be cause for discussion with the doctor. If he looks at you like you're crazy for mentioning it, stand up for yourself. I don't tolerate doctors that do not listen to the patient. Unfortunately, you will find that if IBS is the topic, their eyes glaze over, and they say, "take fiber." UGH!

That is a good sign that there is no visible blood. But, I would still insist on the colonscopy and endoscopy anyway.

As far as the diet goes, I'm not sure. My thought would be to eat soup, jello, pudding, or mashed potatoes. I would think semi-liquid foods would be easier to hold down.

Please keep us informed at how he's doing!

Melissa

[Schwarz]

Due to a cancellation, the surgeon who looked after my son at the hospital was able to take us yesterday afternoon. It was a good visit, however, we may not be out of the forest yet.

I inquired about IBS, the colonoscopy / endoscopy, etc, etc. This east-indian doctor was super accomodating & didn't make me feel like a fool for asking all my 'weird' questions.

He feels that IBS is really not what my son's problem is. However, the feeding of fibre, jello, pudding, mashed potatoes, etc is the right thing to do.

I have another appointment for next week Friday. Should my son have another episode before then, the dr told me to contact him & he'd meet me at the hospital and do an exploratory laparotomy on him (incision in belly button, insert a 'tube' & have a look around). Should there actually be an appendix problem, then he'll remove it at the same time.

When I looked up 'laparotomy' and followed it's different cross-references, I came across Peritonitis, which is "...an inflammation of the...two-layered membrane that lines the abdominal cavity. This condition ...may occur as a complication of a disorder in which your digestive tract is irritated or ruptured... The symptoms vary...but there is always severe agdominal pain...You may be nauseous & vomit. [A] decrease of pain does not indicate that you are getting better...it is a danger sign that signals a need for emergency medical treatment..." . Eeesh ...kinda sounds familiar!

So, as you can see, we aren't totally out of the forest yet, but at least the dr is willing to be on standby to do an emergency laparatomy if necessary.

Thanks for your assistance in offering input during a time of uncertainty.

[LBDropper]

IBS can be harsh but usually not this severe. Also it can be vomitting but usually is not. Since it started with the wreck I would this it is something else and to try a new doctor. IBS usually consist of gas, loose stools, or constipation. You can get pains from the cramping but they are usually resolved with a bowel movement.

[Schwarz]

Sure appreciate your input and your interest, LB.

We had a rather 'eventful' summer with my son's abdominal problems, but it seems to be working itself away slowly.

With the bruising & swelling the abdomen experienced from the lap seatbelt my son was wearing at the time of the accident, the dr figured that the colon was going into spasms as food was getting processed in that particular area of his bowel. Also, the pain that the spasms created were what triggered the vomiting.

Now that school has started, my son has been instructed by the dr to not to exert himself too much in phys ed for the first little while. Injuries to the colon take a while to settle down.

I'm SO glad we aren't looking at IBS! Those of you who must be mindful of this condition must edure some very unpleasant symptoms. If LCing helps lessen your symptoms, then I can only be thankful on your behalf that you've been able to find something that helps.

[KTiki]

Hi Schwarz, I came in on your thread late, but read it all the way through to make sure your son was okay. How is he doing now? It must have been scarey for the both of you to go through all that. I just don't understand why the first emergency room doctor sent him home with Zantac and that was it. My heart goes out to your son. I hope he is pain free and all else is well.
God bless you,
Kathy

[Schwarz]

It looks like things have settled down now for my son. He had 3 'attacks' in all ...1st one was 3 days after the accident (lasting a good 24 hours) and 2nd one was a week after that (lasting about 1/2 a day), and the 3rd one came about 2 weeks after that (lasting about 4 hours) while we were on holidays. Since the end of August, he has not had any more attacks. PTL! Our son was rather bummed out that his whole summer was shot because of his injury ...he had to forego his beloved 5-day canoe expedition with his dad & a bunch of buddies. We let him go on a 2-night campout with a couple buddies the end of September to help brighten him up (mom here was still somewhat nervous about letting him go just in case he had another attack). All went fine with no problems. The surgeon bid us adieu in mid-Sept, saying that he doubts there will be any more problems ...but if there is, I am allowed to phone him directly.

Now to put some weight on this kid ...he's 5' 11" & only 140 lbs!

[KTiki]

:wave: I'm so glad he is doing well. Don't worry, he will gain weight. I have a 10 year old son, he gets a bit chunky just before a growth spurt and then really lanky untill the next one. Is your son in Boy Scouts? It sounds like he and your hubby do alot of the same thing my guys do with the Scouts.

Take care and God bless you all,
Kathy

[Schwarz]

Is your son in Boy Scouts?
No he's not ...my hubby just loves doing this kind of thing with his kids & tries to take some kids from unfortunate home situations along too. It's become an annual event (usually 2 & sometimes 3 times a summer) for the last 4ish years. This event is usually looked forward to for a whole year, so that's why it was so disappointing for my son to have missed it. However, there will be next year & more years to come (if the Lord doesn't change things). :wave:

[Buster]

My apologies on coming iin late to this thread, but I felt compelled to comment. I have been in a similar situation since age 18. I'm now 45 and have a pretty active lifestyle and decent health. I did not have my symptoms through trauma as your son did (maybe?),
and I began to have similar attacks, was sent home with a nice shot of Demerol in my butt which made me feel great, placed on Bentyl for a couple weeks, then everything was OK until the next attack, which varied from 6 months to 2 years later. I went through several upper GI's and they told me that I had an irritation in my Duodenum, which would likely become an ulcer as I grew older. I used Maalox and Mylanta with very little success.
Just as a side note, my father had similar problems and they had finally diagnosed him with Diverticulitis (I think they were still not sure) when he was in his 60's. Anyway, abot ten years ago I had another attack, and Doctors Bert & Ernie gave me a shot and admitted me to the hospital. after two days of meds, they sent me home. The surgeon at the time had suggested removing my appendix, but said that I didn't present with the rebound tenderness like an inflamed appendix, so I had them discharge me. One year later I was back in the hospital, the same surgeon saw me and remembered me, and we agreed to cut the thing out. It was inflamed, and he said that it was post secal (sp?) meaning that the thing was turned around behind something and so I didn't get the rebound tenderness normally associated with a hot AP. Thinking my problems were finally fixed, and I really did feel much better (I guess so, I amlost died from the infection) I had great health until three years later. I developed an abdominal abccess at the same spot that was the size of a baseball, finally felt like I was going to pass out, so I went to the doctor. Needless to say I wound back to the surgeon, and he cut it out, and sugested a colonoscopy. After healing up, I had the colonoscopy done and was diagnosed with Crohn's disease. Went on meds for a few years, and they didn't seem to help much, but I didn't get any attacks, or what attacks I got were pretty mild. Then I got a new Primary Physician who also is an Internal Medicine specialist, and he is of the oppinion that Crohn's shows itself sometimes every day, but in my case upon the change of weather. That pretty much seems to fit what's going on with me. I have been relatively drug free, recognize when the attack is happening, and I sometimes think that they might be wrong because I feel so good, but this is as close to a bullseye diagnosis that I have experienced. Anyway, sorry for rambling - If you feel the need to express any frustrations to me, email me at szymczak~delanet.com and maybe we can get closer to helping your son. I'd hate to see him suffer until he turns 35 or 40 to get appropriate help.

[Schwarz]

I read your post with great interest. Ugh...I can only hope that my kid won't have to endure what you've gone through.

As of now, things seem quite stable as far as the spastic bowel thing is concerned. However, as I read how you downed Maalox / Mylanta, I couldn't help think about how much this son needs something for his stomach too. On our last visit to the surgeon, I brought it to his attention how often my son needs Tums to settle his stomach ache. This had gone on well before the accident (+1 year prior) & things were not getting any better. I explained to the surge how I had gone to our family GP regarding my son's stomach problems & how the GP finally said "I think the problem is more that mom is a little more concerned than what is necessary about the situation" . I was ready to slap the doctor's face! :mad: How dare he verbalize such an unprofessional statement! The problem we have here in our part of Canada is that the shortage of doctors has hit a critical point, and, if you have a doctor, there's no way anyone else will take you on just because you want to change ...there's not enough doctors to go around. So here we are with a 'fat-head' of a GP, and my kid is still not getting over his stomach problems. The surgeon sent us home with some samples of Pantoloc ...I'm sure it's just another brand of Zantac ...saying to take one before going to bed at night. Great ...another dr not willing to find out what the root cause is.

My son has gone through a lot of stomach aches before & after the accident. It has occasionally kept him home from school in the mornings (he needed to get some sleep since he had been up most of the previous night with stomach aches). I have countlessly thought that one of these days this kid is going to end up with an ulcer.

...Then you sent me you post! :eek:

I have an appointment with a complementary dr next week. I had been thinking about asking him how I can help my son with this situation. Here again, this fella is so busy that I had tried for 1-1/2 years to get on his waiting list, & last Nov, I called again pleading for the dr to be willing to look at my health situation. The secretary called me back a few days later and said the dr was willing to put me on the waiting list, and in Feb I got a call, saying I could come in April. Amazing! So, with the dr being insanely busy like that, I can only hope that as I present my son's problem to him, he might have the compassion & time to look at him, run a bunch of tests on him, and attempt to find the root cause of my son's problems.

I hope you don't mind that I keep your post & email address in a reference file to have available if someday I feel I need some input on things should my son start showing more symptoms similar to what you have described. I will definitely keep my eyes open to possibility of Crohn's symptoms ....my husband has a cousin who suffers from that -things like that could possibly run in the family. This cousin has also kept his symptoms well under control by following a strick diet. I don't know exactly all that the diet entails, but he has said that "if God didn't make it, I can't eat it" ...and with this diet, he's been able to lead a pretty normal life.

Thanx for sharing your information with me. I too have rambled on so you will have to excuse me as well. I'm sorry you had to endure so much pain in your life. I can only hope that you will continue to enjoy good health with your cautious eating habits & lifestyle. Good luck!

[Buster]

Please feel free to email me. Whatever cheap advice I can offer, I will. I'll say a prayer for all of us. Buster