This question was answered on Thu 04, Mar 2010 01:57am by Dr. Srivastava

Burning in lower abdomen

    
Asked by john_t85 (Male; 25; AUSTRALIA; Occasional indigestion. Prescribed Nexium for about 4 weeks.; Relevant drugs:Currently nil. ) on Wed 03, Mar 2010 11:55pm

Hi, Thankyou for taking my question. For the past 4 months I have been suffering from on and off burning in my lower abdomen. Its very uncomfortable, it feels as though there is acid running through my intestines, it is particular bad in the sitting position. It is relieved by moving around, and of a night time I get to sleep quite easily and it goes away overnight, only to return in the morning. It sometimes feels like my lower belly is building up a cold sweat and it extends to just below my groin (upper thighs). It hits me for about a fortnight at a time, then eases for a few days and becomes more of a right-side pain/burn, and then the all over burning resumes again. I was treated originally with nexium for a suspected stomach ulcer, the burning did stop with nexium (4 week course), but on cessation, the burning returned. The burning is below my belly button in my lower gut region. It seems to concentrate mostly around the sides but it does burn all over my lower gut region, as I say, particular worse in the sitting position. Putting pressure on the area doesn't hurt. I have had an ultrasound which indicated a mild fatty liver. I was a daily drinker, but I have cut back to maybe 1-2 light beers a fortnight and improved diet for past few months. Nothing else abnormal. I have had extensive blood tests all normal for infections, hep, etc etc, only issue, a minor irregular liver function, but nothing serious. I have had a CT scan of abdomen/pelvis area and nothing was detected. What possibly could this be? I do have quite loose bowel movements on a weekly basis, not every day, but not diarrhoea, but still regular (bowel movement daily and no blood), though it does feel as if the burning eases just before bowel movement. I have also taken an antibiotic for possibly clymidia, but it has done nothing, and I am yet to get urine test results, but the burning has not stopped and I have no pain when passing urine. I can't find anything related on the internet with similar symptoms or relief ideas. I still get occasional indigestion which is relieved by mylanta/zantac, but it does not stop the intestine burning. My GP says a colonoscopy is next on the cards. I hope I have provided enough information, and I hope you may have idea as to what I am suffering from. Getting really sick & tired of feeling as though my intestines are on fire, particularily, sitting down at work during the day, as I say overnight it all calms down, but the fire returns once I've been up for about 15 minutes. I am changing around my diet to see if its food related, but to no avail. I look forward to your response. Many thanks!

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Answer by Dr. Srivastava  on Thu 04, Mar 2010 01:57am:

Hello John, A warm welcome to our site. You have narrated your case with no hesitation but as abdominal pain could have several possible causes of pain therefore I can not confirm any single possibility but will try to suggest the best possible reasons for such problem according to your description. There could be few most probable possibilities which include peptic ulcers (pain related to GERD), fatty liver related abdominal discomfort, irritable bowel syndrome or infectious enteritis(can be ruled out by blood tests and stool test). The burning sensation near belly button region indicates possibility of duodenal/peptic ulcer which is characterized by burning sensation due to erosion of the duodenal lining due to excessive acid production in stomach. Such pain typically shows rhythmic periods of exacerbation (increased activity) and remissions (asymptomatic period or rest). This is similar to the episodic feeling of burning sensation that you experience. Relief of pain after Nexium or other antacids also hints towards the same. This chronic condition can be a sign of Gastroesophaeal reflux disease, if not GERD as full-fledged illness. An endoscopic examination during symptomatic phase may reveal erosive epithelial lining of the affected part. Other possibility is Irritable bowel syndrome which also presents similar episodic pain with no clear cause of abdominal pain after extensive examination and testing. It is believed to occur due to abnormal intestinal contractions or abnormal sensations of hypersensitive nerves of intestine (proprioceptors) giving rise to inappropriate painful sensations. These are called functional pain. This pain is often relieved by bowel movements. Third rare possibility could be fatty liver related abdominal discomfort as you have irregular liver function results and fatty liver but this can be confirmed only if any other sign of liver damage is detected upon examination eg. jaundice, tenderness in liver etc. Mild asymptomatic fatty liver may be seen in otherwise healthy individuals with stressful and sedentary lifestyle. You can discuss these possibilities with your treating doctor to reach to diagnosis based upon the test results he has conducted so far. Hope this information proves helpful for you. One last thing I would like to add which I feel should be told to you is that all these possibilities have an etiological relation to STRESS so you can try to keep yourself calm by avoiding anxiety, stress of work/health or any other form. Try meditation and yoga to stay healthy. Do keep us posted in future about developments of your case or any further doubts. Take care.

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Follow up:

Clarification by john_t85 on Thu 04, Mar 2010 02:37am:
Thankyou very much for your prompt responses. I will certainly follow up with GP for colonoscopy & cease all alcohol intake. My GP has run about 5 seperate, lengthy blood tests and nothing has come up. I have no jaundice or liver tenderness. Nexium certainly took away the burning - but currently taking an antacid, doesn't help the intestine burning, it only stops my infrequent indigestion. Is it possible to have ulcers in the lower gut? The burning is entirely in my lower gut region below 3-4cm down from my belly button. It burns right across this area, primarily originating from the sides. I have no other symptoms presenting. Thankyou again for your advice, much appreciated. It is becoming very frustrating, the constant burning.

Comments:

Comment by Dr Vinod, MBBS,FcGP on Thu 04, Mar 2010 01:59am:
Hello john t_85, Dr Srivastava has given his best views and I would want to discuss further. I would suggest you to go for a colonoscopy or a sigmoidoscopy as advised by your Physician. It is important to rule out inflammatory bowel disease, irritable bowel syndrome, diverticulitis or any tumor in your large intestine. The stomach is just one potential area for burning pain. Any organ in your midsection can cause pain, including your appendix, gallbladder, pancreas, kidneys, and intestines. Dull and burning abdominal pain accompanied with or without acid brash or regurgitation that comes and goes is probably a pain due to peptic ulcer or gastritis. You also conveyed that the pain decreased with nexium and also presently it is relieved by using antacids, proton pump inhibitors of H2 blockers so rule out gastric problems. The pain is often worse when the stomach is empty and goes away after eating. You may also have indigestion, nausea, vomiting, heartburn, gas, and dark stools sometimes. I would suggest you to go for endoscopy for a proper diagnosis and follow up with a gastroenterologist. I would want to give you some inputs of different kinds of pain which would help you in diagnosis. If you have moderate to severe cramps and accompanied by vomiting and the vomit if smells like stool can be due to intestinal obstruction. You can also rule out appendicitis as you had some scans and if the pain is in the lower right side of the abdomen and is referring to the navel presently then get yourself checked for appendicitis. I would like you to rule out pancreatitis and it is good that you have ruled out liver problems like hepatitis and infections by liver functions tests. Here I want to suggest you to abstain completely from alcohol and eat healthy and on time regularly. Change your diet to healthy and balanced meals and for this you can discuss with a dietician. I would also suggest you to rule out heart problems which may mimic this pain, rule out shock and allergy, diabetic pathology and chronic poisoning due to use of some medications. Rule out any kidney problems by going for kidney function tests. Based on your symptoms and presentation I can think about these conditions and if you need further help and suggestions let us know. Take care!

Comment by Dr. Srivastava on Thu 04, Mar 2010 03:06am:
Hi, Thank you for your appreciation. Duodenal ulcers are seen upper half of the intestine but either you may be perceiving referred pain or Iritable bowel problems which could be explained best by your treating doctor after evaluation of all the possibilities including IBS. Take care.

Comment by nafisa Kanji on Fri 29, Oct 2010 03:56am:
I have been following problem and sounds like my problem. Would like to know final outcome.

Comment by John_t85 on Sat 30, Oct 2010 05:47pm:
Hi, I have since this question had a colonoscopy which ruled out any pathology in the bowel. I still have occasional burning and a mild ache in my lower right abdomen, however after seeing a specialist, I have been prescriped Endep (small dose) to ensure good sleep and to assist with pain, it seems to be helping. The specialist believes it is mild IBS. All tests continue to be normal - bloods, ultrasound, CT and colonoscopy. I've also invested a lot of time into more exercise, a healthier diet and time to DE-STRESS. Thankyou to the doctors here for responding and assisting me during what was quite a stressful period.

Comment by on Sun 31, Oct 2010 12:12am:
Hi John, Its good to hear from you that we were of some help though limited due to constraints of virtual opinion on Net. As I had mentioned IBS(Irritable bowel syndrome) as a possibility in your case, The tests remain normal in IBS and diagnosis is reached only after exclusion of those conditions which have direct tests to rule out. Since IBS is something which has unknown etiology and seen in association with acute gastric infections in past, depression and anxiety hence stress relief is very important. Endep is good choice and can be continued in low dose but there is another research upon probiotics where health bacterias and other microorganisms can be administered to IBS patients also Yogurt is also a natural probiotic substance which can help you with IBS symptoms. Take care !!!

Comment by Holly on Wed 13, Apr 2011 11:32am:
Have you ever been tested for parasites in your stool?

Comment by Dinesh Singh Rawat on Fri 10, Jun 2011 05:54am:
I have been suffering burning in my lower abdomen. Its very uncomfortable. it is particular bad in the sitting position. It is relieved by moving around, and of a night time I get to sleep quite easily and it goes away overnight, only to return in the morning It sometimes feels like my lower belly is building up a burning while taking any medicine (eighter allopethic, homepathic or aurbedic medicine) and also notice that food (home made) which we whatever eat make burning in lower belly and it extends to just below my groin (upper thighs).I have done many tested colonoscopy, KFT,LFT,Blood Test, Ultrasound(whole abdomen),Sugar rendam and TSH, Uroflowmentary, Cimen Culture & Specific etc. all are normal except fatty lever. My doctor suggest me for cyctoscopy. I am very upset. Kindly suggest me i will be remain very thankful

Comment by michael solomon on Sat 26, Oct 2013 10:40am:
Same here my liver tests showed as functioning slightly under, I take 30mg lansoprasole 20 to 25 minutes before breakfast. Today i wasn't sure if i took it so i left it! i had ready brek and protein shake didn't feel a thing until 2 hrs after eating i got that bastard burning around belly button area slightly above and slightly below the belly button i definitely missed a dose. ive been getting palpitations in the esophagus for over 3yrs, i feel a slight nipping pain in the left side of my esophagus most likely multiple ulcers or severe inflammation but i never feel pain during eating, palpitations have reduced since i bed 5 and a half hours after a meal. i'm guessing i'll be on 30mg lansoprasole for life seen as missing a single dose causes that lower stomach burning and i take precautions as well ie no pure orange juice cut tomatoes down a lot cut citrus fruits out! and smoke only 7 cigarettes a day! i'm guessing you also have gerd's disease just keep taking the fucking pill dude.

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