Worried about friend

[paulclarkson1985]

My friend has for the last 2 months been in pain with his stomach, he has cramp like pains (Mostly in the mornings) his stools have changed and he sometimes pases a small amount of blood.

He went to see his GP who sent him staight to the hospital for blood tests, these came back clear, his GP also refered him to a specialist, he recieved a letter a few days ago stating he will recieve a phone call in 3 weeks time regarding this, for a chat ? he is in contant discomfort. And also very worried.

Is this normal practise?

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[freakyleaky]

The fact there is blood involved should usually speed things up. He really needs to pester his GP and emphasise the pain he is in.
Scans and tests etc can take an age to sort out but the pain can be controlled in the meantime.

[Bookworm]

The good news is that if they had found anything dangerously abnormal, they wouldn't put him on the back burner, so it's a reasonably good sign that they deal with him this way. It's when you get a phone call asking you to make an appointment ASAP that you should start worrying.

You could get him to try Buscopan, which is available over the counter. It's an anti-spasmodic which has now been repackaged as being "for IBS" which usually works wonders for stomach/intestinal cramps. Be sure to read the posology first in case of contra-indications, of course.

	Record your calls Follow this link to read the review of the Truecall telephone recorder and call manager. This is the Rolls Royce of call recorders. It's a bit pricey but if you buy it with our special offer you will get it at cost: about 20% discount. How much do we make on the deal? - Nothing at all. You can also buy cheaper devices from Maplins. Truecall is the best - but the important thing is to record your calls.

[godpikachu]

hmm, from the symptoms you describe, he could have a stomach ulcer, or at the very least hyperacidity.

[flyingdoc]

You dont pass blood from a stomach ulcer - or at least if you do then its not red blood but black, tarry and nasty.
Normally fresh blood passed PR (from the bottom) is from either piles or possibly a fissure. Less common are polyps that can sometimes bleed.
When you say his stools have changed - how?

[paulclarkson1985]

Thank you all for the replies.

His stools have changed in consistency ie frequent diarreah .

The pain comes in waves mostly after eating and mostly in the mornings.

[flyingdoc]

if he is having diarrhoea then the pain he is having is most likely linked to spasm of the gut - can be very painful.

Eating always stimulates the stomach and gut (called the gastric reflex) so that is probably why it gets worse after eating.

So I suspect that the pain is cause by the diarrhoea, and the blood is most likely coincidental.

the question is what is causing the diarrhoea.

It has been going on (probably) too long for it to be food poisoning or anything like that - has anything else changed? has his diet changed has he been taking any medication travelled recently anything out of his normal routine?

It is important if he is having frequent bouts of diarrhoea that he keeps his fluid levels up, and takes electrolyte replacements also, there are special sachets such as dioralyte or rehydrate that he can take to ensure that he doesnt lose vital salts from his body. Isotonic drinks can also help (like lucazade Iso)

I would also perhaps take immodium (also known as loperamide) which may ease his symptoms as it slows the gastric motility and may alleviate his diarrhoea and ease his spasmodic pain.

[paulclarkson1985]

Hi flyingdoc,
No nothing has changed in his eating habits etc.

I will pass the info to him, thank you very much.

Obviously he is concerned in case this is somthing sinister .

And when he has these spasms they are indeed very painfull.

He however has not lost his appetite but is scared of eating in case the pain starts again. And also he has lost weight latley.

[Sali]

Question for Flyingdoc. I'm guessing this person will end up having investigative procedures at the hospital. Standard endoscopies can be distressing and carry a risk of perforation. I know capsule endoscopies are available now at a few hospitals. Do you think this procedure is less distressing for the patient and does it carry fewer risks. Also would it be possible to see (via the video output) perhaps more detail in areas of the stomach/colon that could not be viewed via the standard endoscopy?

[flyingdoc]

I was wondering about the investigation of this person I have to say - I wonder what blood test he had.
Endoscopy carries with it a risk and would in all probability show the problem, as it sounds like it is in the large bowel that the problem is occurring.
The capsule endoscopy sounds like a great idea but have to confess I have never seen one in real life. The problem may be that they progress through the gut at their own speed and I would think there is potential to miss things - if the camera for instance is pointing left as it passes through a particular piece of gut when the problem is on the right.

I am only speculating though as I have not seen them in use and would not wish to mislead.

[Sali]

Thanks for that. A relative of mine had a capsule endoscopy but only when I pushed for it, after they had to undergo the other kind, (without determining a diagnosis), which they found so distressing. I'm not sure that the capsule camera is angled, but I have asked to see the stills from the procedure. The patient wears a kind of belt contraption which is (supposed to be) checked frequently and monitors the capsule through the colon and presumably wirelessly collects the frequent images. My understanding is that it can take some time (6+ hours) depending on the individual. The capsule is disposable. I get the impression (may be wrong) that the hospitals try the cheaper options first - ultrasound, standard endoscopy - when other options like CT, MRI, capsule endoscopy or whatever - could reach a quicker, less stressful conclusion for the patient. Especially, when the procedures to reach diagnosis are numerous, some repeated. Just an observation.