HomeAnswersMedical Gastroenterologyirritable bowel syndromeWhat causes bloating, stomach cramps, and bowel movement multiple times a day?

I am having bloating, stomach cramps, and pass stools 3 to 4 times a day. Why?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Ajeet Kumar

Medically reviewed by

Dr. Sneha Kannan

Published At May 16, 2020
Reviewed AtSeptember 16, 2023

Patient's Query

Hi doctor,

I am 40 years old, and my digestion is always a concern for me, but I am having bloating, stomach cramps, stool discharge 3-4 times a day since last month. There is no blood found in the stool, and the stool test confirmed a few macrophages in the stool. Often sound comes from the abdomen, and sometimes pain radiates to the back. The pain is located at a specific location below the naval on the left side, and sometimes I have cramps all over the stomach. This pain point is causing trouble for many years but not very significant and is not found on the USG (ultrasound) abdomen. I am taking the medicines Actigut for five days, Meftal-spas continuous, Pantoprazole for 20 days, Normaxin till now. At present, bloating is reduced, but stomach cramps, stool discharge 3-4 times a day still persists. USG abdomen found with a minimal edematous wall (3mm) noted in the sigmoid colon. The laboratory test done are USG (ultrasound) abdomen, stool test, CBC (complete blood count), urine test.

Answered by Dr. Ajeet Kumar

Hello,

Welcome to icliniq.com.

I can understand you must be very upset about your problem. Well, the symptoms you mention seem to be occurring due to irritable bowel syndrome with functional dyspepsia. Irritable syndrome is a gastrointestinal entity where the patient has abdominal pain, which changes with physiologic activities such as defecation, belching. This abdominal pain can accompany diarrhea, which is called Irritable bowel syndrome (IBS) diarrhea (D) predominant (IBS-C) to be precise. The blood test, urine test, and ultrasound abdomen that you shared are very much within normal limits. So do not worry at the moment. You said stool tests contain macrophages, but I cannot see any stool the report among the files you uploaded (attachment removed to protect the patient's identity). Well, macrophages or leukocytes can be present in stool harmlessly and do not suggest any diagnosis on its own. I would recommend you to get some more stool tests that can determine it clearly.

So the IBS usually affects the small and large bowel, and it is not uncommon to have concomitant stomach irritation, which is called functional dyspepsia. So part of your symptoms, such as stomach cramps, bloating are secondary to stomach irritation. You are on lots of medications, many with similar drug classes, which does not seem wise to continue. I recommend you some medication you can use, and let me know in one week how that works in your case. You can also consult a doctor.

Investigations to be done

Stool for H. pylori (Helicobacter pylori), stool for fecal calprotectin, stool for detailed report, for ova and parasites, and for giardiasis stool for fat globules, reducing substance, and stool spot sodium and spot potassium levels, serum TSH (thyroid-stimulating hormone), random blood sugar, and HbA1c (hemoglobin A1C).

Differential diagnosis

Inflammatory bowel disease, endocrine disorders, diverticular disease of the sigmoid, H. pylori gastritis, gastroparesis.

Treatment plan

Tablet Rifaximin 200 mg thrice daily for 3 weeks, Tablet Mebeverine MR 200 mg twice daily.

Preventive measures

Reduce some weight, avoid gas-producing diets such as nuts, peas, cauliflower, cabbage, certain cereals, which you think cause increasing bloating.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ajeet Kumar
Dr. Ajeet Kumar

Medical Gastroenterology

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