Abdominal Pain and Diarrhea
There are numerous causes for abdominal pain. It may originate from stomach, liver, kidney, pancreas, abdominal wall etc. But the pain accompanied with watery stools is usually indicative of intestinal disorders.
Common causes for such symptoms are –
1) Parasites like giardia – presents with abdominal discomfort, diarrhea and flatulence. Ruled out by negative stool test.
2) Inflammatory bowel disease (Crohn’s disease) – ruled out by colonoscopy, CT scan and lack of systemic symptoms like fever and weight loss
3) Colon cancer – normally is accompanied by weight loss and ruled out by negative colonoscopy
4) Diverticular disease – ruled out by negative colonoscopy
5) Malabsorption syndromes – Usually accompanied by foul smelling greasy stools. Malabsorption is confirmed by specialized chemical tests like D-xylose test, glycocholic breath test, triolein breath test, bentiromide and secretin tests. Sometimes small intestinal biopsy is also required. Also needs to rule out lactase defficiency that typically gets aggravated by dairy products.
6) Chronic mesenteric insufficiency – presents as dull cramps in central abdominal area soon after meals. Occasional diarrhea and weight loss are other symptoms. Confirmed by mesenteric angiography. It is unlikely since your pain is not related to meals.
7) Rarely, endocrine disorders like hyperthyroidism may present with such symptoms though diarrhea is mostly painless. This is confirmed by thyroid function tests. Diabetic enteropathy may cause gastrointestinal symptoms like delayed gastric emptying, diarrhea or malabsorption. But abdominal pain is uncommon with diabetes related gastrointestinal problems.
8) If everything is ruled out, then the disease entity called IBS (Irritable Bowel Syndrome) is considered. IBS is characterized by chronic abdominal pain, altered bowel habits and absence of any detectable organic pathology. Bowel habits alteration normally includes alternating diarrhea and constipation, but either of these may present alone. The cause of IBS is still elusive but has some relation to stress. Treatment includes avoidance of stress, intake of dietary fibers like metamucil, loperamide and dicyclomine.