Question: I have had pain in the right lower part of my belly for three months. The pain often goes to the back, but I have no loss of weight or appetite. What could cause such a pain?
There are a wide range of conditions that can cause such a pain, and you will need a wide range of investigations to discover its cause.
The first step is a detailed physical examination and history by your general practitioner. This will be followed by one or more of the following tests:
— Blood tests to check liver, kidney, pancreas, to find any infection, and assess your general health.
— Urine test to check bladder and kidney.
— Ultrasound scan of ovaries, uterus and other pelvic organs. —X-ray of back, bowel and/or kidney.
— CT scan of abdomen.
— Colonoscopy (a flexible tube passed up your back passage) to check the bowel.
— Laparoscopy (tube put through your belly button) to directly look around inside your belly.
A few of the many possible causes could include an ovarian cyst, an abscess from appendicitis, endometriosis, back arthritis, kidney stone, aneurysm (swelling) of the aorta, arterial thrombosis (clot), irritable bowel syndrome, tube infection, hernia, Crohn’s disease, cancer and many more.
I can only guess at a diagnosis. Your GP and the specialists s/he may refer you to, should be able to come to a definite diagnosis that can then be treated appropriately.

Question: Doctors have diagnosed my wife’s condition as a bowel syndrome, and she has to watch her diet as eggs and meat cause diarrhea. Her bowel X-ray shows diverticulae. Can you help us please?
It appears that you may be confused by two different bowel conditions, although it is possible that your wife has both of them.
The irritable bowel syndrome (IBS) causes painful spasms of the gut that result in irregular bowel activity, and is caused by anxiety, stress or depression. The treatment involves a high-fiber diet, bulking agents (eg. Normacol, Meta-mucil) and drugs to stop the gut spasm.
Diverticulitis is the inflammation or infection of multiple small out-pocketing (diverticulae) of the large gut wall. When inflamed, these diverticulae cause diarrhea and abdominal pain. The diverticulae are the result of a low-fiber diet over many years, and the condition is also treated with bulking agents, a high-fiber diet and antispasmodics. Antibiotics are also used sometimes to remove any infection in the diverticulae. The symptoms of the two conditions are very similar, and only by performing an X-ray of the bowel (a barium enema) or examining the bowel with a flexible microscope tube (colonoscopy) can the diagnosis be made. It is certainly possible for the two conditions to be present in the one patient, and one may worsen the other, but as the treatments are almost identical, the differentiation between them is not of critical importance.
Both conditions can be well controlled in most patients. The irritable bowel syndrome often comes and goes depending on stress levels, while diverticulitis will persist for the rest of the patient’s life, causing occasional periods of diarrhea and discomfort.

Question: I have had terrible belly pains on and off for years. My doctor now tells me it is diverticulitis so can you tell me what causes diverticulitis?
Diverticulitis is the inflammation of small bubbles that develop on the large gut. They are out-pocketing of the gut that form between the muscular bands that run along and around the gut. They are caused by excess pressure inside the intestine when there is inadequate bulk in the diet for the constantly contracting gut to move along towards the anus.
If you squeeze a half-inflated balloon between your fingers, it will bulge out between your fingers. This is what happens in the gut, but after a while the bulges become permanent, and these are the diverticulae. When food waste becomes trapped in a diverticulum, it may become infected and painful and cause diarrhea. A high-fiber diet will prevent formation of the problem.