Severe Intestinal Burning Pain, Cramping, and Trapped Gas

[brookevale]

Hi All,

It's been awhile. I have been holding my own not doing too bad until I got the toothache from hell a month ago. After much fighting with my dentist and endodontist, I relented to have a root canal that was divided into three parts. This was under a crowned tooth and I initially begged my dentist to pull the tooth. I was literally in 8-9 out of 10 acute pain for the entire month. Of course I couldn't take NSAIDs, which made me hate MC. Tylenol did nothing, so I had to resort to codeine alternating with hydrocodone. The pain meds completely screwed up my intestines. I didn't go for a week. Then when I took something to go I couldn't stop going. Well, since I started taking the pain meds I have had increasingly severe intestinal pain that is burning and crampy. I saw my GI the other day who said I had trapped gas and needed to take phazyme (which isn't working at all) and Align probiotic. The pain is triggered by eating. I eat clean (very proud of myself for sticking with it). This pain is awful. It is across my mid section from left to right. If I push on my colon and small intestine I get sharp pains. Anyone else get this pain, especially after taking pain meds? Any suggestions? I've also been trying charcoal to no avail.

Thanks!

[tex]

Hi Brooke,

Sorry to hear that you're having such severe pain because of a tooth and its treatment program. Personally, I agree with you that you would have been better off if they had simply pulled the tooth. Root canals are a great source of income for the dental industry, so they really promote them. Unfortunately they're frequently not so great for the patient, because they either involve persistent pain, or they don't last very long, or they lead to other complications (all of which dental professionals are loathe to admit).

Anne (fatbuster205) comes to mind as someone who has been having persistent abdominal pain with her current flare, but her pain seems to be confined to the right side. And IMO, the narcotic pain meds that she has been taking are part of the problem, but she doesn't think so. Pain treatment isn't as well understood by the medical community as most of us have been led to believe.

IMO it's much easier for some of us to become dependent upon or even addicted to pain meds than is generally believed. After we use painkillers for a while, we tend to become accustomed to the effects of the dosage, and the effectiveness begins to decrease. It's possible that prior use may amplify the problem (but I'm just speculating with that statement, and I'm not aware of any research to support that contention). As we begin to develop a tolerance, the continued use of narcotic painkillers can lead to a rebound effect. IOW, the original source of pain may have resolved, but a narcotic painkiller will then mimic the experience of intensified pain. The pain feels worse, more medication is needed to overcome it, and there is a real risk of addiction. This of course is known as opioid-induced pain syndrome.

I doubt that this is what is actually happening in your case (or in Anne's situation), because in most confirmed cases, narcotic painkiller usage continues for a much longer period. But I'm not sure that we can rule it out. Here's why:

Narcotic bowel syndrome (NBS) is a subset of opioid bowel dysfunction that is characterized by chronic or frequently recurring abdominal pain that worsens with continued or escalating dosages of narcotics. This syndrome is under recognized and may be becoming more prevalent. This may be due in the United States to increases in using narcotics for chronic non-malignant painful disorders, and the development of maladaptive therapeutic interactions around its use. NBS can occur in patients with no prior gastrointestinal disorder who receive high dosages of narcotics after surgery or acute painful problems, among patients with functional GI disorders or other chronic gastrointestinal diseases who are managed by physicians unaware of the hyperalgesic effects of chronic opioids

The Narcotic Bowel Syndrome: Clinical Features, Pathophysiology and Management

If you can't feel any hard lumps when you (or your doctor) palpate your abdomen, that should rule out an impaction problem (which may have been the case initially). But unfortunately, if the simethicone doesn't help, I don't have any ideas for eliminating the pain.

I wonder if we might be more vulnerable to this risk than someone in the general population simply because we have MC. You might ask your doctor if she or he has ever heard of NBS. If so, they might be able to provide some insight to rule it out.

Tex

[fatbuster205]

Hi Brooke,
As Tex rightly says I too experience the type of pain you are describing - many sympathies! I do take the narcotic type painkillers but very sparingly so I am not convinced by Tex's thoughts that it has caused the pain in me. In my case, the pain always indicates flare ups and I first experienced it as a student when I was 21 - they thought appendicitis! However, I still get it and I never had any narcotic type painkillers until I was in my late 30s and then that was for menstrual problems.
Hope you heal soon!
Anne