Doc: There seems to be no hip pain, indigestion link

Keith Roach
To Your Health
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Dear Dr. Roach: Can indigestion (possibly due to gas) cause hip pain or sciatica? I always experience these two conditions simultaneously. I get relief by belching, walking and, when all else fails, milk of magnesia. I suspect that the gas is exerting pressure on the sciatic nerve and thereby causing the hip pain. Is there any medical history to support this suspicion? Or is there another explanation? Thank you.


Dear E.J.: I don’t see a direct connection between intestinal distention and nerve pain in the back or hip. The sciatic nerve — which is a very large structure, nearly the size of your little finger — travels through the sciatic foramen in the hip bone. It can be compressed by structures in the hip and back, such as a herniated disc or the piriformis muscle. The contents of the abdomen are far above the sciatic nerve. People with sciatic nerve pain more typically feel pain radiating down the back of the leg into the foot.

The best I can come up with is that, often, people with abdominal distention change their body position, sometimes bending over to relieve the pressure, and this might cause the sciatic nerve, or a different nerve going to the hip, to be pressed on.

Dear Dr. Roach: Would you give me information on blocked bowel movements? I had a colonoscopy two years ago, and they said they couldn’t complete the procedure because of bowel blockage. I’m 86 and don’t want a colostomy.


Dear H.I.: A bowel blockage or obstruction can be partial or complete. There are numerous causes of bowel obstructions. Cancer is the first one I think of, as it’s the worst case, but others include a volvulus (twisting of the bowel on its axis) and intussusception (folding in on itself like a sock).

Symptoms of a bowel obstruction include pain and abdominal fullness, and, paradoxically, can include diarrhea. This is because the part of the bowel beyond the level of obstruction can secrete fluid and mucus, confusing the fact that there is an obstruction. A complete bowel obstruction is a surgical emergency, and there is a surgical maxim that “the sun never sets on a bowel obstruction” — i.e., immediate surgery is life-saving. Clearly, you didn’t have that, and I am convinced that there was a miscommunication at the time of your colonoscopy two years ago. If they were concerned about a serious or worsening obstruction, they would have recommended additional tests or procedures, such as a CT scan or evaluation by a surgeon.

It’s hard for me to guess what it is they meant. I wonder if the preparation they gave you for the colonoscopy wasn’t adequate to clean the bowel completely, and they had a hard time getting to the whole colon. I spoke with a gastroenterologist, Dr. Doug Weine, and he thought that you might have a stricture (narrowing in the colon) due to diverticular disease or tortuous, redundant colon (excess bends and a longer-than-average length).

In any event, two years is too long to wait and worry about your colon health. Get back to the doctor who did the colonoscopy, and get a complete exam done.

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