Intestinal and stomach problems self diagnosis
Copyright 2011 by Morris Rosenthal All Rights Reserved
Diamond symbols linked to decision text.
I'm not a doctor, these are my observations
on troubleshooting my own digestive problems.
Digestive system gas and diarrhea, abdominal pain and bloating symptoms
Do you have constant cramping or pain? If constant means 24 hours a day, seven days a week, it bee some serious physical damage, and it's not even necessarily your digestive system. Spasms or pains that goes on for hours at a time could be though of as constant, but I have another section for occasional pain. Here's the background on the the problem that inspired me to start on this self diagnosis chart. Around a year ago, a week or so my usual "going downhill" symptoms were followed by an intestinal blockage and the worst abdominal pain I ever had in my life. I woke up around 4:00 AM with my stomach making noises so loud I couldn't believe it, and then realized I had a gas pain as well. By the time I was sitting on the toilet, the gas pain was so bad I couldn't move, didn't dare try to massage it out, which might have been the smart thing to do. And for a half an hour, it got worse and worse until I felt that my internal organs were being torn from their places and all I could do was try not to scream like in a horror movie star. Finally, the blockage moved, I had a bad bout of diarrhea, and limped back to bed. During the next week, I was in constant discomfort, if not always pain, with bloating, intestinal noise, cramps, and I'll admit to nerves as well. I couldn't eat except for standing, it was the only position where my stomach didn't feel pinched, and I went to sleep in my easy chair a couple nights because lying down was too uncomfortable. After a week I decided to try mind-over-matter, started running again, eating "normally", even drinking some Scotch at night. By the end of the week, I crashed so badly I barely avoided dragging myself to a hospital:-)
For the next two months, the bloating and cramps were continual, and so were all the noises that sounded like they were coming from the stomach or small intestine. Wet, juicy noises, not like gas at all, and loud enough that I wouldn't have wanted to be in a room with people when they went on for hours at stretch. I started with some ulcer like pain as well, but that cleared up in a week or so. The folded feeling, like my intestines were all swollen and no body position other than standing would relax them, was 24X7 throughout this time, and still comes back in a minor way during relapses today. Also, a stitch in my right side was always there when walking or standing in the same position for a few minutes, and that remains through today, though not as strongly. I suspect the stitch in my side is either an abdominal muscle tear, a torn tendon that hasn't healed, or scar tissue on an organ like the gall bladder. I started by going on a high fiber diet to try to ensure I wouldn't have another blockage, which had scared the hell out of me, but it could be that eating all of that insoluble fiber was irritating the intestine walls. I would also have gas for hours, just walking around farting continually. For two months there was very little change, other than the ulcer-like pains clearing up. I found I could only sleep curled up on my right side. If I moved to my back or left side, my intestines would immediately start making noise, and would keep it up for as long as I stayed there. It really sounded like a hydraulic system where a valve or seal had failed and the liquid was aerated and just shooting past the seal, so the same pumping would get done over and over again.
I forced myself to keep running through this period, limping was more like it, and I was once surprised to here a sound like a punctured tire deflating coming from my abdomen, through two T-shirts and two sweat jacket pullovers (temperature was in the teens), while I was still running! Never experienced anything like that before or since. Part of my winter loop took be in sight of the local hospital, and I swear I'd shake my fist at them (in my head) and say, "You haven't got me yet, you bastards." I kept changing my diet, making it more and more basic, eventually it was largely rice, potatoes, bread, chicken, eggs, canned vegetables, lots of prunes and raisins. I dropped pasta and tomato sauce, which had been the staple of my diet. And after two months, in early February, the constant cramps and bloating gradually cleared up, and I didn't feel sick for a few days. Then it came back, and went, and came back - you get the picture, but the new state of affairs was that I was sick around two days a week, and not bad the rest of the time, other than the intestinal noise and the stitch in the side while walking. I could still only go to sleep on my right side, but if I changed to my back in the middle of the night, sometimes it would be OK.
After four months plus, I still had the noise and the stitch in the side, but the two days a week of bloating and pains cleared up. I also realized at this time that I hadn't been hungry once since I got sick, so this became a sort of a goal, as in, when you get hungry again, you'll know you're better. A month with no real change went by, and then based on what I'd been reading, I decided to try the gluten free diet .After about a month of it, I woke up hungry a few times, and then one day found myself so hungry that I felt hungry even while I was eating. I don't know if this is because I have Celiac and it helped, or if it was because I wasn't eating enough, because I certainly lost weight during this time. When the noises and the stitch in the side still didn't clear up, I dropped the gluten free diet and it didn't seem to make a difference.
I was getting used to the intestinal noise by this point, and I had long since realized that the stitch in my side went away if my right hand was raised, like carrying something over my shoulder, or wearing a back pack to recycling and holding onto the shoulder strap. To me, that agreed with either an abdominal muscle problem or internal scar tissue, but I refused to give up the floor exercises and stretching I do for my back, or running with my routine of sit-ups before hand. So I don't think the stitch in the side is really related to the digestive problem, though it may have been caused by the swelling behind the original blockage, or I suppose, by a gall bladder problem. I haven't had the bad acidic diarrhea (really like battery acid - see Diarrhea, mad dash?) for a year now, which is the longest period without it in my adult life, so that just might mean the gall bladder was overactive.
I decided to try the gluten free diet again, and to be more careful about it, and this time I really felt better and the amount of intestinal gas and noise really seemed to be reduced, but then, maybe it was the Activa yogurt. I stuck to it for around two months, and decided I was fit to travel, and dropped the diet on arriving in Israel. After two weeks, I was going downhill again and got back on it, but I still have a lot of noise and gas, plus I've had trouble with needing to use the bathroom six or eight times a day, so it could just be that my previous time on the gluten free diet simply corresponded with the remission of another intestinal disease and a period of low stress. I do hate traveling, and was running around like crazy looking for an apartment as I got a little sick again.
Is it worse sitting or lying down? A torn abdominal muscle can hurt all the time, and healing is very slow, particularly if you don't stop working or exercising. It may be worse in some positions, as I've read are issues with the gall bladder and appendix. Neither the appendix or gall bladder seem to have super specific symptoms beyond pain, attacks can lead to pain radiating all over, but really bad pain around the belly button seems to be a common sign of an appendix problem. I actually had something that felt like the classic gall bladder attack last summer, pain in the right chest and under the right should blade at the same time like a tight band being screwed down - went on for over 24 hours, ibuprofen did nothing, I even ventured some Scotch that barely made a dent. But I'd been having pain in the right chest for a couple weeks after sessions of mixing plaster by hand, even hurt when I breathed for a few of those days, so I wrote it off to overuse of a muscle in an unaccustomed way.
The stomach gurgling or intestinal noise is worse lying on my back than any other time, it's almost automatic that if I lay on my back it will get noisy, and my left side isn't much better. Yet the noise isn't ever accompanied by pain or cramps, it almost seems to be a symptom of the muscles being too relaxed, failing to hold the liquefying food and gasses from backing up the wrong way. The job of the stomach is to break the food down with acid and churning, and while I've never read an explanation of why some people start to experience stomach noise, I suspect either the stomach has been stretched out and the muscles are too slack. The result is like squeezing a bag filled with solids, liquids and gas, you're going to get a lot of squirting and squishing sounds. If the bag was completely full (like a water balloon) it wouldn't make any noise.
Any problems that lead to overproduction of stomach acid or a weak seal between the stomach and the esophagus are going to lead to heartburn, especially if you lie down. Sitting can be worse as well as your abdomen often gets folded up if you don't sit straight. Many people mistake heartburn for a heart attack, it can be that painful. The other pains are usually gas pains or muscle cramps and spasms. If a pain moves around over a few hours or if it appears in different places each day, I assume that it's gas pains, and the pain is due to stoppages or blocks caused by food in the intestines that prevents the gas from exiting the natural way. Muscle, tendon or scar tissue pains aren't going to move around unless you are continually probing your abdomen to look for problems, in which case you might be causing muscle soreness yourself. I've got a little hard ridge over the belly button that hurts if I press it, but is fine otherwise. Maybe it was always there, who remembers?
The elephant in the room with all unexplained pain is, "Do I have cancer?" By coincidence, when I was getting constant pains in the abdomen over the course of two months, I read a novel in which one of the characters was an old man with stomach cancer, and the symptoms were eerily similar except for one thing. The character's pain was blinding, and getting worse all of the time. My stomach pains were never horrific, other than the first night with the intestinal blockage, no knives twisting in my guts or making me drop to my knees. If I had something like that going of for weeks, I would go somewhere and pay for an X-ray. Also, while I lost a few percent of my body weight during the first couple months and then a few more percent when I tried the gluten free diet, it wasn't the kind of weight loss you'd expect from something very serious. It was more in line with bad nutrient absorption since I was forcing myself to eat regular, and when I got sick of people asking why I was so thin, I was able to put some weight back on by eating lots of snacks.
Is it worse when fasting? I've been fasting at least once a year for 25 hours since I was a 12, thanks to Yom Kippur. I was a little nervous about fasting this past year, but it didn't go any different than any other year, just a minor headache by the afternoon due to not drinking any water. Ulcers are supposed to hate fasting, people with ulcers are usually advised to eat more frequently, but to take smaller meals. Some people with intestinal problems try to eat avery few hours, which means up to a half dozen small meals a day. I actually tried this for a while, found I had more trouble with bloating, a swollen feeling in both sides, and I also had some trouble with meal planning. I means, What are are you going to eat six times a day, even in small portions?
Some people who never fast assume that it does the body great damage, I tend to think that it's actually a vacation for the body, a break from the work of digesting food all the time. Once of the more radical things you might encounter if you go to a hospital with severe intestinal inflammation is they may decide to take your colon offline for a few days. If I understood what I read about it, they literally shut it down, assumedly with drugs and a feeding tube, since it's hard to imagine them actually doing surgery and then having to undo it three days later. Since I consider my general health to be good, if I was that desperate to give my colon a break, I'd try a partial fast for more than 24 hours, staying away from solid food but drinking water and maybe soup broth. People trying to have visions routinely fast for many days, and it doesn't seem to damage their bodies - their minds I can't comment on.
If the problem clears up entirely while fasting, that would point to it being a problem processing the food you eat, as opposed to ulcers, tears, or other damage. The reason the food processing is causing cramps and pains may be a disease, but it may also be your diet. Digestive problems can result eating things that cause a disease to manifest itself, like gluten for celiac, allergic reactions, and problems like eating dairy after becoming lactose intolerant. But you also have to consider that people are all different, and in your digestive system, certain foods and drinks may not play well together. The first thing to try is always dropping things like alcohol, coffee and strong tea, which in addition to being triggers for inflammation, are also diuretics. The easiest option to fasting, which will help you quickly identify whether some particular food is at fault, is to go on a rice fast or something similar. Some people swear by a brown rice fast, going for a week eating nothing but brown rice and drinking water, but I don't quite see the point since your digestive track will be clear of everything you've eaten in the past within a couple days. On the whole, I think the best approach is to limit your diet for a test period to simple foods you prepare yourself, rice, yams, potatoes, vegetables, maybe some Activa and plain chicken, and see if there's a big improvement. If so, you're probably on the right track and can slowly add back other foods, if not, it's more likely the underlying problem is disease or damage, and may require more time or medical intervention.
Do you have excessive burping and gas? Belching and flatulence, better known as burping and farting, are caused by gas produced from the breakdown of food, although swallowing a lot of air can also produce gas. If you salivate a lot, you''ll probably end up swallowing a lot of air with the saliva, and that can add to gas. Many of the foods that are recommended for IBD and IBS also cause flatulence, the only starch that doesn't casie flatulence is rice, though you can certainly swallow a lot of air eating rice if you rush. Since my digestive system went on permanent tilt a year ago, I often hit weeks at a time where I'm farting at an elevated rate, and every few days during those periods the flatulence is almost continuous for a period of several hours after eating. I haven't fooled around with taking any of the anti-gas products that they sell, in part because I live and work alone and am a guy so I really don't give hoot, and in part because I hate the idea of taking something that may suppress the symptoms and prevent me from potentially troubleshooting the underlying problem.
I'm sometimes reminded of the story about the old woman who goes to her doctor and says, "Doctor, I've had this terrible gas for weeks now. The only blessing is that it doesn't make any noise and it doesn't smell at all, so nobody else knows." The doctor says, "Take these pills and come back in a week." A week later, the old woman comes back and says, "Doctor, I don't know what was in those pills you gave me, but now my gas smells awful! It's a good thing it doesn't make any noise, so people can't tell it's me." The doctor shouts, "Great, the pills cleared up your stuffy nose. Now we'll see what we can do for your blocked ears." So far, it seems to me that when the body is producing incredible amounts of gas, it's mainly air and doesn't stink, but then again, I'm not sitting behind me:-)
One of the easiest gas and belching conditions to self diagnose is lactose intolerance. If you stop eat and drinking all dairy products and the symptoms clear up, it's pretty obvious. Whether you get an official diagnosis of lactate intolerance from a doctor or not, you may find as years go by that you can tolerate diary products now and again, as long as you keep the quantity and frequency low. And there are many products for lactose intolerance you can buy at the supermarket which seem to work for most people if you don't mind taking pills. Another eating trick that can reduce the amount of air you swallow is not drinking during the meal, to chase down food. The old myth about beans is true, they do generate a lot of gas, as do carbonated beverages and beer. If you eat a mediterranean diet, you'll find out that chick peas are actually beans, so humus does cause flatulence.
A lot of people try probiotics to control gas and improve digestion. On the other hand, some probiotics contain ingredients that may actually cause gas. I haven't made a study of the probiotics thing, some of the people who swear by them seem a little nutty. I had good luck with an expensive capsule sold by Walgreens (they cost like a buck a pop), meaning I was taking them during the best month I've had in the past year. Of course, I was also going back on the gluten free diet at the same time and some other things happened to be going right in life, so who knows. I took a bottle of a different type with me to Israel, accuflora, and I can't say it's worked for me, I suspect it may be causing gas. If you read the various forums on digestion, IBD and pro-biotics, you'll find some people describing it as a war between good bacteria and bad bacteria, where during the initial "battle" period, you may have increased trouble with gas as the good bacteria try to take over. I'm a somewhat skeptical of this argument, but I've only tried the two pro-biotics, and I'm naturally biased against any "solution" that involves taking something forever, even if it's just a supplement.
Can you see blood in toilet? Major bowel movements may cause minor bleeding. It's not something I've had too often, but if you are badly constipated or have an intestinal blockage that finally yields to a build-up of gas, stomach kneading and vigorous muscle contractions, it's not that surprising that there can be some minor intestinal or rectal bleeding, even showing up on the toilet paper as bright red blood, that may be gone the next time you use the bathroom or within a day. The farther the bleeding is from the rectum, all the way back to the small intestines or the stomach, the less it's going to look like red blood. Bleeding from stomach ulcers may cause black, tar like stools, and digested blood can also stink to high heavens. Long term bleeding is one of the symptoms of colon cancer, something you don't want to ignore for years if you are getting older.
Around fifteen years ago, I had my first serious intestinal problem, which started with sharp pain in my side for a couple weeks that felt like a has swallowed a bone eating street food. At a later date, and I don't remember whether or not I was constipated as well, I had a horiffically painful bowel movement and the bowl was full of blood. What was even scarier is that the bleeding continued at a good clip, I remember going to the bathroom again a few hours later and finding my underwear full of blood, it had seeped out without my knowing or being able to stop it. I was freaked out enough to basically stop eating solid food (I was traveling overseas at the time), and moved up my return plane ticket so I only had to wait around a week. The bad bleeding stopped, but there was blood on the toilet paper the few times I used the bathroom for the next ten days, and there was a paralyzing pain, the absolute worse in my life, about a half hour before I needed to use the bathroom each time.
When I got back to the US, I went to a doc-in-the-box, a walk in place where you pay a $100 and get to see a doctor - probably more expensive today. He gave me a digital examination, ie, a finger in a rubber glove, and said he didn't find what he expected. I realized later that he expected an anal fissure, and he advised me to go for an endoscopy to find out what was wrong. I didn't like the idea of paying somebody to run a camera up my behind, and I was feeling a little less panicky by this point so I decided to give it time. He did give me one good tip I wouldn't have thought of, which was to get some stool softening stuff, even gave me some free packets of metamucil, which is basically ground up psyllium seeds, which are super high in fiber. I had dropped a good 10 pounds from the partial fast by then, and I'm a lightweight to start with, so I took psyllium with each meal and started eating moderately three times a day. There wan't any blood on the toilet paper by this point, but that pain, like sitting on a knitting needle and having it go all the way in, persisted. If I was standing and talking to somebody when the pain hit (it was always about a half hour before I needed to use the bathroom), my face would turn white, I'd be unable to breath, I would have sworn my heart would stop for 30 seconds. If you've ever had a large scab from a deep wound, and accidentally poked something into it, this felt sort of like that, except ten times worse and drawn out. But after another week, it seemed a little less, another week a little less, and by the end of six weeks, it was gone. It's now my reference point for everything else, even when I had pains and bloating for two months straight, I could tell myself it wasn't as bad at that time:-)
Does your digestive track make loud liquid noises? I think the general view is that intestinal noises are all cause by gas, but it seems to me that most of the noises I get are liquid noises, more like sloshing, liquid getting sprayed into a bag, get squished around and bubbled up. I supposed there has to be gas present to expand the stomach or intestines to the point the the liquid can make noise, the body isn't operating in a vacuum, but it's all new the past year. I don't remember every hearing a sound from my stomach or intestines before unless it was a gurgle after a day of fasting or getting sick with the flu. Now, noise from my stomach an intestines is the norm, I get it every day and night, and during some bad periods, it would be continuous for many hours at a time. The real loud noises I can even here while walking, and once while running.
Since I have some small experience with hydraulic systems and vacuum systems from cars and engineering, I tend to think of the digestive system in terms of valves and seals. I've looked up what the digestive system has for valves, the major ones seem to be at the outlet of the stomach between the stomach and small intestine (pylorus valve) and between the small intestine and the large intestines (ileocecal valve). I think that these muscle valves are properly called sphincters, and there another one at the outlet of the large intestine, but I'm not trying to write a medical text here. The point of these valves is to keep the partially digested food flowing in the right direction.
During the first two months I was sick, my best guess was that the intestinal blockage and subsequent half hour of tearing gas expansion had damaged a valve, and that my digestive system is now subject to backflow. This agrees with my stomach being quiet when I lay on my right side, but noisy on my back or left side, as the weight of the the internal organs in the abdominal cavity may be doing some of the work a damaged valve should be doing, simply blocking back flow through gravity. The fact that I've generally improved over time, despite not fully recovering, suggests that their may be a slow healing process going on. If a valve muscle was torn or simply stretched all out of shape, I could imagine it taking a long time to recover, especially with the digestive system being constantly swollen and out of whack due to the malfunction.
I suspect it would be possible to troubleshoot liquid noises and motion with audio equipment, a home version of ultrasound. Sometimes I can hear (and perhaps feel with very limited sensitivity) liquid slurry that seems to be moving back and forth in the same path if I lay on my back. I suppose it could all just be in the stomach, where a lot of mechanical action (kneading and breaking of the food) is supposed to take place, but I have the feeling it's actually in the small intestine, or flowing back and forth between the stomach and the small intestine through a damaged pylorus valve.
Have you otherwise experienced poor healing or bad health? The main symptom that make me consider disease as opposed to simply physical damage to the digestive tract is that I have had trouble healing for years. Maybe it's just age, but simple muscle strains and pulls that might have been sore for a week in my 20's or 30's now take many months, in some cases, over a year to heal. I bought myself a couple blood tests for inflammation factors over the Internet (had to walk into their local clinic to get the blood drawn), which came back negative, so I suppose I don't have rheumatoid arthritis. The other thing that turns up for muscles injuries that don't heal well is vitamin deficiency. Whatever my diets over the years, I've never eaten badly enough to have vitamin deficiency, so that makes me think about Celiac or other diseases of the small intestine that prevent the absorption of nutrients and vitamins. A decent diet and decent working of the small intestine to make use of the food is necessary for all types of healing, so slow healing can be a sign of intestinal problems.
There's also the question of general health. I rarely get sick, with the exception of the past year and some previous trouble with stress and nerves, so it's pretty obvious to me when something is wrong. If all I want to do is sit in a chair and stare at the wall all day, I know I'm sick. No energy, lots of extra dizzy spells, even cognitive impairment. But for all the problems of the last year, they didn't keep me from sleeping the way anxiety does, and sleep deprivation can quickly lead cognitive break-down. And part of my being able to sleep well is that I continued with running five or six miles three times a week, even if it was more of a limping jog at times than a run. Running through the winter on ice with bloating and pains also means that I could easily have pulled or torn an abdominal muscle slipping on ice or going through snow and not even noticed at the time. So the stitch in my side that won't clear up may be an injury completely unrelated to digestion that I incurred at that time. I can say that during my second stint on the Celiac gluten free diet for a couple months, I felt pretty healthy, even better than what I would call my norm, but after a break for the diet of just two weeks and over a month back on it, I haven't gotten back to that place.
Do you experience hard or frequent stools? Choosing between constipation and diarrhea is not my idea of fun, yet many of the intestinal diseases and conditions lead to alternating periods of constipation and diarrhea. What seems to be less reported is frequent defecation, often combined with passing mucus, or going to the bathroom with the feeling that you will have a bowel movement and only producing gas or mucus. I don't remember suffering from constipation in the last couple decades, but I do get the occasional intestinal blockages, which are extremely painful due to the trapped gas expanding with nowhere to go.
I used to associate needing to go to the bathroom eight or ten times a day with nerves, but I'm finally figuring out that while stress may trigger frequent stools or make the condition worse, there's some other underlying cause. I don't think it's diet, since I get very careful during times the times I feel I'm living in the bathroom. And it seems to come and go, like most of the intestinal problems associated with the colon. Since there's no pain involved, and the need to go so often often coincides with passing clear gel, which I assume is the mucus lining of the intestines, I'd guess that either the mucus is being overproduced and leading to a slippery digestive tract, or some type of inflammation is keeping the mucus from coating the intestine walls. At least for me, there no pain involved in going to the bathroom so often, unless it's the occasional abrasion from wiping with toilet paper so frequently, but the nearly constant need for a bathroom makes it very uncomfortable to be away from the home for any amount of time.
Are you a good fiber eater? Maybe some kids get detailed explanations or frequent jokes about fiber from their parents, I don't remember being aware of the role of fiber in the diet until I was nearly thirty years old. If you don't get enough fiber, you're going to have nasty bowel movements, whether hard or loose, and inconsistent as well. If you eat enough fiber with every meal, you should end up with lager, softer stools, and much more regular digestion. There are fiber supplements, like metamucil, and while they work, I prefer the old fashioned method of eating prunes and raisins. There are plenty of foods with good soluble fiber, which is easier on the intestine walls than the insoluble fiber, but you have to be careful if you've gone on a limited diet for troubleshooting. For example, brown rice has a reasonable amount of fiber, white rice has very little. Fruits and vegetables are good in general, breads are also good, but breads are out if you have Celiac and various whole grain breads, while loaded with fiber, can be hard on inflamed intestines.
If you know enough about the foods you eat to be sure you are getting enough fiber, and you're still having hard stools, constipation, or intestinal blockages, it could still be a non-fiber dietary issue. For example, alcohol is a diuretic, like coffee and some teas, and diuretics cause you to urinate more. That means less water content in the slurry of digested food that reaches the large intestine, whose main job is to scavenge water from waste before it leaves the body. At the risk of oversimplifying, wet turd equals soft, dry turd equals hard. If you are drinking or taking diuretics, your stools may get harder until you stop. Drinking more water should help, though you may just urinate it out if you continue with the diuretics.
Do you experience occasional pain? I assume everybody gets occasional pains in the digestive tract. I don't get excited about any pain that moves around, it's when pain or discomfort occurs in the same place month after month that I start wondering whether there's some underlying cause. I think it's also important to know your body well enough to be able to distinguish between different sorts of pains. Gas pains can be very intense, for example, but the feel very different from muscle cramps. People do go to hospitals with gas pains and the like, and they may be thrilled to get the "good news", especially if they don't pay the bill directly. A very consistent pain, like the one I experienced for around a month and a half some fifteen years ago, always about a half hour before a bowel movement, explains itself. There was something wrong in the large intestine, a tear, a growth, scar tissue, that stopped me from breathing when a stool scraped past. But it did scrape past, and the pain was very consistent for the first couple weeks, before it began to gradually weaken. I guess my main approach to occasional pains is that as long as they aren't getting worse, they're probably getting better.
The way I've learned about my body over the years is by giving each problem time to get better on its own. It's easy to confuse simple muscle pain for other problems, especially if you break an exercise routine for the sake of determining whether the exercise is making it worse. I dropped running for a month while traveling, along with the fifty crunches I would always do before to get my abdominal muscles in balance, and when I started up again, not surprisingly, if felt like I'd been beaten on the stomach for a few days. Food poisoning and poorly cooked food can also cause tremendous intestinal pain. I made the mistake once of eating some undercooked bread, it was actually wet in the center, and ended up in severe abdominal pain for a couple hours afterwards, almost as bad as an intestinal blockage. I assume there were some yeast still alive in the the uncooked bread, and they had a party it in my guts.
Have you had vomiting and are you losing weight? If I vomited up everything I ate for several days in a row without knowing why, I would probably go to a hospital. The "knowing why" caveat is that many years ago, when I was frequently knocked down by anxiety and stress, I did throw-up everything I ate for days at a time. Fortunately, I wasn't vomiting blood, though I did have a friend years ago with ulcers who would cough up blood on a regular basis and didn't think anything of it. He didn't quit boozing either, so I wouldn't give him too much credit for knowing his body. Of course, since my first reaction to throwing up is usually to fast until I feel better, continual vomiting for days isn't very likely.
Losing weight is a much trickier issue. One obvious reason for losing weight is losing your appetite. I found that out this past year when I simply stopped getting hungry, and even on a regular eating schedule with what seemed to be regular meals, I lost weight. I've heard that this is one of the benefits of medical marijuana for people in cancer treatment or with other diseases that make them disdain food,smoking pot gives them the munchies. I can't tolerate the stuff myself, so when I realized I hadn't been hungry for months and was losing weight, I started adding things like ice cream and candy bars to my diet, stuff I never eat. I also started taking one of the over-the-counter lactose intolerance pills before eating ice cream, since the stuff always gave me gas, and it seemed to do the trick.
But weight loss could also be a sign of a serious underlying condition, like the small intestine not absorbing nutrients, or cancer. I'd recommend searching out your symptoms online and reading as much as you can stand. The trick is to take the tidbits you learn from here and there, and to incorporate those terms into you searches as follow up. You'll often find the equivalent of a second opinion, where in addition to the symptoms you though matched your condition pretty closely, you find that their are negative indications, factors that basically exclude the diagnosis from applying to your condition. It's almost funny reading through the well known medical sites, where their self diagnostic paths always end in "See your doctor immediately" or even "Go to the emergency room." If I took them seriously, I'd have gone to the emergency room a half dozen times in the past year, as opposed to not once in my life.