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Pre-Surgery Diagnosis Needed?
Intestinal problems can be very complicated to diagnose. There are a wide variety of causes of bloating including motility disorders, hypothyroidism, narcotics use, small intestinal bacterial overgrowth, etc. In addition, hernias can cause symptoms of bloating, nausea, abdominal pain.
Typically, the bloating, pain and nausea are due to direct involvement of intestine with the hernia. In my practice, I have also regularly seen patients without intestinal involvement of their hernia (ie, hernia with fat content only) who have bloating, nausea and this resolved after the hernia repair. In analyzing these, it seems that the nausea and bloating are the body’s reaction to the pain from the hernia.
A CT is adequate for evaluation of the abdomen. MRI is more useful for the pelvis. CT with Valsalva (beardown) would be preferable. A careful review of the CT would show the umbilical belly button hernia and any Spigelian hernia. Spigelian hernias typically occur two finger breadths below the level of the belly button and on the edge of the rectus muscle (the abs or six-pack). It sounds like you are describing pain at the same area.
I do not know what studies have been done to evaluate your GI tract. From what you have posted, there is no major motility disorder of the colon, which would be the only reason to perform an ileostomy, and even then that is a drastic procedure and still does not address the colon motility, which remains in situ.
Umbilical hernias may present with pain at their periphery, usually a couple of finger-breadths to the side, but not lower in the abdomen. You may have a simple inguinal hernia. That is much more common than a Soigelian hernia. In such a case, a dynamic MRI pelvis would be helpful. Also, as I explained above, your symptoms may be associated with an inguinal hernia. I have seen it in my practice dozens of times.
Do you notice any bulging or protrusion in the area? Is any of your nausea, bloating, pain associated with activity? Intercourse? Menses? Sitting? Coughing?