Discussions By Condition: I cannot get a diagnosis.

abdominal pain - underlying diagnosis?

Posted In: I cannot get a diagnosis. 8 Replies
  • Posted By: anon_bos
  • October 3, 2007
  • 04:02 AM

:mad: I am so frustrated!

Here's background -
I am a 42-year old woman, 5 feet tall and 125 pounds. A little over a year ago, I was diagnosed with a hiatal hernia and gastroesophogeal reflux disease (GERD) after a weekend of abdominal pain followed by severe reflux the following Monday. (I also happened to have been diagnosed with an ovarian cyst at the same time, but am not sure it was related. The cyst resolved on its own.) I currently take Protonix for the GERD. I guess it helps but I still get belching attacks and pressure in my upper back at night, which leave me exhausted with a sore throat and hoarse voice the next day.

:( More recently I have been having chronic abdominal pressure and pain in my lower right side, accompanied by frequent constipation. When I do go, I have narrow stools, incomplete evacuation, and sometimes mucous. The belching is worse when I am constipated too. The abdominal pain is constant but worsens after sexual intercourse. Having a bowel movement does not relieve the abdominal pain. To complicate matters, I appear to be starting perimenopause; my periods come at 5-6 weeks rather than the 28-30 days. As expected, the abdominal pain/pressure worsens premenstrually but is not totally relieved with the onset of my period.


I have been following the direction of my primary care doctor and a gastroenterologist to avoid acidic foods, try a lactose-free diet, and reduce fat intake, but the symptoms are still occurring. A pelvic ultrasound showed no abnormalities in my uterus or ovaries, and an abdominal ultrasound was completely normal. Bloodwork for liver and kidney function was fine too. My primary care office thinks that I might have IBS, but I am concerned that I have a mass or obstruction, or something going on in my lower GI tract that is related to the upper GI symptoms.

:confused: What should be the next step to take to get a diagnosis? I have a follow-up appointment with my gastroenterologist in a couple of weeks.

Appreciate any suggestions - and that you read this far in the first place!

:)

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8 Replies:

  • I had a slow attack of appendicitis (at least a month) with some of the symptoms you are having. Get some blood work and a CT of the abdomen/pelvis. Also have your gyn draw some hormone levels, and if you want to start Hormone Replacement Therapy, then peri-menopause should be your starting point. Also a barium enema and a colonoscopy if you are worried about a mass.
    rad-skw 1605 Replies
    • October 4, 2007
    • 11:02 AM
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  • Thanks for the reply. :) Lower abdominal pain is still present. It appears it could be a number of different things, from benign to more serious, so I am actively pursuing a diagnosis and will go to the ER if I have a fever or vomiting. At the advice of my gastroenterologist, I am following up with an Ob/Gyn appointment to determine whether there is something that the pelvic U/S didn't pick up. My gastroenterologist will schedule a colonoscopy after that. Whew! It is difficult an advocate for myself - I go from thinking I am imagining things to being angry at the system for being so fragmented.
    anon_bos 1 Replies
    • October 5, 2007
    • 04:00 PM
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  • i went thru a ton of GI tests.. every last one came up short - negative/normal. several stool samples for h.pylori, c.diff and others. Drs told me it was anxiety and all in my head!ask your GI Dr about Babesia/Babeosis and see what he/she says. meanwhile, do your own research on it just in case they blow off the subject. see if it fits your lifestyle, where you live, and where you've been.wishing you well.. good luck!--sonicbmxps - do a search and read my posts.
    sonicbmx 44 Replies
    • October 6, 2007
    • 02:53 PM
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  • Protonix has quite a few bad side effects, including abdominal and stomach pain, constipation, blood in stool and sore/dry throat...please look this up on www.drugs.com. I agree a follow up with your obgyn is important. Could be endometriosis. This is hard to diagnose. Your symptoms point to this as a possibility, and the change in your cycle is important. Docs seem to love diagnosing people with GERD...interesting how that will occur when a new drug comes out. I personally don't think this is a correct diagnosis, and even if it was, the meds aren't getting to the CAUSE of this problem. Please consider trying acupuncture or NAET (Nambudripad Allergy Elimination Techniques) to help resolve your symptoms. If you find your obgyn is thinking endo, acupuncture is VERY helpful for treating this problem. To help with your bowel problems I suggest getting a good quality PROBIOTIC with several strains of bacteria to improve your intestinal flora. Best wishesDOM
    acuann 3080 Replies
    • October 6, 2007
    • 05:28 PM
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  • Never go along with a doctor's diagnosis if you are not comfortable with it. This is your health, not theirs. I have GERD and have been taking Prevacid and it is great. I think you're not responding well to your med and should discuss trying something new for a while to see if it helps. I have a friend who has IBS, it is not pleasant. Almost all food goes straight through, no solid stool, always diarrhea, lots of abdominal pain. Think you should get a second opinion from someone who will look at all aspects of your issues.Good luck!Bobbi
    Anonymous 42789 Replies
    • October 9, 2007
    • 04:16 AM
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  • I have had a lot of undiagnosed symptoms that are somewhat similar to your, but not exact, Look into chronic pacretitis. It is alon g the same lines of endometreosis, as it is very difficult to diagnose, I am finally going to see a specialist about this, as my primary is convinced that this is whats going on, after three years of pain. good luck
    Anonymous 42789 Replies
    • October 9, 2007
    • 08:00 AM
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  • Lower right abdominal pain, mucous in stool and diarreah are all very common with IBD (Most likely Crohns), and it is often misdiagnosed because of the location of the pain. You can use this simple test to see if the pain is caused by your intestines. Put pressure on the area that hurts... If your pain is worse when you relieve the pressure then it's the colon. You are smart to have that colonscopy. Hope this helps...
    Anonymous 42789 Replies
    • October 9, 2007
    • 10:11 PM
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  • Drinking more fluids can help sometimes with horseness if you are possibly dehydrated. It could also help with the constipation. Are you on any narcotic meds for pain? If so they can also can cause constipation and mouth dryness (and throat dryness).I had problems with Protnix myself. It does have more side effects than some others out there; but don't stop it without consulting the dr as to perhaps trying something else or not.The pressure in your back... that should be checked out. Have you told your dr? I am guessing yes. It could mean a few things; from bloating from gas and edema to problems in your upper GI (including GERD). Or even heart disease.Yes get the gyne problems checked out . And yes, colonoscopy is also good idea ( colonoscopys can reveal many problems and rule out many other GI problems. The colonoscopy can also give you peace of mind and perhaps save your life if they find a polyp and remove it before it becomes cancerous).The abdom./pelvic cat scans can also be helpful. Hang in there; it sometimes a frustrating process going through the work of finding out what ails you. Abdominal problems can be hard to diagnose no matter how good a dr is. **But it does help to have a great dr Good luck.
    Anonymous 42789 Replies
    • October 11, 2007
    • 01:02 AM
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