Discussions By Condition: I cannot get a diagnosis.

Can't get a diagnosis

Posted In: I cannot get a diagnosis. 36 Replies
  • Posted By: mdlewis
  • March 25, 2007
  • 07:52 AM

I have had upper right sided abdominal and flank pain on and off for about 3 years. It's been intermittent, intolerable at times, and tolerable at other times. I've had both my appendix and gall bladder removed (3 years ago), but that did not take care of the problem like the doctors thought. In the past 8 months, This pain has come back in episodes. I saw a naturopath who told me I had a broken rib. No x-rays, so unsure. The pain went away for about a month, then last October the pain came back right up under my bottom ribs on the right side and into my back. I thought it could be a kidney stone, I've had those before. Went to the ER in severe pain, (doubled over, passed out) and had a CT scan. The docs found an ovarian cyst about 6 cm on my right ovary. We treated that with BCP and it shrank. I was again fine for awhile, and then the pain would come and go intermittently, not too bad. Two weeks ago, I woke up with a very high fever and intense pain once again in the same place. I've now been to the ER 3 times in 2 weeks, because they said to come back if things get worse or different, and my own doctor can't get me in until next week. On my first ER visit, CT scan no contrast showed my intestines filled with stool. I hadn't been constipated, but the doctor told me I was very constipated and gave me some Glycolax. I took that for four days, and nothing was moving. (I actually became constipated after that first ER visit because of the pain killers they gave me in the ER). Four days later I started vomiting bile type substance and went back to the ER. This time, I had an abdominal x-ray, and more blood tests. X-ray showed nothing and blood tests were normal except for a "borderline" Lipase level. So now, maybe they are thinking I have a bowel obstruction or a biliary obstruction or bilary stones. I'm sent home, only to go back 2 days later in so much pain, I couldn't walk upright. I wanted to stay home and wait it out, but my doctor insisted I go to ER. I had a CT scan with contrast this time which showed nothing. The doctors are baffled and have referred me to a GI doctor, but they can't see me for another 3 weeks. There is only a couple in my area. Has anyone had any thing similar to this happen? Any ideas on what's wrong with me? I can't really tolerate narcotics, so I'm taking Aleve and using heating pads and ice packs. Any advice would help.

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36 Replies:

  • probably SOD
    Anonymous 42789 Replies Flag this Response
  • Your symptoms remind me of what my mother went through, who had not been diagnosed until the toxins in her body were dangerously high. She had failing kidneys. When you say threw up bio, back ache, and abdominal pain, it describes her to a tee. Her blood pressure went up and at times, all blood pressure medications did not work because this was not the underlying problem. The toxins put a strain on her heart, raising her blood pressure, and eventually made her sleep most of the time. Swelling of her legs, feet, and ankles also developed to the point where they started to tear from the inside out. Doctor at the time failed to check her for kidney disease. Could this possibly be more then one cause to your symptoms? I had my gall bladder removed about 5 years ago. Right afterwords I felt better but the IBS worsened. Each time I ate fried greasy foods or fast food, it was horrible and sudden reactions. I still have these symptoms and will most like continue. As far as the pain under rib. Is this the gall bladder area? I developed pains and went to doctor thinking it was my liver, since the gall bladder is or was attached to the liver. I developed scare tissue and this was causing the discomfort for a few years. I still have pain when I bend a particular why like reaching for something.You digestive system and stomach will be more sensitive after gall bladder removal because it was an aid in digesting your food.Taking laxatives will and can do more harm then good. I would go on a liquid diet for a while (week if necessary) until you are able to get back to almost normal, then daily add fiber drinks or pills to your diet but not before cause it will cause severe cramping and may do damage to your intestinal tract.Good luck!
    EthansGrandmother 1 Replies Flag this Response
  • What is SOD?
    mdlewis 13 Replies Flag this Response
  • Is there any connection with the pain to your periods?
    Anonymous 42789 Replies Flag this Response
  • Hi thereThere is alot more information that is needed to have some idea of what is happening.Firstly the nature of the pain. You state it is on the right side. Is it closer to the rib cage or closer to the pelvis. Is it a crampy pain that makes you want to curl up your legs or is it a sharp pain, like a knife.Does it radiate anywhere, like to your legs, your chest, the other side of your abdomen or to your back. How often do you get the pain, every day, every week, every month every year. Is there anything else associated with the pain that you can think of.Is it related to your menstrual cycle at all (just before the period, inbetween two periods)Secondly, regarding the vomiting, what is the exact colour of the vomit. Is it related to the pain that you are experiencing. Have you had this type of vomiting before. Have you ever had symptoms of dyspepsia/reflux/hearburn.Are you intolerant to any types of medication. Did the doctors in the ER see your vomit.Besides the lipase test, do you know which other tests the doctors in the ER did. When you did the CT with contrast, did you eat the contrast or was it injected into you. Do you know the names and results of any of the other tests that you were given. Finally do you suffer from any other medical condition besides the ones you already mentioned. Do you take any other medication. If so what are their names. Have you ever used an antispasmodic. So you consume alcohol do you smoke. Do you have any children. Are you still having regular periods. Have you ruled out pregnancy.The answers to these questions my give a clue as to what the cause of your symptoms areWith Peace
    Anonymous 42789 Replies Flag this Response
  • Not that I know of, however, in the last few months, my cycle has changed it went from 28 days for the longest time, to 24 days two months in a row, then I had a 30 day cycle Jan-Feb, and now I'm back to 28 days this month. I'm not sure if that has anything to do with it or not
    mdlewis 13 Replies Flag this Response
  • Does the pain come at a specific time point in the cycle.Could you provide detailed answers to the detailed questions posed to you in one of the threads above. It would help in trying to figure out what the diagnosis is.
    Anonymous 42789 Replies Flag this Response
  • More details on my symptoms. The pain is usually under my ribs on the right side, and radiates to my back, and sometimes down toward the lower right side of the abdomen. I just had my period and the pain was gone, however my period ended and the pain is back only not as severe. I would describe the pain as sharp stabbing pains. As for the vomiting, I had bright neon green acidy vomit that has stopped. I had some episodes of heart burn, but the doctor in the ER thought that was from the pain medication I was given (Dilaudid). All of my blood tests were normal except my Lipase test which was "borderline". I had a CT scan with no contrast and 5 days later had a CT scan with contrast which I drank, and also had it injected. The results were negative for anything. I smoke about 1/2 pack a day, drink maybe once every few months socially. I take Welbutrin 150 mg once a day for a month. Looking back, I've been dealing with this problem sporadically for about 3 years. I've lost my gall bladder and appendix because that was what the doctors thought the cause was. I'm not pregnant (tubal ligation). Thanks for the replies, I hope this info helps.
    mdlewis 13 Replies Flag this Response
  • Thank you for the greater detail. It gives some direction as to what could be going on.The differential that I can think of is Firstly: Recurrence of Ovarian Cyst.The relation of the symptoms to your period suggest that it is occuring at the middle of your menstrual cycle, when you are ovulating. This is a very common condition (my wife had it too) and can be extremely painful. The pain occuring in the right upper part of your abdomen could be explained by the fact that the ovary and testes migrates from that region whilst we are still in our mother's wombs. Pain in the ovary can therefore be referred to that part of the abdomin. Sometimes the pain can be so severe that it in itself causes vomiting. I suggest you see a family physician/general practitioner. See wether he/she agrees with the above and then go for further gynaecologic consultation. Secondly: You may also have gastritis (inflammation of the stomach lining) but this may be an entirely unrelated condition. It does not sound like you have a stomache ulcer at this stage. The gastritis is most likely due to the fact that you smoke and the fact that you are using a type of drug (Aleve) that falls into the category of what is known as a non-steroidal anti-inflammatory drug (NSAID). This may be contributing to the heartburn that you are experiencing. For this I suggest you cut down (or preferably stop) smoking altogether. Avoid Aleve and any other NSAID if possible and using it only if a doctor who is aware of you condition prescribes it. NSAID's should be used cautiously in those people with sensitive stomachs. Also avoid coffee, spicy foods and try to manage your stress better.Thirdly, if you are a smoking, I am assuming that you also have a very stressful life. Stress in itself can cause one to get severe crampy like pain in the form of Irratable Bowel Syndrome and Spastic Colon. I highly recommend that you find yourself a good general practitioner/family physician who can guide you as to which specialist to see and when. This will save you alot of money and anxiety and stress in the long run. This family physician should prioritise which are the most important problems and which to investigate further by referring you where necessary. Many problems including the pain from an ovarian cyst can often be very effectively managed by a family physician. Also the family physician would be tuned in for warning signs that may warrent more urgent referral. Also stick to one physician and dont shop around since it is much better to build a relationship with one than to see a new one who has to start a differential diagnosis and treatment from scratch. Speak to the family physician about your problems and the need to see a GIT specialist first, or whether perhaps you shouldnt be seeing a gynaecologist first. ( He/she might possibly give you medication that does not make it necessary to see either and makes your problem go away altogether.)Print out this entire thread and take it with you or email it to any doctor that you will be seeing next. It will help them quite a bit.Good luck with getting better. Please post back what the outcome is - whether or not you do get better.
    Anonymous 42789 Replies Flag this Response
  • Thank you so much for the advice. I actually am seeing my PCP tomorrow. Regarding the recurring cysts, I went to the gyno yesterday and had an ultrasound of my ovaries, focusing mainly on the right where I had the cyst before. The cyst is still very small, about 1 cm, so she does not think it is related to this problem. I printed out your advice and will take it to my PCP visit tomorrow. Thanks again.
    mdlewis 13 Replies Flag this Response
  • Hi thereDid you get resolution on the diagnosis. Are you starting to feel betterWith Peace
    Anonymous 42789 Replies Flag this Response
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  • Well, I had some relief for a couple of weeks, but yesterday the pain came back suddenly, only lower, and I also had pain in my bottom. It hurt to sit down normally. its not a hemmorhoid though. My husband made me go back to ER, but they just gave me a shot of morphine and took some blood. The tests came back normal so they sent me on my way back home. Today I called my PCP to try to get in, and find out about the results of the stool sample he took, but it is now 7:30 pm, and he never called me back. I'm feeling very frustrated.
    mdlewis 13 Replies Flag this Response
  • Read this post carefully and answer every question: Besides the location, Is this pain the same as before or is it different. Also you say that it is lower than before - how much lower - is it on the same side or not.Also if you dont mind answering the following question for this pain episode as what was asked to you previously:" the nature of the pain. Is it closer to the rib cage or closer to the pelvis. Is it a crampy pain that makes you want to curl up your legs or is it a sharp pain, like a knife.Does it radiate anywhere, like to your legs, your chest, the other side of your abdomen or to your back. Did the pain go completely away in the past few weeks. Is there anything else associated with the pain that you can think of.Where in your menstrual cycle are you/were you when the pain came back. Did you start your period, finish your period. Are you mid cycle.What did the PCP think the problem was. (It sounds as though, if he did take a stool sample, that he was thinking that this could be somehow related to the Gasto-intestinal tract - although I may be wrong)When you went to the ER, did they do tests again or not. Specifically, did they do a dipstix test on your urine, looking for blood, white blood cells, protein and glucose. Do you experience any unusual symptoms when you urinate. Finally what are you taking for pain relief. Is morphine the only thing that kills the pain. Are you using anything else.Answering the above questions should once again help us to get closer to the diagnosis. I am hopeful that a solution will be foundDont lose hope this is a just test from God. Just have faith in Him and I am sure you will get better. A better diagnosis will just facilitate the process and I think we are very close to getting there. With Peace
    Anonymous 42789 Replies Flag this Response
  • Thanks for your reply. As you know, I am feeling very frustrated. To answer your questions, the pain is on the right side still, and now it is both under my rib cage, into my back, and down where my appendix used to be. It is very sharp at times and I bend over to get some relief. Right now, I am in the middle of my menstrual cycle. My PCP is sending me to a GI doctor, but not sure when. He thinks I have Crohn's, or Ulcervative colitis. Both my mom and Grandma had UC, and my cousin has Crohn's. I don't really have any bloody stools, the other day I had some black ones though. Last week I was sent to the ER again in terrible pain. That was when the pain struck in my lower right abdomen suddenly and was very intense. I also had pain in my rectal area it felt like I needed to pass gas, but I could'nt and it burned. The ER is sick of me by now, so they just took my urine (which was fine), and blood tests were all normal. They gave me a shot of morphine and sent me home. I cant tolerate most narcotics very well. They either make me throw up, even with anti-nausea drugs, or they make my heart go into palpitations and keep me awake and hyper for days. I have taken a couple of Darvocet,. but they don't help. I'm also still taking the Bentyl, but that doesn't help either. I'm just starting to get used to the discomfort. I'm having another bout of pain right now, and its usually worse after I eat anything. I don't have a gallbladder, but it feels the same as when I was having gall bladder attacks. My doctor wants me to go to the ER when I'm in this much pain, but I'm now refusing to go because they are pretty sick of me. They won't run any other tests, and Just want to fill me up full of drugs. It dulls the pain for awhile, but as soon as it wears off, I'm in bad shape again.
    mdlewis 13 Replies Flag this Response
  • Have they ever done a full stool culture test? I would suggest they do this and check for parasites, bacteria, giarrdia, c. diff, candida. In Chinese medicine, just because an organ is removed, doesn't mean that the function has changed. In other words, you may still be having GB issues and a qualified Oriental Medical practitioner may be very helpful for you. We diagnose very differently and look at the whole picture, including tongue and pulse diagnosis. Please look into this as an adjunct treatment, especially to help with your pain. Also, Chinese medicinals are extremely helpful for Crohns, UC and other GI disorders. To find a practitioner near you please visit www.acufinder.com It is time to look at your illness in a different way, and a good acupuncturist, NAET practitioner, or naturopath may help point you in a better direction. I think diet is playing a part in this, and NAET could help diagnose where you have a problem, ie. food intolerance. Best wishesDOM
    acuann 3080 Replies Flag this Response
  • In September, after a night of light drinking, i ended up quite nauseaus and was so for the whole next day, i didnt drink for another two weeks, and the same thing started happening, and I got a pressure in my back, so i stopped drinkingRandomly a few weeks later my stomach was very upset, i had no appetite, and i was nauseaus, so i took some prilosec and was on it for several months and was pretty good, occasional uneasiness with some back pressuresHowever, about three weeks ago, i stopped taking the prilosec for a few days and started taking metoclopramide, a motility drug, after about four days on it (i dont know if there was a correlation) i was very sick nauseaus and had no appetite for several days and I still do not have much of an appetiteDuring this time, i had catscan, upper endoscopy, gastric emptying and other tests done- I still dont have much of an appetite and feel nauseaus, Ive been thinkin a lot about death, and have started to get headaches, dizziness, and i occasionally see afterimages or stars in my vision (I had my eyes checked and they found nothing)Can someone please help me, im really worried
    billio12 1 Replies Flag this Response
  • Chron's or Ulcerative colitis seems like something you definitely need to look at, especially in light of the fact that there is such a strong family history. It has been a long road and it seems like you have really gone through alot. As I said before, you are one step closer to a diagnosis. Just hang in there. Remember it is all part of a greater test. When will you be seeing the GI specialist?
    Anonymous 42789 Replies Flag this Response
  • I did have a stool culture test. I used to work for a naturopathic doctor back in Oregon, and she said I may have a parasite. The results were negative for parasites, but it had mucous and blood in it. I am seeing a GI but not sure when. I have to wait for a referral. I hope its not Crohns, my cousin has that and had to take Prednisone which has led her to gain 50 pounds. I cant afford 50 extra pounds. I am currently looking for a naturopathic doctor in my area, because sometimes, I think they go a little deeper into diagnosing things. Thanks for all the good advice.
    mdlewis 13 Replies Flag this Response
  • Usually docs will work you in fairly quickly if they know that it is emergent. I'm not sure what part of the country you live in, but if there is a major medical center nearby, I would gather all of the CT's US, MRI's, and labs that you have had done locally, and take them to a bigger hospital and go the the ER. Hopefully that will get something done quickly, or at least get you a diagnosis. Usually, if there is severe pain, a surgeon will at least want to do an exploratory laparoscopy to "look and see" what is going on. For all of the technology that we have, sometimes they can't figure it out without actually going in. Good Luck.
    Anonymous 42789 Replies Flag this Response
  • Yes, please look for a naturopath, NAET practitioner or acupuncturist who specializes in Chinese herbal medicine. I can't stress enough how successful these treatments are for GI disorders! And prednisone is horrible - avoid it at all costs if you can. There are many other ways to treat Crohns and Ulcerative colitis other than with drugs which further mess up your immune system function. The problem with Western medical diagnosis for Crohns is that they have no idea what causes it, and can only treat with fairly toxic meds. I believe that diet/food intolerance may play a huge part as well as immune system dysfunction. An alternative practitioner will hopefully get you on the right path back to health. The reason I asked about stool test, and specifically for clostridium dificile bacteria, is because this can cause a horrible form of colitis. You have to specifically ask to be tested for this individually I think. I would make sure they have records of testing you for this. Best wishesDOM
    acuann 3080 Replies Flag this Response
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