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Forum Name: Gastroenterology Topics

Question: Severe Abdominal Pains


 pierceme333 - Wed Jan 07, 2004 3:29 am

For the past year I have been expierencing random severe abdominal pains. They are not localized and can last a few seconds to a week. Nothing helps. I have been on several medications (birth control pills, vicadin,antispasmatics, antidepression, etc.). I have seen about 3 doctors for this (a family doctor, gynocologist, and a gastrointestinal doctor). No one can pin point the problem. I have been checked for endometriosis and IBS, Crones and other major colon diseases. I have had several tests and x-rays, everything always comes back clear and negative. The pain makes me nauseated, sometimes dizzy, and cause back pains. It is very hard to function!!! I have frequent urination problems, I urinate anywhere from 2 -3 times an hour usually. I have atleast 2 bowel movements a day. I am a 22 year old who occasionally smokes and is a social drinker. the only other problems I have are severe periods that come randomly (i can skip months and I have even gone an entire year without one) & they last a couple of days to even two weeks, I have even had a period for 3 days stop for about a week and then had it start for a week. they are very painful. I have severe mood swings. I also have trouble sleeping. it takes me for evey to fall asleep, even if I am very tired, I wake up atleast 5 times during the night and I never feel rested even if I recieve 8 hours of sleep. (Sorry about any of the spelling errors)
This expierence has been very difficult and frustrating!!! Please If anyone has any sugesstions please contact me!!!!!
 Dr. Russell M - Sat Jan 10, 2004 5:03 pm

User avatar Hi!

Can you shed some light regarding your menstrual history, sexual history, marital history, and history of child birth if any. Have you had history of vaginal discharge? Have you had cultures of the vagina/cervix done? Has your doctor discussed regarding a D&C?

- Bill
 pierceme333 - Mon Jan 19, 2004 1:43 am

I am single. I have not had any children. My menstral period is very irregular and is extremely painful. I started having periods when i was about 15 1/2 the flow can be spotting to a very heavy flow within the same cycle. I expierence alittle discharge its white in color mild scent. i have had 5 sexual partners, but only 2 of them have been male. I'm not sure if I have had any vaginal or cervical cultures, there has been so many tests I can keep tract. Im currently trying to get copies of all of my medical charts. I have not had a D&C. I hope that answers all of your questions. Im very open to any questions so don't hesitate.
 Dr. Russell M - Mon Jan 19, 2004 9:22 am

User avatar Hi again!

Have you had fever? Has your gynecologist done an internal examination for you? Like, per vaginal, and if so, did the doctor ask you if there was pain at any particular instance of the examination? If the cultures have been taken according to your records, kindly notify the results.

Pelvic Inflammatory Disease [PID] is one possibility that runs through my mind now. It is an inflammatory disorder of the uterus, fallopian tubes, and adjacent pelvic structures. Risk factors for PID include young age at first intercourse, multiple sexual partners, intrauterine device (IUD) insertion, and tobacco smoking. A delay in diagnosis or treatment can result in long-term sequelae such as tubal infertility. Lower abdominal pain [90%], vaginal discharge [75%] , and unanticipated vaginal bleeding [40%] can occur. Fever, nausea, and vomiting occur late in the course of the disease.

Medical treatment in the form of antibiotics are available, while surgically, laparoscopic examination would help if the diagnosis is in doubt.

Hope this helps.

Warm regards,

bill
 pierceme333 - Mon Jan 19, 2004 3:53 pm

Yes I have had fevers, I get sudden hot flashes to the point where I sweat. Or even the other extreme where I will get so cold I'll shake. The gynocologist has done vaginal exams on me and yes sometimes it did hurt, ecspecially when my stomach was bugging me, it hurt me to the point of tears. I have had a laparosocpy to check for endometriosis, do you think that PID would have been evident then? I have a high pain tolerance and the pain I suffer from is to intense for me to function some of the time. I looked up info on PID...I have always had irregular periods even before I became sexually active. I have never had an STD, I haven't been with a man sexually in about 3years. Does any of that matter? And I noticed these symptoms about a year ago after a car accident.


Thank You for your relpies, andrea
 Dr. Russell M - Mon Jan 19, 2004 5:15 pm

User avatar Hi!

The diagnostic criteria for PID include 3 major and 1minor criteria. The three major ones are as follows:

1. Lower abdominal tenderness i.e., pain on palpation of the lower abdomen.
2. Adnexal tenderness i.e., pain on palpation of the fallopian tube, ovary, and other structures besides the uterus.
3. Cervical motion tenderness i.e., pain on palpation of the cervix during an internal pervaginal examination.

The minor criteria can be ANY ONE of the following:

1. Chlamydia or gonorrhea STD infection.
2. Temperature higher than 100.4 degrees Fahrenheit or 38 degrees Celsius.
3. Increased white blood cell count [WBC] of 10,000 WBCs per cubic mm.
4. Purulent material in the peritoneal cavity obtained by culdocentesis or laparoscopy. Culdocentesis is the removal of fluid inside the abdomen (peritoneal cavity) via the vagina.
5. Pelvic abscess/collection of pus or inflammatory complex detected by sonography or by bimanual palpation by hands.
6. Patient is a sexual contact of a person known to have gonorrhea, Chlamydia infection, or nongonococcal urethritis.

Irregular periods can happen and be normal during the first two years of menarche i.e., the beginning of menses. Even if you did not have an STD, as mentioned above, it is enough that any of your sexual partners had STD before. Besides, from my earlier post, you would recall that the risk factors for PID include multiple sexual partners, not STD per se. The fact that you have discharge from the vagina and lower abdominal pain would be enough to get yourself treated for PID in the third world countries where laparoscopy and culdocentesis are not always readily available.

Was there any pelvic trauma in your car accident?

A laparoscopy would help diagnosis of PID only if a bacteriology culture was taken during the scopy or if post-inflammatory adhesions are found within the pelvis. Early in the course of PID, a laparoscopy can help irrigate the pelvis and separate its adhesions, if present.

All said and done, PID may not be what has affected you, and I could be wrong. As always, there is no substitute for direct clinical examination.

I hope this helps.

Warm regards,

Bill
 pierceme333 - Mon Jan 19, 2004 5:24 pm

The trauma occured mainly to my knees my stomach really wasnt effected. I just hate for all this pain and uncertainty be cuased by such a disease. Thank you Andrea

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