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Forum Name: Gynecology

Question: Fluid in pelvic cavity PLEASE HELP ME Having Severe Pain


 darkestdays30 - Tue Jun 05, 2007 4:31 pm

I picked up some of my test results & a CT I had done at the hospital while my stent was in my ureter and it showed mild hydronephrosis on the left side (it was moderate when the stone was in it), and it showed a trace amount of fluid in the pelvic cavity which is freeking me out. I was checked for cancer during the stone surgery & didn't have it. Could it actually mean my bladder is hemorraging or ruptured? I can't believe it could be ruptured and that I would still be alive to tell about it. I actually thought it was hemorraging after the laxative prep for my colonoscopy caused me to start bleeding & hurt my bladder so bad. But the fluid did not show up on the previous CT scan (before the stent was put in). What else could that be indicating? And if it does indicate bladder trauma, why didn't the hospital do anything?

They noted that my liver function was normal though I have elevated alkaline phosphorate, and low amylase. I think the pain medications are getting the best of me.

My gallbladder is distended now (after the stent was put in) and I have never had problems with my gallbladder before.

My protein was 3+ so I'm sure that means my kidney's have taken a good wack from the stones & that stent I had in me. But there was only a trace of protein before the stent was put in. My left one hurts so bad since the stent was removed, hurt when the stent was in there too but not half as bad as it does now. I can't move without it jarring the pain. I actually think that stent damaged my kidney somehow but I don't have kidney failure.

On the urinalysis, the red blood cells were too numerous to count, 1+ leukocyte esterase, and 1-2 white cells. Right before the stent was put in, it was 33 red cells, 13 white cells, 1+ leukocytes. No UTI.

And my bladder is in the worst pain I ever felt in my life. When I try to pea (when I'm having the pain), it takes quite some time cause the pain is so bad, it gets so much worse after I start urinating. It's like my bladder is stiffening up and can't relax because of the pain. It did that to me when I had the bladder repair & hysterectomy and I couldn't pea on my own for several days after. I started getting a constant feeling of needing to urinate today when it was hurting so bad though I can't part of the time. My urination is fine when I am not hurting (when the pain meds kick in) though there's a little hesitation.

I still see blood in my urine too. I know what is happening to me can't be perfectly normal. Could you please try to explain why all of this is happening? I don't understand and I don't know why my doctors are just letting it happen. I went to my PCP today and he wouldn't give me any pain medication, said I needed to get it from my urologist. So I went there and he wasn't working, but the woman that works for him said he will not prescribe it after the surgery is over. She said she didn't know why I'd still be so sick. What am I supposed to do? If that pain hits me like it did earlier today, I am going to just die or be wishing I would. I don't have any narcotics left to help me get through it.

Am I freeking out over nothing or do I have reason to be so worried? I don't feel like any of my doctors are taking adiquate care of me. And I am really scared. I can't even put into words how bad this pain is. I would rather have the kidney stones anyday.
 Dr. Chan Lowe - Tue Jun 05, 2007 8:08 pm

User avatar The free fluid in the pelvis is a non-specific finding and is seen on CT scan quite frequently. It does not indicate a rupture of the bladder or other organ. Probably it is a little fluid in response to some inflammation that is formed to help coat and protect the inflamed organ.

I wonder if you have another stone that is lodged in the ureter somewhere. I would suggest that you see your urologist again. You may need some more imaging to see what is going on and why your pain is not getting better.

Best wishes.
 darkestdays30 - Wed Jun 06, 2007 10:08 am

I'm glad to here that, though I still think my bladder is hemorrhaging, and I do have another stone in my right kidney, it's only about 1 mm & wasn't causing any problems. I believe he left it there. I started hurting in my right side yesterday & it hasn't stopped but I've hardly had any pain in that kidney before that. My skin got really redish looking, my hands/feet/ankles/knees looked a little swelled yesterday & I have this purple spot on my toe & my knees were turning purple.

The more active I get, the worse the pain in my bladder gets, & the worse I bleed from my urine. It hurts really bad when I get urine in my bladder & kills me to pea. I just can't help but to think it's hemorrhaging. I wish I could get further evaluated but nothing else is going to be done.

Does a mildly distended gallbladder mean anything? I have been vomitting more and it hurts if I don't eat, but hurts worse when I do. I thought it was reflux but now I have a tendency to vomit from eating and never did that before. I can only tolerate bland foods. My cholesterol is high now too. Could that indicate gallstones or is that also a nonspecific finding?
 darkestdays30 - Wed Jun 06, 2007 11:16 am

I just ate a plate of french fries since fatty foods are harsh on your gallbladder.

This happened as soon as I ate, pain intensified twice as bad, having spasmic type pain (tightness) in my epigastric area, belching like crazy, and getting gassy.

Acid reflux or gallbladder trouble?
 Dr. Chan Lowe - Wed Jun 06, 2007 10:23 pm

User avatar It seems unusual for a passed stone to still be causing this much trouble. You may need to pursue the gallbladder issue a bit to see if you have gallstones (unrelated to the kidney stones).

Also, you may want to see a nephrologist (kidney specialist) as well as following up with your urologist.

If you feel as if you are not getting proper care it is always reasonable to get a second opinion. Most physicians are not offended by this and welcome a fresh look at a patient's case.

Best wishes. Hang in there. I'm confident you'll get better. Hopefully it will be soon.
 darkestdays30 - Thu Jun 07, 2007 8:57 am

Oh but that kidney stone never passed even if it is tiny. I only had a small particle of one pass since the surgery, it feels just like glass so I can see why they hurt so bad. I had lazer surgery where they were broken up but last time I saw him, he actually said he took them out?????? I don't think he actually took them out. I think the residue is still there.

I have hydronephrosis. I feel that should of been re-checked to make sure it was gone. I have complications from the stent & after the removal. I feel like that should have been looked into.

When I was first evaluated. I had a negative UTI and 2 other doctors blame it on IC & 2 tried to convince me it was a UTI even though my cultures were negative, my urologist even blamed it on IC though I told him I had kidney stones. The only reason I found out what was wrong was a trip to the ER and some major crying on my part to my urologist.

My upper GI bleeding was not evaluated as to why and here I am going into a panic thinking it might be my barrett's turning into cancer. The possible reasons she gave me for it were not at all believable. But she did keep an eye on me at least. Not that I can say my other doctors are doing that.

Will a family doctor permit you to go to them if you are already seeing another one and have no intentions of switching? My kids go to one that tried to get me to switch over to him & I wouldn't do it but he's a big sweetheart. He would help me, no doubt whatsover.

But I love my doctors to death. They just frustrate me to no end sometimes. LOL.. A second opinion, I wouldn't mind. But I don't want to replace them.

I do feel better. Both my kidneys still hurt, my abdomen still hurts, and my bladder is still sore, but the pain is not extreme anymore & the bleeding isn't as bad. Maybe it'll just take longer for me to heal than most. I hope that's all it is.

My gastroenterologist is going to call today and tell me what she thinks about the gallbladder issue. I hope that is the problem. Would make me very happy other than thinking my reflux is that out of control. Thanks for your thoughts. I sure feel better.
 Dr. Chan Lowe - Fri Jun 08, 2007 11:47 pm

User avatar It's good to hear that you are starting to feel better. Most physicians are happy to provide a second opinion, even if you are not planning to switch to them. Also, most physicians would not mind their patient seeking a second opinion. I generally welcome the idea. It's one more set of eyes and brain to think about the case and make sure I haven't missed anything.

When you call to make an appointment just let them know its for a second opinion and not to establish care.

Best wishes.
 darkestdays30 - Mon Jun 11, 2007 1:46 am

My bladder healed finally, not bleeding anymore, but still have pain in both my kidneys. But I can live with that. My doctor wouldn't do anything about the gallbladder issue, since I had a hydroscan last year that was normal, and all my other tests were okay (so she thought), then she said it was probley nothing to worry about. I'm glad to know I can't develop gallstones since that test was okay LAST YEAR. LOL. That is funny.

Thanks for helping.
 darkestdays30 - Tue Jun 26, 2007 11:44 am

I decided to tell my doctor about my blood work and she sends me off to check for a tumor marker for your pancreas. Why would low pancreas enzymes have anything to do with that? My amylase and lipase were both low. I don't think I have cancer of my pancreas but lacking understanding why she thinks it might be a possibility. I figured it was just a fat digestion issue. She checked me for malaborsorption of fats, which I already know I have, and food allergies.
If you had gallstones, could it mess up your pancreas function?

Where do you hurt at in your abdomen with gallbladder/pancreas problems? I have pain in the upper/mid abdomen & sometimes near my belly button. It's like I feel something there in the upper part when it hurts, it's weird. You actually don't have any organs in your epigastric area, do you?

Not vomiting anymore, but still getting really sick if I eat anything fat (like a cheesburger, pizza, or such).
 Debbie Miller, RN - Tue Jun 26, 2007 6:07 pm

User avatar Gallbladder pain, typically is more to the right in the abdomen. Stomach pains are where I believe you describe. If all investigations of the stomach are normal, as with ulcer, GERD, etc. the other organs near that area are the pancreas and the transverse colon. Pancreas pain often occurs after meals. Irritable bowel syndrome can also cause epigastric pain after meals and occurs with spasms. This is sometimes treated with antispasmodic drugs.

The pancreatic duct carries digestive enzymes out of the pancreas. If a gallstone blocks the opening to that duct, digestive enzymes can become trapped in the pancreas and cause an extremely painful inflammation called gallstone pancreatitis. This is the way that gallstones might possibly affect the pancreas.

Another interesting thing is that you can have pain that is not right where the problem originates. Called "referred pain" you can feel gallbladder pain between your shoulder blades or under the shoulder even.

In the meantime, I would eat a diet low in fats and try to make yourself as comfortable as possible by not aggravating the condition. Also, it would be helpful to keep a detailed food diary with notations of how you feel throughout the day and how it relates to what and when you eat particular foods. This may be useful information for your doctor.

Good luck with this ongoing discomfort.
 darkestdays30 - Tue Jun 26, 2007 8:59 pm

I have fat malabsorption but the other blood work turned out okay (they called earlier). I'm really glad of that. But I'm still confused about all of this. Now I'm told the pancreas enzymes are nothing to worry about. Does that exclude pancreas disease because I tested negative on a tumor marker? I would think the malabsorption would just be more proof of a gallbladder and/or pancreas problem. Can't either cause such a problem?

I had a slightly distended gallbladder on my last ct scan, she said that was probley nothing to worry about either. I'm starting to think her view is that it doesn't matter just as long as it doesn't kill you. But that doesn't help me feel better.

I have reflux to the extreme. I cannot go a day now without having indigestion and heartburn. By the time I go to bed, I feel like dying. The indigestion gets so bad when I lay down. Just all at once it got ten thousand times worse, actually around the time I got the kidney stones.

I do have barrett's and chronic inflammation in my esophagus and stomach. I hurt over into my right side sometimes but the pain is seriously lodged in the middle. I also have been getting pain alot in my mid back & shoulders both.

The thing is, my indigestion has never been this bad. I never got heartburn much but it's a daily issue now.
Never in the 5 yrs I've had reflux, did a hamburger stir the symptoms up. Now something like tomatoe sauce or something really spicy, sure, but not foods just high in fat.

I didn't notice malabsorption symptoms until I started having blood in my stools & vomiting it up mths back.
Most foods have fat content. I can limit the worst but I really don't know how to limit it all without just starving.

Can the same thing that causes kidney stones cause gallstones? I'm actually starting to feel like I have kidney stones again. Havin some pretty bad flank pain right now on both sides. The debris never passed but it didn't hurt like this before. I don't know what caused those stones the begin with unfortunetly. I just started having problems while using a laxative prep for a colonoscopy and started bleeding from my urine.

I've had tests year after year on my gallbladder, up until this year. Typically, when my stomach problems would flare up, she'd think it was my gallbladder. I actually knew it wasn't. But now I think it is and she doesn't. Does anyone see the humor in this?
 darkestdays30 - Wed Jun 27, 2007 9:32 am

I found all of the answers to my questions online I asked in the previous post.

However will malabsorption cause your abdomen to hurt if you eat fatty foods and produce reflux symptoms really bad?

I think something is going on with my gallbladder (my cholesterol is high too) but just thought I'd ask incase it's a possibility.
 darkestdays30 - Thu Jun 28, 2007 4:52 am

There is one other thing I thought of, that I never told my doctor about, but when I had the kidney stones, traces of glucose kept showing up in my urine. I've never had glucose in my urine before. Well I decided to check it yesterday for blood since my kidneys are hurting and it showed up again. I read in websites that a glucose tolerance test is a diagnostic tool for pancreatitis.

Do all of these problems sound like it's likely related to my pancreas & gallbladder or is it truely nothing to worry about. I'd hate to get too arguementive with my doctor unless I had good cause. Thank you.
 Debbie Miller, RN - Thu Jun 28, 2007 1:03 pm

User avatar Your situation is so complicated with many systems involved. If I were you I would see a doctor and take a list of all the symptoms you have described here. You could see an internal medicine specialist, a gastroenterologist, a nephrologist or urologist. At any rate, I think you can only sort this out with the consistency of a medical doctor who can evaluate all the symptoms together, along with actually looking at you. I doubt you will be able to do any further diagnosis on your own this way. Good luck.
 darkestdays30 - Thu Jul 05, 2007 7:09 pm

I went to my doctors about this. Gastroenterologist said these tests were probley nothing to worry about
and my family doctor said it indicated pancreas disease (with the pancreas enzymes low & the fat in my stool). That I'm a little worried about. I'm going back in 3 weeks to see if the new reflux medication helps. So far it does just a little.

I went to the pharmacy today and purchased a liquid multi-vitamin and multi-enzyme formula. Will this likely help my digestion problems? I have been having the worst case of fatigue I've ever had in my life. Does the energy from your body basically come from your food or how else does it get it? I'm hoping this stuff helps me feel better. I'm wondering if my past dx of chronic fatigue syndrome and irritable bowel may have very well been from malabsorption/malnutrition issues. I would give ANYTHING if that was so. At least I could do something about it. So I think.

Thanks.
 darkestdays30 - Fri Jul 06, 2007 7:59 am

The stuff is giving me over half of my energy back & I just started using it yesterday. Where I took it late in the evening, I only slept 2 hrs though. But I didn't wake up feeling tired as I usually do.

There's one problem here and I don't at all understand why it's doing this to me. But I am having what I think is spasms in my organs and numbness/tingling sensations shooting through my body. My epigastric pain being the worst going straight through my back, it also is hurting my gallbladder, stomach, almost down to my belly button and right below it too. After taking it again not too long ago, it caused the same problems. Doesn't take very long after I take the medication before it happens.

I'm using GNC multi-enzyme formula (2 capsules daily) and a tbsp of Centrum multivitamin/multimineral suppliment. I'm taking them both one after the other. Could you actually get a drug interaction from natural suppliments?
 Dr. Chan Lowe - Fri Jul 06, 2007 10:24 am

User avatar It is always a possibility to get a drug interaction from supplements as well. It's pretty unlikely to occur with a multivitamin but supplements should always be considered as a possible source of interaction.

The multivitamin is generally considered safe but I would caution you against using supplemental enzymes if you don't need them (i.e. you haven't been found to be deficient.) Using excess enzymes can lead to very severe colonic obstruction which can be quite dangerous.

Best wishes.
 darkestdays30 - Sat Jul 07, 2007 11:10 am

I was told my tests indicate insufficiency & pancreas disease from my family doctor and then my gastroenterologist said these tests were nothing to worry about. Are they indicating pancreas disease?

My amylase & lipase were both low on my blood test. And I had fat in my stool. However this medication is for mutiple enzymes. I wouldn't want to do anything to hurt my colon. Should I ask my dr for a prescription instead? I know I cannot properly digest fat, meat, or anything really sweet. But yesterday, thought I'd see how good this stuff was working and ate some pizza and it didn't hurt me at all. Typically kills me with indigestion, diarrhea, and stomach pain.

And my fatigue is just so much better since I started taking that stuff. I quit taking them at the same time and the enzymes don't bother me at all. But the liquid vitamin makes me want to vomit, I get nauseas, it hurts my belly & causes the tingling sensations when I take it by itself. But without them both, my fatigue doesn't improve.
 Dr. Chan Lowe - Sat Jul 07, 2007 2:57 pm

User avatar With such a dramatic response to the enzymes it makes me suspicious that you may have some deficiency of your pancreatic enzymes.

Have you been anemic? If so, there is a condition called Schwachman-Diamond syndrome that is associated with anemia and pancreatic insufficiency.

It may also be worth being tested for cystic fibrosis (although if this is the cause it is likely to be very mild).

Following up with the GI specialist may be helpful. I would let him know about the effect the enzymes have had.

I suspect that the over-the-counter enzymes are much less potent than the prescription ones so the risk is less but I cannot say this for sure. If you are deficient, the risk of problems is even less. Really the problems arise when there are too many enzymes in the GI tract.

Best wishes.
 darkestdays30 - Sun Jul 08, 2007 9:29 pm

No I'm not anemic but my bowels were black last night. Haven't went today. Vitamins or enzymes wouldn't make your upper GI tract bleed would it? The vitamin hurts my stomach but I can't see it doing that. I also had such problems mths ago but it cleared up. Didn't find out why.

I will talk to my dr in 2 weeks at my follow up appt. I am very amazed by this stuff. Just wish it didn't make me so hungry. But at least I can eat now. lol.

Thanks for the advise. You all are so helpful.
 Dr. Chan Lowe - Sun Jul 08, 2007 9:41 pm

User avatar Black stools can be an indication of blood. However, often the iron in the vitamins can give a black color as well. If it persists I would recommend that you have you stool tested for blood.

Best wishes.
 darkestdays30 - Wed Jul 11, 2007 10:28 pm

It stopped after I quit taking the vitamins. Even lacking much pain now. Had no idea iron would do that. lol. I know I have had some severe reflux symptoms, and it's a constant annoyance. But what's the association with your pancreas and reflux disease? These enzymes are somehow helping that. My reflux is at least 60% better. The only problems I have with these enzymes are #1 causing constipation & #2 causing extreme hunger. I don't want the fatigue but I don't want to get fat either. I heard nothing much can be done if your pancreas is diseased. Hope that's not true. There's no point to keep taking this stuff if it's just going to make me really big, which I think would just make this whole thing worse. And when I say extreme hunger, I mean EXTREME.

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