Doctors Lounge - Oncology Answers
"The information provided on www.doctorslounge.com is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician."
Forum Name: Ovarian Cancer
|bindy - Sun Dec 31, 2006 7:10 am|
Hi, For the past year now i've been dealing with abdominal pain. It's not like a dull pain, shapr or anything like that it's in a way more of a discomfort. At times it's like a pressure/bloating feeling which depending on wether i've done activity or been active for a while will only include my upper abdomen, or else my abdomen as a whole.
Initially i belived my abdominal problem to be borught on by a horse riding accident which happenned about the same time. With that i came off my horse and landed (from what i can gather) onto my shoulders at the base of my neck.
In any case. Up till now i've belived that my ongoing abdominal pain/discomfort was a muscular related thing, as the pain/discomfort increases after i've done activity. After numerous doctors and finally one who would send me for proper tests, i had a CT scan the other day. I don't know what to look for in the films but i looked at my report, as i go back to current specialist on the 15th of FEB.
It bascially said that everything was fine except that i had small mesenteric nodes (which i'm still trying to find information about) and that i had Bilateral small ovarian cysts. I'm just wonderign now wether my symptoms could be related to this and not the horse riding accident at all. When i think about it after reading symtpoms on the net i have had maybe a few of the symptoms of ovarian cysts. Also a few years back i had similar problems, at least i gather so but they went away after a while. Wether that could have been the same problem then i don't know. But if anyone has any info or advice i would really like to know.
My symptoms are:
>Upper abdominal discomfort which is tender to touch, and also this is the same for the middle of my abdomen vertically.
>After activity my abdominal pain/discomfort increases sometimes dramatically and i feel as though i'm going to vomit and some times i've come close but as yet i haven't vomited.
> the abdominal pain is there all the time, i find when i do the least activity, moving aroudn etc i feel a considerabel amount better but it's still there.
>temperature seems to aggrivate it more as well... if i'm in aircon and become too cold i will begin to feel neasious.
> my periods have been more painful and they tend to make me feel really neaseuos and i really can't do anything.
> my bowle movements also haven't been liek they were before. frequently i'll either be constipated or have diarhea. When i have diarhhea right befor ehand i'll feel as though i'm going to be sick but i haven't been sick.
I'm certian it's not food related, as i've tried different diets excluing weat, lactose etc.
I'm 15 years old and weigh 58kg (last time i was weighed which was 2 weeks ago (roughly).
Thanking you Bindy
|Dr. Chan Lowe - Mon Jan 01, 2007 7:58 pm|
Abdominal pain can be quite ellusive in discovering its cause. I have a few questions for you regarding your pain.
1) Where in the upper abdomen is your pain? Left, right, middle, etc.
2) Does eating help or worsen your pain?
3) Do you get the pain in correlation with your periods, are your periods regular, and is there any possibility of STD's?
4) Are you on any medications?
5) Have you had any blood work done and if so, what were the results?
Ovarian cysts can cause some of your symptoms, although they do not typically cause upper quadrant pain alone. More commonly they cause lower quadrant pain. Also, cysts can be an incidental finding. Typically they are given 3-6 cycles to resolve and often do without treatment.
A few other possibilities for your pain include gallbladder disease, pancreatitis, gastritis and early inflammatory bowel disease.
I would suggest continuing to follow up with your doctor.
Hope this helps. Keep us updated.
|bindy - Tue Jan 02, 2007 1:01 am|
Thank you for your quick reply. I have been told by the numerous doctors that abdominal pain can be hard to diagnose because there are quite a few things that could be the cause of it. Unfortunately it's been a trial-and-error process over the past year.
In answer to your questions:
1)> It's in the middle, of my upper abdomen. It doesn;t move around or anything like that and is always there. Increased by activity. It's about the size of my hand when placed, and reaches down to just above my belly button. (i hope that makes sense)
2)> Some times that depends... I've foudn travelling in the car a big problem and seems to aggrivate my abdomen quite a bit. And at times when i'm going for a car trip i take a sandwhich or somethign with me to nibble on and often this helps. Although if i've done enough activity which leads me to feel as though i've overdone it ( i originally believed my abdominal pain/discomfort to be muscular because activity worsens it) eating food doesn't really help. Generally as i don't; do anythign now because i end up feeling worse off, eating isn't too bad... Although if i eat a large meal i find that my abdominal discomfort (same upper, middle abdomen) can increase but shortly passes if i sit and do nothing. For this reason i do tend to eat smaller frequent meals during the day.
3)> The abdominal pain/discomfort is always with me. I did take asperin- panadol etc at one stage but when they wore off i foudn it wasn;t worth being introduced to the abdominal pain/discomfort again as i will feel as though i've done activity and 'over done' it. (which still confuses me because ot me thats muscle in a way... When i have my periods I've had severe period pain and my abdominal pain/discomfort is decidedly of a more neaseus mature. (i find it hard to distinguish between wether it's pressure, blooating etc and neasea at times.. No possibility of STD's because I haven't had sex.
4)> No medications
5)> I've had about three blood tests during 2006r and have to get another one before i go back to my current muscle and bone specialist. All have come back telling me that i have a low iron level. For which i was given some iron tablets to take, that was early in 06. Other than that samples were testsed for celiac disease (not sure on the spelling), has to do with gluten intolerancy. I would have to find my results for the other blood results.
All throughout 2006 i belived my abdominal discomfort/pain to be msucle related because my discomfort increases dramatically after i've been active. previously i was a very active person. i ride horses and now when i ride horses well, i don't' because afterwards i feel as though i'm going to vomit but i haven't in the time i've experienced this. I also belived it to be muscular because the cold woudl affect me like my muscles were cramping up and causing problems and when i have done activity and have the feelign that i've 'over done' it applying a hot water bottle the warmth has helped.
Any information you can give me woudld be great. I think what i've typed is a bit mumble jumble but i'm forever thinking simple things could help in a diagnosis and it's hard to know wether anything is realted or not.
|bindy - Tue Jan 02, 2007 1:03 am|
sorry, just a bit i forgot. You mention:
[[ A few other possibilities for your pain include gallbladder disease, pancreatitis, gastritis and early inflammatory bowel disease. ]]
Would these show up on my CT scan i had recently?
|Dr. Chan Lowe - Tue Jan 02, 2007 2:34 pm|
Your answers are quite helpful. Given your description of the location of your pain (in the epigastric area), the most likely origins of your pain are the stomach and pancreas. Recurrent pancreatitis can be quite painful. It is checked for by a blood test for amylase and lipase levels. I think this is less likely but should probably be checked for if it hasn't been already.
The more likely thing base on your description of symptoms is a gastritis. There are several things that can cause gastritis. I would recommend you get a test for H. Pylori, a bacteria that can cause gastritis and ulcers. Additionally, we are learning more about a set of conditions called eosinophilic esophagitis and esoninophilic gastroenteropathy. They are thought to be a food allergy-but not allergy in the classic sense with hives, etc. There are a few different treatments if this is causing the problems. These are diagnosed by doing endoscopy and biopsying the lining of the esophagus and stomach (under anesthesia so you won't remember it). A GI specialist is needed for this.
There are several foods that are the common culprits for food allergies: dairy, eggs, tree nuts, peanuts, wheat, and shellfish are among the top. One could try a total elimination diet of these foods for 2-4 weeks. If the pain goes away, add them back one at a time to see which was causing the symptoms.
Gallbladder disease is less likely with this location of pain (although not impossible). A CT scan would likely have showed some thickening of the gallbladder if this was present.
Menstrual pains may be adding to your symptoms but I do not think that is the originating cause. I was considering endometriosis; however, this pain tends to be cyclic with your periods.
I would suggest you see a pediatric gastroenterologist to help you work this up. If you are able to do this, I would suggest not trying the food elimination before going, so that you don't "partially treat" the problem and make it harder to figure out.
One other random thought. If you are having low iron levels chronically, you may consider checking a lead level. High lead levels can suppress iron and cause abdominal pain. (Much less likely than other problems, but an easy test to do.)
Also, you may try some antacids with the pain to see if it helps. If it does, gastritis is very likely.
As to your question about CT scans, they would show gall stones, may show gallbladder thickening, and would show any cysts, etc. that may be associated with the pancreas or other organ. They are unlikely to show evidence of gastritis or functional pain problems as they are static pictures.
Hope this helps, keep us updated.
|bindy - Tue Jan 02, 2007 5:31 pm|
Thankyou for all the information you've provided.
I had an endoscopy a while back and wasa told that i was 'normal' biopsy was taken and was tested for Helicobacter Pylori. Tests came back saying that it wasn't present. The GI asked if anything else helped and i explained how i'd been having chiropractic and bowen (massage) treatments and they give me some relief but doen't cure/fix it completely. he aid that if it doesn't go away in a few months that we can go back and more tests will be done. At the moment it looks like i might have to go back...
I'm just confused with in the event that it is a gastro type issue causing me my problems can activity increase discomfort/pain? Because that seems to be whats dumbfounding the doctors i've gone to for this problem.
[[[One other random thought. If you are having low iron levels chronically, you may consider checking a lead level. High lead levels can suppress iron and cause abdominal pain. (Much less likely than other problems, but an easy test to do.) ]]]
Woul your mention (above) about my lead levels suppressing my iron level and causing abdominal pain be worsened by activity?
Thank you again BIndy
|Dr. Chan Lowe - Tue Jan 02, 2007 6:19 pm|
High lead levels would not have increased abdominal pain with activity, as far as I'm aware. However, if there is some inflammatory condition going on, it is certainly possible that exercise could irritate it-regardless of the cause. If, for example, you had some inflamed lymph nodes in the mesenteric covering of your intestines, activity would bounce them around irritating the already inflamed area.
With the intermittent diarrhea, you may also have a component of irritable bowel syndrome. Unfortunately, we really don't have a good understanding of this syndrome but we are learning more all the time. There are some new treatments for this. I would recommend seeing your gastroenterologist again. You may need some of the tests repeated. Also, you may consider a trial of an acid blocking medicine to see if this helps.
|bindy - Sun Jan 07, 2007 3:29 am|
---However, if there is some inflammatory condition going on, it is certainly possible that exercise could irritate it-regardless of the cause. If, for example, you had some inflamed lymph nodes in the mesenteric covering of your intestines, activity would bounce them around irritating the already inflamed area.---
The report i got back from my CT scan the other week mentions mescenteric nodes on my large bowel as well but i can't find much about these nodes on the internet that is human or else the kind i'm wanting info on. I'm guessing the lymph nodes you refer to are the same thing ??
|Dr. Chan Lowe - Sun Jan 07, 2007 7:19 pm|
These nodes are, indeed, the nodes to which I was referring. Inflamed mesenteric lymph nodes can cause a significant amount of pain. Occasionally, this can be so painful that a work up for appendicitis is done.
Interestingly, acute mesenteric adenitis would typically not continue for a year's time. I would be suspicious of some ongoing inflammatory state or reaction that is causing the nodes to be inflamed, such as a food allergy or other inflammatory bowel condition.
Again, I would recommend re-evaluation by your gastroenterologist. Hopefully, you can find an answer soon for your symptoms.
|bindy - Sun Jan 07, 2007 7:39 pm|
Thankyou for all your supportive information
|Dr. Chan Lowe - Sun Jan 07, 2007 9:55 pm|
Always a pleasure. I hope you feel better soon.
|| Check a doctor's response to similar questions|
Are you a Doctor, Pharmacist, PA or a Nurse?
Join the Doctors Lounge online medical community
Editorial activities: Publish, peer review, edit online articles.
Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.