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Date of last update: 10/15/2017.

Forum Name: Gastroenterology Topics

Question: Pelvic pain, Consult w/GI

 NikkyLeClair - Thu Feb 24, 2005 4:59 pm

I have been having constant, nonstop burning in my pelvis for 4 months now. On the left side I have the most severe pain, which stabs and burns. My OB/GYN has decided she doesn't believe this is gyn. problem, so she is referring me to a GI doctor. I don't understand why, this seems uterine to me. Any ideas?

Also, I have had 3 pelvic ultrasounds and a pelvic MRI which all appear negative. I don't have bowel problems.

Nikky, MA
 Dr. Safaa Mahmoud - Thu Jul 27, 2006 12:56 pm

User avatar Dear NikkyLeClair,

Causes of pelvic pain include:

- Gynecologic and obstetric causes like uterine leiomyomas (uterine fibroid) or adenomyosis (endometriosis) and pelvic inflammatory disease. The diagnosis of these conditions can not be excluded by a conventional pelvic US or MRI. A vaginal probe ultrasound and laparoscopic study should be done to confirm the diagnosis of leiomyeoma and adenomyosis or to exclude them. So, having your MRI and US normal do not exclude gynecologic causes, especially if you have other gynecological symptoms.

- Urological causes like cystitis in which urgency and urine frequency are the main features. Which is not the case in your condition according to the informations you have mentioned.

- Gastrointestinal causes like diverticulitis or cancer. In such cases other GI symptoms are very evident and abdomen-pelvic US and MRI are helpful in the diagnosis of such cases, although colonoscopy is mandatory to confirm or to exclude the diagnosis. This possibility is also remote as you do not have any GI symptoms.

- Patients with previous surgical interventions should be checked for pelvic adhesion. Also, laparoscopy is the technique of choice.

- Musculoskeletal, commonly after complicated vaginal delivery resulting in pelvic floor relaxation disorder.
- Neurological in cases with pudendal nerve neuralgia, dysesthesia and vulvodynia are the main features but dyspareunia is unusual.
Complete History and physcal (especially gynecological exmaination) are very important in these conditions

- Psychological causes by exclusion.

I advise you to follow up with you doctor and to discuss with him the other investigations he is planning to use to rule out gyneacological problems.

Hope you find this information useful,
Best regards,

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