Digestive Disorders / Gastroenterology Expert Forum
Right Lower quadrant pain
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Right Lower quadrant pain

I went to the ED in July with severe Right lower abdominal pain and bloating. I had my appendix out in 2005. The CT showed inflammation and my WBC's were elevated. I was diagnosed with diverticulitis and put on flaxyl and cipro. 2 weeks later I had diarrhea-woke me up at night and went 14-20 times a day for over a week. Had general fatigue and chills/aches at night. Had coloscopy in August-showed some mild inflammation in ilieum and rectal area-was put on Asacol. Asacol helped the rectal pain but RLQ pain continued. Went back to ED in Nov for severe RLQ pain. CT and bloodwork normal. I had changed from Asacol to Pentasa the week before and the rectal pain had come back-significant burning pain. Went to another doctor and had more bloodwork-borderline IBD tests. Went off Pentasa for a few days in Dec and had severe RLQ pain and right hand pain. Got better after a week back on Pentasa. Had another colonoscopy-essentially negative in late Jan. I continue to have burning pain in my rectum and RLQ and right hand, general fatigue. Stress makes it worse. Do I have crohn's, lupus, what????
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I agree with the workup and treatment thus far.

RLQ pain can be due to appendicitis, but is less likely with a normal CT scan.

Inflammatory bowel disease or irritable bowel syndrome can be considered.  A colonoscopy can be considered to evaluate for this.  Small bowel is sometimes difficult to see with this test, and a small bowel series can also be done.  

Another option would be a capsule endoscopy to assist in visualizing the small bowel.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com
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My apendix was removed in 2005 so I know its not appendicitis. Physician mentioned possibility of scar tissue causing pain but that doesn't explain the rectal or right hand pain. My physician did not believe the pill cam was as good as sometimes advertised and thought maybe the next step was an exp lap. What are your thoughts there.Thanks
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