Six years of severe abdominal pain after exercise

Hi Guys,

I saw a post on abdominal pain after exercise yet it didn't seem entirely the same as the problem I was wanting to discuss. For reference it is here: http://www.medhelp.org/posts/Exercise--Fitness/Intense-stomach-pain-after-exercise/show/426182 .

The condition relates to a close friend of mine. After exercise she reports pain in her abdomen that starts as dull ache and builds up to where she cannot stand. Across the front over the womb area the dull ache develops, becoming severe pain described as throbbing. Across the back the dull ache around kidney area becomes shooting pains from the anus up the back to the lower rib area - this prevents her standing and causes her to feel sick. The shooting pain lasts for 15-20 mins but the dull ache can remain for days. Brought on by exercise especially but has brought on by standing for long periods or even some food intakes (high fat especially). Painkillers and lying down is all she can do but this has limited efficacy.

Some history that might be important - Previous history of muscle trauma (possibly a tear) in the abs area due to overzealous exercise when younger but never diagnosed or any further problems found, anal fissure that was treated via botox injections to release muscle tension (now fully healed), Laperoscopy revealed one malformed Oviduct and pelvic congestion but advised by doctor that neither contribute to cause pain, ultrasound of kidneys and abdomen revealed nothing, bloods all appear fine, vaginal/cervical inspection all OK.

As you can see by the title, she has been suffering with this for six years and it is ruining her ability to enjoy things fully. She can't do any exercise that she enjoys, standing up at work sometimes is too much, etc. Any help would be greatly appreciated to bring an end to this.

Thanks,

Carv.

[Dr Vinod]

Hello!

It is very important to know the complete history of the person.

Is her pain related to menstruation, pre menstruation and ovulation as this can be a possibility? Is she on oral contraceptives or any medications?

Does she have any loin to groin pain in the past which might be related to stones in the urinary tract?

It is always good to rule out UTIs by a urine test.

If she had a C-section or any operation earlier then she has to rule out present complications.

It is always good for her to have a balanced diet and have proper breaskfast before she starts her workout.

I would also suggest her to follow up with a sports expert physician to rule out any injuries to the abdominal muscles and to start work outs slowly and to acclimatize properly and to avoid all forms of exercises which causes discomfort till properly diagnosed.

Take care!

[Carv]

Her pain is not related to menstruation as it does not occur rhythmically every 28 days in time with the menstrual cycle. She can go for months without a problem and then have weeks of constant trouble, thus menstrual cycle seems unlikely. She is taking an oral contraceptive, which is Progesterone only.

There has been no complaints of loin/groin pain.

Sexual health exams have ruled out infection being the cause as she has tested negative for UTIs, Chlamydia, etc.

The Laperoscopy that was mentioned is the only operation she has had in the area and this was performed in mid-2008 so should be healed by now. There was pain before this however.

She eats sensibly and has not been skipping meals or neglecting her diet. As I said, the pain can sometimes be caused by simply standing up at work for a period of time, something that should not be causing such pain. She cannot do more than 10 minutes of jogging without the pain developing and forcing her to stop, so it's quite debilitating.

Regular visits to the doctor about this, some of them on an emergency basis, have not been that helpful and have not yielded any conclusions. It is difficult to know where to send her next as family doctors and hospital staff seem unsure of what to do.