abdominal and back pain

I am a 32 year old healthy woman who has a good diet and frequent excercise.  I have been experiencing pain in which I thought may be menstrual, but now am wondering.  It is in my lower back and abdomen.  It has existed for several months on and off, the longest lasting, consistenly for 2 weeks.  The pain is dull with waves of pain that are so severe and sharp that it feels like a stab in my back. Sometimes when the pain is so bad, I become natious.  My bowel movements are normal, I have been urinating a bit more in the evenning, although have been tested for a UTI-which was negative. I have not gained or lost any weight and otherwise feel healthy.  The pain is affecting my daily activities, and work.
any ideas?
thnk you
stephanie

[Kevin Pho, MD]

There can be many GI possibilities - including pancreatitis, ulcers, inflammation of the upper GI tract as well as irritable bowel syndrome.  

A reasonable workup would include discussion of the following tests: upper GI series or upper endoscopy (looking for upper digestive diseases - ulcers or inflammation), amylase/lipase (looking for pancreatitis), an abdominal CT scan (looking for masses or inflammation) as well as liver tests and abdominal ultrasound (to evaluate the liver and gallbladder).  

If the pain is lower in the abdomen, a colonoscopy can be considered for a comprehensive evaluation.

Non-GI causes can include the kidneys (which can be evaluated via blood tests and ultrasound) as well as GYN causes.  

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 patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[luckless]

Have the doctors considered the possibility of endometriosis?
It sometimes causes pain and GI symptoms when the intestine is envolved.

[surgeon]

I think endometriosis is an excellent suggestion, and ought to be mentioned to your gynecologist.

[CAmom]

You should read the question on 5/14 about "Rib cage pain" from me... this is a little known syndrome and not one doctor here has offered it as a possible diagnosis...