Abdominal Pain Gas

[Amyuku]

Hi. I am a 38 year-old-woman who has been extremely healthy and active in life (playing soccer 4x/wk). Early last year, I had a knee surgery which took me out of my routine. I have been unable to resume that level of activity and gained 30 lbs.  I was just starting to run on the treadmill again in early Nov. last year when in mid Nov., I had a laperoscopy and hysteroscopy performed to help understand my infertility (no pain at this time). My OBGYN found some scar tissue on the left and removed it and some endometriosis on the intestine and removed it. I was under the impression this was a minor surgery so I immediately started in with some exerted activity around the house. Within a week, I was suffering from acute and debilitating pain (level 9)on my right side--maybe 2" below and to the right of my belly-button. MD said I needed to rest and that some take longer to heal than others. I stayed in bed for a few days and continued on w/ normal activities. Within the second week, I suffered this acute pain again. Blood and urine tests were run and all came up negative. I stayed in bed and really slowed down all my activities. By December, I wasn't doing any excercise and experiencing level 2-3 pain. I kept thinking it was going to go away...didn't. I pressed MD for answers in January this year. They didn't know. When I asked if it was associated w/ my surgery, he said maybe some scar tissue had formed. I thought, "how could it be scar tissue when I felt it in the same spot ever since the surgery?" It also presents about 2" above the naval and to the right. I also have tight stomach muscles on the right. So, they did an ultrasound on my mid-section and found nothing. They suggested a chiropractor and deep tissue therapist as the pain had gone around to my lower back on the right.  Where's the gastro piece? I have also had increased gas, less frequent bowel movements, stomach gas that makes so much noise I am afraid my cube mates will hear when I stand next to them and foul smelling feces. I am embarrassed to talk w/ others and wonder if I am imagining things? I started really paying attention and noticed that sometimes when digesting, I feel a pain in the bowel area. This deep tissue therapist said it may be this muscle that runs the entire right side that may have some adhesions. When he worked it, it felt better so I started walking the treadmill again--the pain increased to level 3-4. It's hard to even find the pain when pressing. It took the office a few x to locate it--it feels like it's deep in my midsection...and it does seem to move around a little but presents in the 2 places I mentioned above the most.  I want to massage it, put heat on it to alleviate the pain. I have tried quiting coffee, diet sodas, adding oatmeal to my daily diet...anything to make my digestive tract feel better. I have begun to think maybe it's not surgery but gastro issues occurring at the same time...but that seems too ironic...but I know it happens. Please advise.

[Kevin Pho, MD]

Tough to say without examination.  On the right side, things like the appendix, liver/gallbladder, irritable bowel disease and inflammatory bowel disease are all possible.  

I would consider an abdominal CT scan and ultrasound to evaluate the organs (looking at the appendix and liver/gallbladder).  The bowels can be evaluated with an endoscopy (preferably a colonoscopy if there are changes in the bowel habits).  The small bowel can be difficult to visualize during an endoscopy - an upper GI series with small bowel follow-through can be considered if small bowel disease is suspected.

These options can be discussed with your personal physician or in conjunction with a GI evaluation.

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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[DiggerGrl]

Wow! This sounds a bit like what I've been experiencing lately. Abdominal pain (hard to describe) that has now traveled into my back...So basically I now have a constant dull ache in my stomach and back that won't go away. Mine is accompanied with constipation a lot, and I'm starting to worry. I'm in freak out mode thinking I have something seriously wrong. Been to a GP who doesn't have answers and now am moving to my OB/GYN to rule out Ovarian Cancer or cysts. HORRIBLE. Look forward to seeing how people respond to you.....

[Amyuku]

Thanks for your input. It feels good to have a place to share and be shared with :)  I have been working with my OBGYN.  At the moment, my trust is a little shaken.  For you, an ultrasound would be a good next move...that will detect tumors, cysts, etc.  Not sure about ovarian cancer.  But, I have to say, I had similar fears and was starting to freak out myself.  I still am in freak-out mode fearing I am going to have to deal with this forever.  I am also angry at my physician for not outlining the high incidence of adhesions after gynecological surgery...which seems to be coming up a lot in my reading.  And, lastly, I am mad at myself for not researching more before moving forward...was so excited to get to the next step of having a baby...I was in "full speed ahead" mode.  Hopefully the MD will have some good input, too.

[DiggerGrl]

I guess all we can do is take one day at a time and keep on the check-ups and doctor visits. Aside from an abnormal pap in college, almost 15 years ago, which resulted in a biopsy and minor surgery (clean bill of health since,) I've never had a female issue, or health issue to speak of. Feeling so out of wack and not sure what to think, makes the mind wander and jump to the worst case scenario though. Our bodies are complex things, with so many things that can potentially go wrong, that who knows what this will end up being. Right now my biggest complaint is the dull ache in my belly, accompanied by low back pain...which is often more uncomfortable than my belly. Luckily I'm catching whatever it is, after only going on for a couple months, and hope it can be easily diagnosed and fixed. I know the plan now, on the 15th, is to do an exam and get some blood work done. Next step will be the ultrasound...Which I will push to have done that very day!!!

[debra42]

i had a bad attack about a month ago it started around my belly button and moved up across my breast bone and now its in my lower right abdomen i have had tests done one dr tells me one thing another tells me different what do you think it is if you could help me i would really appreciate it