Abdominal Pain - mittelschmerz or something else?

[Christine__0__0]

  In Reply to: Mittelschmerz or something more serious? posted by Christine on June 04, 1998 at 09:36:31:
  : I have suffered from lower abdominal pain for many years which doctors constantly diagnosed as Irritable Bowel Syndrome.
  I did not think this was the case and was eventually referred to a gynaecologist who carried out a laporoscopy in January. He
  found and removed scar tissue from around my fallopian tubes which he believed was caused by Pelvic Inflammatory Disease.
  I am now suffering from similar pain mid-cycle every month. The Dr. has diagnosed it as mittelschmerz or mid-cycle pain. The
  pain I am experiencing begins low down on the left or right hand side (sometimes both), it starts as a throbbing ache and
  gradually gets worse with shooting pains now and again. This continues for three or four days and then I am left with a bruised
  or swollen feeling centrally which is uncomfortable with movement such as walking or sitting down. My understanding of
  mittelschmerz is a cramp lasting one or two days. Does anyone know if the pain I have described sounds like mittelschmerz?
  The Dr has recommended I go on the pill but have previously had a negative reaction to it. Any advice would really be
  appreciated.
  ==========
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  Dear Christine:
  We have reviewed your question and feel that it is more appropriate
  that you post it in the Gastroenterology & Liver Diseases Forum.
  
  I selected IBS as the topic area as I could not find an appropriate one
_________________
Dear Christine,
Abdominal pain is always a difficult problem for the physician.  Many different causes can produce pain in the same location.  Physicians often direct the investaigation based on the diseases that they know.  A gastroenterologist would look for inflammatory bowel disease and often make the diagnosis of irritable bowel syndrome when he can not find any objective evidence of disease.  Similarly, a gynecologist may diagnose pelvic inflammaory disease and Mittelschermz.  I assume that you have had a complete investigation for gastrointestinal illness.  Because some of your symptoms are possibly related to defecation, it is possible that you do have irritable bowel syndrome.  To relieve some of your pain, I would suggest that you increase the amount of fiber in your diet in an attempt to regulate your bowel pattern, the usual approach for this problem.
I do not believe, however, that taking fiber will make you perfectly better.  You need to meet with your doctor and verify that all possible causes of pain have been excluded.  For example, did you have a CT scan?  Have you been examined when the symptoms are more pronounced?  Often the findings from examinations during a flare of pain are very helpful in making a diagnosis.  Have unusal causes of abdominal pain been excluded?  Have symptomatic treatments e.g. analgesics, anti spasmodics been tried?  Finally, you must evaluate the possibility of a trial of the 'pill' to determine if your pains are improved.
Sometimes, we can not make a specific diagnosis for the cause of abdominal pain.  This represents a good news, bad news situation.  The good news is that serious illness has been excluded.  The bad news is that without a specific diagnosis it may not be possible to prevent recurrent attacks of pain.
This information is presented for educational purposes only and should not be considered a formal medical evaluation.  Always ask your physician specific medical questions.
HFHSM.D.-rf
*keywords: abdominal pain, irritable bowel disease
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