Abdominal pain, changing recently

[J-Gancio]

  I am a 21 year old female weighing 125 lbs. using Desogen oral contraceptives, whcih I have been on for about 6 years. I've had abdominal pain for nearly five years now.  At first they could be relieved by having a bowel movement or by curling up into a ball until the pain passed, but since last year they have gotten so bad that nothing seems to help them.  They come at various times and are unpredictable.  Sometimes the pain is dull and bearable, albeit uncomfortable, and other times it is sharp and so painful that even standing up straight becomes a task in itself.  The attacks can last for from a few minutes to all day long and sometimes they come back the next day.  Lately  the pain seems to have relocated somewhat, as in now when I get a full abdominal pain it sometimes spreads to my back and like tonight, it is only located in the lower left abdomen quadrant and is painful to the touch.  My doctor suggested I might have gastritis but the Axid she gave me did not help the pain and neither does taking Tums or Zantac 75.  I also cut caffeine considerably and have cut down on carbonated beverages to no avail!  I do not experience any other problems, ie no diarrhea or constipation, but frankly it has become unbearable and no one seems to have any idea.  Any suggestions and/or ideas would be of great assistance as I can bring them into the doctor's office and maybe bring to light something she may have overlooked.  Thank you.
  J. Gancio
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Dear J Gancio,
According to your e-mail the abdominal pain started several months after beginning birth control pills.  If possible, this medication should be stopped for several months to determine if the abdominal pain improves.  If the pain is not related to your use of oral contraceptives, there are a number of possible diseases to consider.  Diseases of esophagus, stomach, small intestine, pancreas and colon must all be considered.  If you have not lost weight, your energy levels have not changed and your bowel pattern is regular without blood, then you may have irritable bowel syndrome.
Unfortunately, it will be impossible to exclude the different diseases on the basis of history and physical examination only.  You will need to have X-rays of stomach and small intestine as well as a barium enema to exclude GI pathology.  A CT scan of the abdomen may be helpful in the appropriate clinical setting.
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by your physician.
If you want, we would be happy to see you in the Division of Gastroenterology at Henry Ford Hospital, in order to review your records and initiate treatment to improve your symptoms.  You can arrange an appointment with Dr. Fogel, one of our experts in the investigation of abdominal pain.  He can be reached by calling the Henry Ford Physician Referral Line at [phone].
HFHSM.D.-rf
*keywords: abdominal pain, irritable bowel syndrome
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