Help! Left sided pain and other symptoms!

[Vicki J]

I am a 34 yr old female who recently had twins (4 mos. ago), following a healthy pregnancy and successful vaginal delivery.  A couple months ago my ob/gyn suspected I had developed postpartum obsessive-compulsive disorder.  Shortly thereafter (about 5 weeks ago), I developed a pain in my lower left abdomen (about the area of my fallopian tubes).  I had an urgent care examination (pelvic exam, urinalysis, and microscope exam of a small amount of fluid found in my abdomen).  The doctor said everything seemed normal so I should have an ultrasound for further testing.  I instead went to my ob/gyn who felt it was a ruptured ovarian cyst.  The pain really didn’t go away completely after I saw him, though, as he indicated it should.  It just came and went.  In the meanwhile, I developed a severe case of hypochondria – believing that I had any/every illness you could imagine.  (I had a mole removed that I thought was cancer – it was benign.)  Anyway, I suffered for a week or more, practically throwing up, couldn’t sleep, crying, worried, etc.  Started to develop severe anxiety symptoms and had a panic attack about three weeks ago.  (I was about a week into my buspirone prescription at this point).  During this time of severe anxiety, I felt like every time I would eat my digestive system would process quickly and I would have to eliminate more frequently.  I also thought I could feel my body trying to eliminate although nothing was in my system (this didn’t hurt).  After awhile, things got a little better anxiety-wise and, if I remember correctly, I returned to just eliminating once a day (which is more usual for me).  I think my stool is normal; it is generally medium colored, has a distinctive shape, yet it may be somewhat loose ? following my morning coffee and cream.  However, my left-sided abdominal pain returned last week so sharply that I felt like something inside was going to explode!  It also seemed tender to the touch.  I went to the ER and had CBC, electrolyte tests, and two types of ultrasound exams done.  The doctor said the CBC and electrolyte test results looked great, and the ultrasound did not indicate any kind of cyst or mass present.  She said she found a small amount of fluid in my abdomen.  (I don’t know what that means.)  I have also experienced what seems like my intestines having spasms (moving around) for at least a couple weeks now.  Also, within the last few days,  I have developed severe aching in my rectum (could this be due to sitting down for a long period?)  Help me, please, doctor!  I am a total stress case.  Even if you aren’t sure what it is, could you give me an idea of what it probably isn’t so I don’t have to worry myself sick.  Thank you.

[Kevin Pho, MD]

Possibilities would include diverticulitis, irritable bowel disease, inflammatory bowel disease as well as various types of infection.  

I would consider a CT scan, looking for any inflammation suggestive of infection, and if negative, a colonoscopy can be considered.  This combination would be pretty comprehensive in evaluating for most GI disease.

If negative, GYN causes certainly are possible, and a transvaginal ultrasound can be repeated to look at the ovaries.

If everything is negative, irritable bowel disease would then be considered, and treatment optimized (i.e. possible antispasmodics as well as increase fiber in the diet).  

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

[yoshi]

who is helping you with the daily chores now??
you have to take good care of yourself for what you have been thru.

[Vicki J]

Sorry, to add to my question - I forgot to mention that I seem to have a little increased gas, occasional vaginal discharge in the last few days (small amount, clear or mucusy), had a little mucus in my stool for one day, and have had occasional left-sided chest pain w/slight cough (I think I might be dealing with a cold/respiratory illness? my 1st grader had).  Thanks.