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chronic right-sided abdominal, flank, and lower back pain
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chronic right-sided abdominal, flank, and lower back pain

I've been experiencing pain, pressure, burning feeling on and off for a year. sometimes the pain is every day for as long as two months. It seems to be related to my period, so I have been diagnosed with possible endometriosis and put on BCP. A lot of the time the pain isn't around my cycle. Always on my right side. Sometimes in my lower right back, in my right flank, and sometimes in my right abdomen. It spans from my ovary area, all the way up to under my ribs. Often feels like burning.
Now my bowels are all messed up for the last two weeks. I had 8 straight days of "D", then some abnormal BMs. I've had indegestion and heartburn for the last three days, along with the normal pain. I had my gallbladder out in 1993.

Last night I was in pain on my right side. I was laying on my left side and I felt a large, hard area on the right,right next to my lower ribs. It was like my intestines or liver were inflamed. I switched to my right side and and felt my abdomen on the left for a similar swelling, but there wasn't one. This morning the hard area is gone, but the pain is there.
I've seen several docs, my primary doc seems to think it's all in my head. One doc. told me there was nothing wrong with me and to go home and play with my kids. I have not even been referred to a GI doc.
I had a pelvic U/S which was normal. I've had a normal CT scan and normal bloodwork.
After a year, could something serious (fatal) be causing these pains? It comes and goes for weeks at a time.
I'm worried about ovarian cancer, haven't had a CA 125.
Does this sound like endometriosis or IBS?
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21 Comments Post a Comment
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Avatar_n_tn
I've been burping a lot too, and am bloated.
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Avatar_m_tn
When you say "bloodwork" I would think that is usually a standard CBC. One thing I would do is to check for a liver problem. You need to have your liver function tests done or AST and ALT enzyme levels tested. This is not always a normal part of a CBC so I would ask my doctor what my liver enzyme measurement was and have them tested to rule out a liver issue.
If that is fine and this persists, I'd work on diet and exercise and eliminate all processed/prepared foods and increase veggies and fruit and see if diet changes help. Id also avoid alcohol if you drink.

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Avatar_n_tn
I don't drink.  I had liver function tests done last January, right after the pain started.  They were normal.

The things I've been most concerned about lately are ovarian and colon cancer.  My symptoms seem to go along with those problems.  I've even gone to the emergency room once with rectal bleeding.  They diagnosed me with internal hemmorhoids. The heartburn/indigestion/burping  I've been having the last few days has also come with left-sided and chest pain.  Those things are indicitive of colon cancer. And the bloating, pelvic and back pain are seen in ovarian cancer.  I've also had abnormal stools -- ribbon shaped, after 8 straight days of diarrhea.  Thing is, I know these symptoms could be IBS, or the current recent symptoms could just be some intestinal bug.  I've just been to the doctors so many times within the last year, they think I'm a total hypochondriac.  But it's just because I have undiagnosed problems they are ignoring.
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Avatar_n_tn
Any previous pelvic surgeries or abdominal surgeries could have caused adhesions.  Do some research on adhesions and you'll be amazed at all the problems they cause.  This could explain the change in stool shape.  My Gastro told me he had a hard time getting the scope up probably because of adhesions pressing on my bowel. IBS is a very broad term used rather loosely at times when they can't explain the digestive symptoms.  I'm sorry you have been told it is in your head.  I personally know how that is very painful for someone to not have the compassion to try and understand your pain and fears.  I am going through the same ordeal.  Next month will mark a year of trying to solve this pain mystery.  Keep listening to signals.  CA125 is not a reliable screening test for OVCA.  There are women with normal range results who are diagnosed with stage 111 after surgical biopsy.  It's hard to tame the fear.  Do you have any history of urinary frequency or kidney problems.  Good Luck and my prayers for you to find answers and healing.
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Avatar_n_tn
Forgot to add that was the surgeon took out my gallbladder in June he discovered my liver covered with massive adhesions.  Asked my husband if I had been in a car wreck or something.  I complained to pain upon bending forward etc...in this area prior to surgery.  He dismissed adhesions saying he didn't believe they caused pain.  I had two prior c-sections, a laparotomy of ruptured ovararian cyst and peritonitis.  Hopefully I proved his adhesion theory was wrong and maybe he'll be sensitive to this in the future with others.  I had an MRI/MRCP in late OCT that picked up intrabdominal adhesions as well.
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Avatar_n_tn
I don't have urinary frequency or kidney probs.  I've been dealing with my undiagnosed pain for a year also.  Sometimes it's totally gone for weeks, other times, like tonight, it hurts and it even feels like my ribs are sore on the right.  My pelvic area hurts on the right, there's pressure in my abdomen on the right, and my flank, and even my hip hurt.  I can't imagine it to be IBS, but my CT scan showed nothing, and I don't know what else it could be.
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Avatar_n_tn
Can you self refer with your insurance?  I can't believe you haven't been sent to a Gastro for a colonscopy/endoscopy.  This appears the normal course for ruling out many serious disorders.  Many gyn's seem to send their patients this route first, which of course adds to the frustration if nothing is found and it is ovarian cyst, etc... related.  If you can, I recommend finding a good Gastro, perhaps at a reputable teaching hospital, if this is possible through your insurance.  I had a MRI/MRCP at Emory in Atlanta because my regular Gastro seemed to not be "listening" and wanted to simply prescribe IBS drugs which don't take the pain away.  I have lost 25 pounds since Oct.  My symptoms are worse with my cycle as well.  Next Tues. I'm having a trans/vag US, ordered by Urologist who found bilateral pelvic masses on a pelvic US in her office. I also have bilateral complex renal cysts which were found on the MRI.  Be persistent.  I had to wait a month for my appointment with the Gastro at Emory.  Godspeed to you.
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Avatar_n_tn
Have you talked to your GP recently about the bowel changes?  I'd call and explain your symptoms to the phone nurse and ask what in this wonderful world you need to do to get a referral to a Gastro?  Even ask if they can make the appointment for you to get you in sooner.  Don't be afraid to ask because the "squeaky wheel gets the grease" is my experience.  Say a simple prayer before you pick up the phone.  God listens and answers rather quickly sometimes.  I really share your frustration.  I know true hypochondriacs who get what they need because they are so demanding and violent tempered.  You can be assertive without being demanding.  Good Luck.
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Avatar_n_tn
No, I can't self-refer.  The type on insurance I have, every doctor is in the same building.  I can only go to my GP, or my OB-GYN without a referral.  Since I've already been seen for this problem, if I want to be seen again I have to wait weeks.
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Avatar_n_tn
I think you might have endo. I had alot of your same problems and felt like the doctors just thought I was wacked... but come to find out I was covered in endrometreosis. (missed spelled) When they went in she could not belive how much I had everywhere including my bladder and colon. I still have problems and they think it is still linked to endo. So you make want to go back to the Gyn. See if some of this pain doesn't happen around that time of the month. You haven't had a hysterectomy have you? If the Gyn can't help you he can refer you to a gastro. Hope this helps in some small way. I understand how frustrating it can be too.
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Avatar_n_tn
The gyn already said it may be endo, but he had no desire to refer me to a GI doc until I tried the Pill for several months to see if it helped the pain.  I'm nervous about the pill because I'm that magical age, 35!  But I've had irregular cycles since I went off the pill at 24, I had a lot of anovulatory cycles, to where I took Clomid to get pregnant the first time.  I know it sounds like I'm a prime target for endo.

The Gyn however didn't think my bowel changes were related to endo.  He said that it's VERY rare to have it on your bowels.  It's funny though because my cousin has been having bad rectal pains around ovulation, and even blood in her stool.  She had a colonoscopy, which was normal, and her doc thinks she has endo.  She wants her to have the lap surgery to determine it.  My Gyn says they don't do the lap surgery anymore to determine it, they try the pill instead.
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Avatar_n_tn
Tworm -- did your side actually hurt, like if felt like muscle or nerve, when you laid on it?  Mine does sometimes when the pain is bad or constant.
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Avatar_n_tn
I couldn't belive my eyes reading your post. I have been having exactly the same problems as you.

I've been experiencing pain, pressure in my upper right quadrant under and around the rib area. Sometimes it extends around to my back. My doc thought it might be my gallbladder but its not. I have had a burning feeling on in my lower back and flank. I also have pain in my abdomen. My pain comes and goes as well.

In June my bowels started up as well. I had diarreah (diarrhea) and after that calmed abnormal bowel movements. I have had indegestion and heartburn as well.

I had a colonscopy after the bowel problems and they did find ulcers in my colon, but they didn't find conclusive evidence of inflammatory bowel disease. Anyhow after a few months they put me on asacol and started treating me for IBD witch can be either ulcerative colitis or chrons.

After a while I started to get tired (extremly) after work. Usually after eating. I would be in a coma like situation for a hour or maybe even two. This symptom scared the sh... out of me and I haven't been able to accept that diagnose. Thats why I have been trying to find another cause. That and because of the pain in my URQ and becaue I don't totaly relate to the symptoms of Colitis.

Like you I've seen several doctors, and most of them think I am nuts for not accepting my vague diagnose.

Anyhow about a month ago I went to see a OBGYN, who found a chlamydia infection! I was totaly taken by surprise, since I haven't had unprotected sex since 2003! I did have a chlamydia infection in 2002 but was given meds for it and thought it had cleared up!

To make a long story a little shorter:

After alot of research I found that Chlamydia and a range of other bacteria (some are normal bacteria found in the intestines) can cause URQ, from Pelvic inflammatory disease that can cause perihepatitis also called Fitz-Hugh-Curtis Syndrome. ( http://www.emedicine.com/med/topic797.htm )

It can also cause reactive arthritis that explains my joint pain that started years before having any of the other symptoms.

I found a couple of articles about PID and colitis - and this one seems to have looked into it a bit.

http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1292456&pageindex=1#page

Anyhow, I am on meds at the moment hoping that it will take away some of my symptoms, but I have read that after having an infection for as long as I have it can take up to 1 year for the symptoms to leave, and I might not be able to get rid of all of them.

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Avatar_n_tn
Hi wonderingtoo,

I doubt a chlamydia infection would be dormant for that long a time, and I actually didnt mean to imply that you might have the same bacteria as me. PID (pelvic inflammatory disease) can be caused by a number of bacterias. Many of them are normal bowel flora bacteria or normal bacteria in your vagina.

There are also other causes of PID, such as surgery or even UTI's have been known to cause PID.

Hope things work out for you.

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Avatar_n_tn
I can't imagine I could have Chlymadia.  I've been married for 16 years!  And I've only every slept with my husband, although he had other partners before me.  What are the symptoms?  Could it be dormant without symptoms for that long?
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Avatar_n_tn
When the pain is there, it occasionally hurts a little in that area when I urinate.  I guess that seems to me like the bladder is pushing against something when I go.  What does that sound like?  Still endo or IBS?  I've had the pain this time for a couple of weeks straight, and am ready for it to go away!
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Avatar_n_tn
sounds to me like possible urinary tract infection, and possible back problems pressing on the nerves to these areas, see a chiropractor for subluation
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Avatar_n_tn
I had all the same symptoms, 1 year also.  Finally, after removal of an ovary, uterus.....they just did surgery to remove adhesions on my lower right flank.....tons of it....attached to my ureter, instestines.....I thought I was going crazy!   Adhesions do not show up on ANY test....I've had all of them, IVP, CT, Endo, Colon...every test you can imagine.   I could feel lumpiness in my right side....and it caused constant pain.   Doctor, after doctor.....so frustrating.   They just did the surgery and were amazed at the damage the adhesions were causing.   I have some on my left side but it was not in pain.   So definately check this!!   You will have to convince the Dr. to go in........it is the only way they can see it!!!
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Avatar_f_tn
So, I neverpost, but I guessitis my duty to pass it on, since alot of people online helped me after years of misery.  Longstory short I am 27and have had 5 procedures this year.  After being diagnosed with anxiety,IBS,bad posture, etc. I had a ap and stage 3-4 endo was found.  Endo can invade many areas of your body.  I just had mine excied from my bladder, ureter, uterus,bowel, etc.  I even had endo on the ligaments that circle around to my back.  In my last surgery to excise the endo this week the doctor found my liver covered in adhesions.  This explains my shortness of breath and pulling sensation.  I am still not sure of how we are proceeding with the liver issue since my doctor seemsto blame PID for that.  I have been in a long term monogmoous reltionship, so the STD explanation kinda baffles me.  Anyways, enough about me.  My main concern is that you know that gynos have ruined my life and completely misdiagnosed me for years.  Only recentlydid I refuse a Luporn shot and get the total excision surgery.  This is what you proably need.  Don't let your doctor prescribe pills when you know your body is not acting right.  The longer you wait the more damage you are doing to yourself.  You need to take charge and search out an endo specialist to diagnose you.
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I am astonished and relieved to have started reading these comments. I have been suffering for the past 5 years with symptoms a kin to many in this conversation and have always thought that there was something odd going on:

chronic abdo pain mid cycle, always right sided, goes in an arc from deep in pelvic area( near appendix; mine removed in 1986) extending to up under my ribs. Can't eat, exercise , even walk properly. Totally disrupts my bowel movements; hard mass etc as others have described, then post ovulation pain dissipates but then the trouble starts:

Serious mood swings kick in, body swells, retain water, bowels almost stop, get very down and depressed. Like a woman possessed; Total personality change, aggressive, sarcastic, nothing suits, feel the world is against me, loath my husband etc!!This can't be normal.

Once my period comes I go all withdrawn, almost on a come down presumably as my raging hormones readjust. Return to being a warm caring person. body snaps back to normal, pee for England, bowels go into overdrive and energy levels return. Sadly this only last about 10 days if I am lucky and then it starts all over again.

Confessed to my GP in 2008. My husband came with me and vouched for all the suffering and hell we all go through each month, GP put me on antidepressants to help with what she thought was PMS and IBS. It helps a bit.  Saw a Gynae too who listened to me as though I was making it all up and seemed to think it was utter nonsense. She did an ultra sound and internal exam and said no ovarian cysts and said symptoms were more of PMS or IBS, she suggested antidepressants as a relaxant to the bowel. I kept saying why all the pain on the right side mid cycle each month? no one mentioned or considered endometriosis. I am convinced that it is.

Only way I can make things better is by eating as little as possible, keeping as thin as poss hence lowering oestrogen and making symptoms less severe!!!

Constantly tired and sex drive non existant. This is no way to live. Dare not go bakc to the GP they just dont seem to care or listen. Get the feeling of well you seem to cope. I even requested that they do a hysterectomy, and was just dismissed. I have 2 gorgeous children and am 44.

If things carry on, doubt I will keep my long suffering husband and ruin our childrens lives as well as my own. What can I do to make my Drs take me seriously??

I haven't talked to them about it in years because I feel they just dont believe me and think I am making a fuss about nothing. I am sure it is endometriosis and would happily get rid of my uterus and tubes if it would help.

Any suggestions on how I can go forward?  yet still left to muddle on in silence. HELP PLEASE?!
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Avatar_m_tn
I've had these issues for 20 plus years and now it is just getting worse and worse.  I dug out my old records from my infertility days (blocked tubes) and laparoscopy and noticed Fitzy adhesions mentioned all over my liver.  I have to sleep with my right arm over my head and hang my right foot over foot board in order to "stretch" my right side. I have had every test also...and they always point to it just being IBS and over active muscles on my right side.  I am ready to insist on surgery...to clear up these adhesions....but can you tell me what you did and if you did indeed have sugery, did the adhesions grow back?  I haven't worn a belt in 25 years and the older I get the more it hurts.  thank goodness for ambien .  Romesmom!
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