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Persistent Abdominal Pain of unknown origin
I've had persistent abdominal pain since Mid July. It started quite suddenly with an event/attack severe enough to cause me to end up on the floor, I may have passed out I don't know. I just remember my husband finding me on the floor curled up in the fetal position, and having super severe abdominal pain. The pain passed after 20 mins or so, felt like forever, and I thought all was good, but I was wrong. I began to have intermittent mild attacks, all in the same spot of my Right upper quadrant with nausea/vomiting, and over the course of the next 2 weeks they increased in severity until I couldn't stand it anymore and went to Urgent Care (I am still waiting to establish care with a new Primary care provider), I was diagnosed with a UTI, possible kidney infection and prescribed antibiotics.
Ten days later I finish my antibiotics, and all is seeming somewhat better. I'm still having mild pain, but not too bad, then about 4 days later, boom, back to square one and urgent care. Now they are thinking it is my gallbladder. I'm scheduled for an abdominal ultrasound (external & internal), the day after I see the Dr. in urgent care, I'm at work and in so much pain that the urgent care nurse sends me to the ER. They do the ultra sound there, can't find a thing wrong. Everything looks 'normal.' I'm given a shot of Toradol and sent home with a referall to a Gastroenterologist.
I get a call, and am scheduled for a HIDA scan prior to seeing the GI Dr. My HIDA scan is normal (90th Percentile), although about 3 min after I am given the CCK, I have a severe attack of pain. I wait a month to see the GI Dr. Three weeks prior to my appt with the GI Dr., I start to have more pain, increased nausea, and severe constipation. I'm prescribed Zofran for the nausea, to be taken every 8 hrs, which seemed to help some with the nausea. Two weeks prior to the appointment I start having trace amts of blood and mucus in my stool, and am told to monitor it, if it gets to be more than a tablespoon go to ER, otherwise wait to see the GI dr. Finally get to see the GI dr, he pushes on my stomach a little bit after taking a history. He seems puzzled by my sensativity and orders the Colonoscopy and EGD.
Yesterday was my colonoscopy and EGD, and the prep for the colonoscopy kicked my butt. I will NEVER take the Nulytely solution again. I probably only kept half of it down, didn't get any sleep the night before due to constant vomiting & diarreah. The day of the test wasn't so bad just prior, but coming out of the ansethesia was not very fun. I was having super severe gas pains, and having a hard time releasing the gas, infact I'm still having gas issues 32 hrs later. Yesterday, as I'm lying in the recovery area, fighting to come out of the anesthesia, having a hard time of it, my first clear memory is of him grousing about wanting to leave, that he was sick of waiting. I really shouldn't have left, but he talked the nurse into it, and me as well. It's done and there's nothing I can do about it now, except remember not to ask him next time, but call my Mom or Sister. (Pity party whine vent over). They took several biopsies from my esophogas, stomach, and duodenum, but they all came back non-remarkable, and benign.
So now the next step is an Upper GI series (X-ray/flouroscopy). Hopefully this test will yield some information and help my Dr. come up with a diagnosis. I was sent home from work early today because I just about passed out, and the Dr that cleared me to drive myself home said I don't belong at work for atleast today and tomorrow. Possibly longer depending on if I can get the nausea under control enough to eat & drink (I haven't had anything but a few sips since I did the prep on sunday).
At this point, I'm not sure where to go, or what might be going on. I'm sick of being sick, and am getting scared it might cost me my job.
If anyone has any input, give me ideas on what this might be, or can help in any way, please do. Even if it is sharing your own experiences that are similar, I'm at my wits end with this stomach ache.
Ten days later I finish my antibiotics, and all is seeming somewhat better. I'm still having mild pain, but not too bad, then about 4 days later, boom, back to square one and urgent care. Now they are thinking it is my gallbladder. I'm scheduled for an abdominal ultrasound (external & internal), the day after I see the Dr. in urgent care, I'm at work and in so much pain that the urgent care nurse sends me to the ER. They do the ultra sound there, can't find a thing wrong. Everything looks 'normal.' I'm given a shot of Toradol and sent home with a referall to a Gastroenterologist.
I get a call, and am scheduled for a HIDA scan prior to seeing the GI Dr. My HIDA scan is normal (90th Percentile), although about 3 min after I am given the CCK, I have a severe attack of pain. I wait a month to see the GI Dr. Three weeks prior to my appt with the GI Dr., I start to have more pain, increased nausea, and severe constipation. I'm prescribed Zofran for the nausea, to be taken every 8 hrs, which seemed to help some with the nausea. Two weeks prior to the appointment I start having trace amts of blood and mucus in my stool, and am told to monitor it, if it gets to be more than a tablespoon go to ER, otherwise wait to see the GI dr. Finally get to see the GI dr, he pushes on my stomach a little bit after taking a history. He seems puzzled by my sensativity and orders the Colonoscopy and EGD.
Yesterday was my colonoscopy and EGD, and the prep for the colonoscopy kicked my butt. I will NEVER take the Nulytely solution again. I probably only kept half of it down, didn't get any sleep the night before due to constant vomiting & diarreah. The day of the test wasn't so bad just prior, but coming out of the ansethesia was not very fun. I was having super severe gas pains, and having a hard time releasing the gas, infact I'm still having gas issues 32 hrs later. Yesterday, as I'm lying in the recovery area, fighting to come out of the anesthesia, having a hard time of it, my first clear memory is of him grousing about wanting to leave, that he was sick of waiting. I really shouldn't have left, but he talked the nurse into it, and me as well. It's done and there's nothing I can do about it now, except remember not to ask him next time, but call my Mom or Sister. (Pity party whine vent over). They took several biopsies from my esophogas, stomach, and duodenum, but they all came back non-remarkable, and benign.
So now the next step is an Upper GI series (X-ray/flouroscopy). Hopefully this test will yield some information and help my Dr. come up with a diagnosis. I was sent home from work early today because I just about passed out, and the Dr that cleared me to drive myself home said I don't belong at work for atleast today and tomorrow. Possibly longer depending on if I can get the nausea under control enough to eat & drink (I haven't had anything but a few sips since I did the prep on sunday).
At this point, I'm not sure where to go, or what might be going on. I'm sick of being sick, and am getting scared it might cost me my job.
If anyone has any input, give me ideas on what this might be, or can help in any way, please do. Even if it is sharing your own experiences that are similar, I'm at my wits end with this stomach ache.
It just goes to show you that taking pictures from the outside isn't a fool-proof way of ruling out a problem on the inside! I'm so glad you gott the surgery you needed!
Thanks to all for posting their advice. I did have my ferritin/TIBC/iron checked, and it came out ok. I ended up being admitted for dehydration and abdominal pain on 9/30. On 10/1 the surgeon decided to repeat my ultrasound, and it was a good thing he did. My gallbladder was chock full of stones and sludge. So he scheduled me for surgery 10/2 first thing in the am, and removed my gallbladder. So now I'm hoping that once I'm healed that should take care of the nausea and abdominal pain.
Were the biopsies all to test for H. pylori or were any of them for other reasons?
I hope you ask for iron testing. I have had low iron in the past with a normal CBC, but the normal CBC didn't keep me from having iron deficient symptoms in my opinion. Particularly after you nearly passed out recently, I hope the doctor will order ferritin and blood iron testing for you ASAP!
Maybe you could go for an appointment specifically about your genitourinary system to try to force the doctor to address your concerns with ordering testing or at least referring you, but if your doctor chooses not to, maybe it's time to choose a new primary care physician. Frequent urination though it is dark sounds abnormal to me! Has your doctor at least run kidney function blood tests recently? How's your blood salt level? And with your low blood pressure- has anyone considered Addison's disease? Has anybody done an echocardiogram to check how your heart is functioning with your low blood pressure?
A lot of your symptoms even sound like you might fit right in to our dysautonomia group on medhelp's community forum! You might try a post over there and see if you don't get some responses about similar symptoms going on.
http://www.medhelp.org/forums/Dysautonomia-Autonomic-Dysfunction/show/266?page=1
Zofran was what they were going to prescribe for me as well, but I told them I had phenergan at home and that it worked better for nausea for me (I get migraines) than Zofran and the nurse was fine with that. Sounds like your a nurse- so you know it's so important to get adequate fluid intake- if you can hold in even little sips of lemon water (lemon for nausea), it's time to check in for a doctor to prescribe IV fluids, if they feel it's in order, since with your dark urine and nearly passing out, etc., it sounds like that really may be!
I hope you ask for iron testing. I have had low iron in the past with a normal CBC, but the normal CBC didn't keep me from having iron deficient symptoms in my opinion. Particularly after you nearly passed out recently, I hope the doctor will order ferritin and blood iron testing for you ASAP!
Maybe you could go for an appointment specifically about your genitourinary system to try to force the doctor to address your concerns with ordering testing or at least referring you, but if your doctor chooses not to, maybe it's time to choose a new primary care physician. Frequent urination though it is dark sounds abnormal to me! Has your doctor at least run kidney function blood tests recently? How's your blood salt level? And with your low blood pressure- has anyone considered Addison's disease? Has anybody done an echocardiogram to check how your heart is functioning with your low blood pressure?
A lot of your symptoms even sound like you might fit right in to our dysautonomia group on medhelp's community forum! You might try a post over there and see if you don't get some responses about similar symptoms going on.
http://www.medhelp.org/forums/Dysautonomia-Autonomic-Dysfunction/show/266?page=1
Zofran was what they were going to prescribe for me as well, but I told them I had phenergan at home and that it worked better for nausea for me (I get migraines) than Zofran and the nurse was fine with that. Sounds like your a nurse- so you know it's so important to get adequate fluid intake- if you can hold in even little sips of lemon water (lemon for nausea), it's time to check in for a doctor to prescribe IV fluids, if they feel it's in order, since with your dark urine and nearly passing out, etc., it sounds like that really may be!
So I've called out of work again today. Since I can't see the GI doc that did the procedures, I'm seeing someone else. I have been off work for 2.5 days now and the EGD/Colonoscopy have proven to be more trouble than they were worth. They seem to have made everything worse (or the prep did), and I just keep getting told to push fluids. Well that doesn't work if you can't keep 'em down. Hopefully this new doc can do something to help me. I hate switching docs/seeing someone else in the middle of something, but I've little choice. Atleast I could work before, now I can't, too worried about passing out while taking care of one of my patients.
Do you know how x-ray/fluoroscopy might reveal Crohn's better than the direct visualization they've already done? No I don't know what the rationale is behind this next test, just date and time to report for it. I had a very hard time coming out of anesthesia, infact I don't remember anything but little snippets of the entire day. My husband was of little help on remembering/asking questions.
Did they see no sign of endometriosis in the bowels (which can cause bleeding)? My bowels were clear, and the biopsies they took showed nothing. The pictures that I have from the EGD look good, tissues look healthy.
Did they check your ferritin (iron stores) after you noticed blood in your stool? The only blood work that has been run since I noticed blood in my stool was a CBC & BMP. The BMP was run at my insistence yesterday after I just about passed out at work. They have not done any iron studies.
Since you had an infection of the urinary tract when all this started and possibly a kidney infection, did they do any further diagnostic testing regarding your genitourinary system? No further examination of my genitourinary system has been performed since the infection despite my complaints of continued dark urine & frequency.
They include taking an anti-nausea medication prior to the co-lytely, a welcome change from previous colonscopy preps, I think! The anti-nausea med doesn't help (for me) with the co-lytely/nulytely/golytely. That was the prep that I had and it made me violently ill. I didn't get to sleep at all the night before the procedure because I was in the bathroom with either diarrhea or vomiting despite taking zofran.
I've spent today basically bedridden, unable to eat or drink due to nausea. I've passed out once, my bp last check was 82/46 and glucose 68. both low, but I just get told to try and eat/drink and the nausea will pass eventually. I can't function at work like this (I'm in healthcare), and am just sick of being sick.
Did they see no sign of endometriosis in the bowels (which can cause bleeding)? My bowels were clear, and the biopsies they took showed nothing. The pictures that I have from the EGD look good, tissues look healthy.
Did they check your ferritin (iron stores) after you noticed blood in your stool? The only blood work that has been run since I noticed blood in my stool was a CBC & BMP. The BMP was run at my insistence yesterday after I just about passed out at work. They have not done any iron studies.
Since you had an infection of the urinary tract when all this started and possibly a kidney infection, did they do any further diagnostic testing regarding your genitourinary system? No further examination of my genitourinary system has been performed since the infection despite my complaints of continued dark urine & frequency.
They include taking an anti-nausea medication prior to the co-lytely, a welcome change from previous colonscopy preps, I think! The anti-nausea med doesn't help (for me) with the co-lytely/nulytely/golytely. That was the prep that I had and it made me violently ill. I didn't get to sleep at all the night before the procedure because I was in the bathroom with either diarrhea or vomiting despite taking zofran.
I've spent today basically bedridden, unable to eat or drink due to nausea. I've passed out once, my bp last check was 82/46 and glucose 68. both low, but I just get told to try and eat/drink and the nausea will pass eventually. I can't function at work like this (I'm in healthcare), and am just sick of being sick.
You mentioned they did an EGD, which was where they looked at your upper GI system. I think I recall reading/hearing lately that Crohn's is hard to diagnose. Do you know how x-ray/fluoroscopy might reveal Crohn's better than the direct visualization they've already done? Did they see no sign of endometriosis in the bowels (which can cause bleeding)? Did they check your ferritin (iron stores) after you noticed blood in your stool? I have been fighting with dropping ferritin myself, presumedly owing to GI bleeding.
Since you had an infection of the urinary tract when all this started and possibly a kidney infection, did they do any further diagnostic testing regarding your genitourinary system?
Have they checked your musculoskeletal system in the area to rule out costochondritis? I had a painful problem myself in the upper right quadrant and it even made me nauseated. Doctors thought might be gallbladder or liver (so did I), but after those were ruled out, a doctor discovered the costochondritis.
Also, gas can be very painful and, because of my own situation, I discovered that the transverse colon is a common place for gas pockets to collect. Irritable bowel syndrome (which I was diagnosed with as a teen) can cause gas, constipation, diarrhea and in some even vomitting.
It would be nice if they could locate the source of your bleeding. All they found in me last year was mild esophagitis and gastritis in the EGD and with the colonoscopy, a small internal hemorrhoid . I'm scheduled for another colonoscopy this year after having had that one last year, which was followed by barium enema since prep didn't go well for the colonoscopy. I got those after occult blood stool testing came back positive times three.
This year's colonoscopy is scheduled because another, different office is where I'm being seen now and because of dropping ferritin and continued occasional signs of blood. They include taking an anti-nausea medication prior to the co-lytely, a welcome change from previous colonscopy preps, I think!
Since you had an infection of the urinary tract when all this started and possibly a kidney infection, did they do any further diagnostic testing regarding your genitourinary system?
Have they checked your musculoskeletal system in the area to rule out costochondritis? I had a painful problem myself in the upper right quadrant and it even made me nauseated. Doctors thought might be gallbladder or liver (so did I), but after those were ruled out, a doctor discovered the costochondritis.
Also, gas can be very painful and, because of my own situation, I discovered that the transverse colon is a common place for gas pockets to collect. Irritable bowel syndrome (which I was diagnosed with as a teen) can cause gas, constipation, diarrhea and in some even vomitting.
It would be nice if they could locate the source of your bleeding. All they found in me last year was mild esophagitis and gastritis in the EGD and with the colonoscopy, a small internal hemorrhoid . I'm scheduled for another colonoscopy this year after having had that one last year, which was followed by barium enema since prep didn't go well for the colonoscopy. I got those after occult blood stool testing came back positive times three.
This year's colonoscopy is scheduled because another, different office is where I'm being seen now and because of dropping ferritin and continued occasional signs of blood. They include taking an anti-nausea medication prior to the co-lytely, a welcome change from previous colonscopy preps, I think!
I'm due for an upper GI series in a few days, but as far as my Dr is concerned IBS is way down on the suspect list. Crohns is a possibility, hence the upper GI. Gallbladder is still a possibility, but further down on the list much like IBS.
I'm sorry to say I dont know much about it, but I do have a friend with IBS, irritble bowel syndrome, and I have another friend with Chrones disease. Have you been tested for either of those? I was thinking gall stones, as that is very much what it sounds like, but you've explored that avenue already. I hope you get some help with this soon :(
I'm negative for all forms of hepatitis, abdominal ultrasound & CT were both clear. No stool cultures have been performed because of the severity of constipation, stools are too hard to perform testing
I don't have much knowledge of intestinal problems, if that is what is yours. I did have a friend who had diverticulosis, but actually your symptoms are more severe than hers were. Since you said you were having nausea and on the floor with so much pain. Maybe you should get checked for Hepatitis A, B, C and D or Polycystic Kidney Disease (you would see the cysts on an Abdominal ultrasound or CT). Maybe you should do a stool culture to check for organisms. Hope you feel better soon, it sounds really uncomfortable =(
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