8 months of Pain with findings but no answers

[KCBUTCH]

Dear Dr.
for 8 months ongoing pain in stomach/very specific areas.  Directly at naval( a constant ache when palpatated brings me to tears so severe) - The same for area directly to left of my naval if facing me/ from naval it radiates up to very painful point  at my diaphram which has led me to not even be able to tolerate wearing a bra.  I have had upper GI w/ small bowel follow-thru, Colonoscopy, Endoscopy, CT ab/pelvis, H-Pylori test and Ultrasound.  My Upper GI showed ab mucosa in mid-jejunum and fat in the intestine as well as inflammation,( it took 3.5 hrs for the chalky fluid to follow-thru for the xray to be done)
  My Endoscopy showed Edema, inflammation and patches of red irritating tissue.  My Glidian anti-body came up low positive for celiac but the biopsy came up neg.  have had 4 laperoscopies (naval/to the right were entry and exit points)  a full hysterectomy leaving one overy on left/appendectomy.  GI dismissed me to go see a surgeon to consider adhesions being the source of my pain. >H.Pylori neg. also
>>>I have had severe low blood pressure symptoms which get worse when the pain is worse.
Meaning I get very dizzy and go black often upon standing, leaning up, standing from leaning or crouched position.
Even just leaning over a tall table to fully upright I get dizzy.<<< pain the feels like a burning/ache. and is very sharp when touched.  If touched I get worsening pain that radiates to all areas for hours.  I am always distended worse after eating.  By the end of the day I look 4-5 months along i am so swollen
If I lie down flat the pain increases especially if I lie on my sides. Needless to say I have done neither. I sleep propped up.   My bowels have either been none or soft and several x's aday  
My question is -could lysis surgery really be the answer?  Or should I follow-up with another GI? Could adhesions really be the cause?

[Kevin Pho, MD]

You have had a comprehensive evaluation for your symptoms, and I agree with the diagnostic course thus far.

Adhesions may have been seen on the CT scan, and the surgeon is indeed the correct consultant to see.  Conservative measures are normally tried first before considering lysis surgery, and a low-residue diet would be an appropriate first measure if adhesions are suspected.

Otherwise, if you continue want to pursue a GI route, a 24-hr pH study and esophageal manometry would be the next, more specialized, tests to consider.  GERD and an esophageal motility disorder would be excluded with these tests respectively.  

These options can be discussed with your personal physician.

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 Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd

[bachcha]

My dad takes Advil he found it works for him I may need it myself soon.


www.shopeastwest.com/med

[KCBUTCH]

Thank you for answering my question so quickly.  I think my GI I saw was quite short with me and having even a vague second opinion helps me realize I need to pursue all areas.
I can say I feel like They're so busy looking for horses and My tummy might be a Zebra if you catch my drift.