Diverticulitis Misdiagnosis? Any Idea What This Is?

[tomzilla]

Hello Doctor Pho.

Here's a timeline of attacks of pain that have been diagnosed as diverticulitis. Treatment not working. Wondering if misdiagnosed. Any alternative diagnoses, suggestions?

1. 6 months ago
Had attack of acute of pain in lower right abdomen. Thought it was a very bad gas cramp. Pain subsided in about 2 hours. Did not see doctor.

2. Dec 15/08
Had attack of acute pain in lower right abdomen. Pain was severe. I felt nauseated, double over unable to stand.  Lasted for an hour. I was left with a radiating ache in right abdomen down to my groin on right side.

3. Dec 16/08
Had attack of acute pain in lower right abdomen. Went to hospital emerg. They do tests: blood, urine, CT, X-Rays. They suspect kidney stones. No stones found. The doctor at hospital emerg says the kidney looks somewhat inflamed in CT as if it may have recently been infected or is newly infected, suggests I tell my doctor that CT reveals the diverticulae in my left abdomen (which she finds curious and worth noting though the pain is in my right side).

The ache is such that it is uncomfortable to lay on my stomach, wear a belt or lean over. I went to my doctor who suggested I had diverticulitis. He didn't think there was any sign of appendicitis, tests didn't reveal kidney stones. I  was given a course of antibiotics on 3 different occasions: Cipro, Penicilin, and Sulpha-something-or-other. The pain did not subside. Still that dull ache in abdomen down to groin on r side.

This past weekend, I had a bout of gastroenteritis: vomiting, diarrhea, fever. Still have that ache in right abdomen.

Incidentally, over the past two years, I've also had attacks of pain in the anal area, an intense ache that radiates down to my right foot. My doctor has suggested that pain is prostatitis and prescribed antibiotics on those occassions. In two years, I’ve had a half dozen of those attacks. I mention this other issue only because it seems similar.

Thanks,

Tomzilla.

[Kevin Pho, MD]

Diverticulitis typically presents on the left, not right side.  That said, I agree with the CT scan.  If diverticulitis was present, it would have been seen there.

Indeed, kidney stones are a possibility, along with problems with the appendix, irritable bowel syndrome or inflammatory bowel disease.

A colonoscopy would be the next test to consider, as well as a small bowel series.

If prostatitis is suspected, a prostate massage, and subsequent analysis and culture of the prostatic fluid, would be the next step.

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

[tomzilla]

Thanks, Doctor Pho. I'll take these next steps.

Tomzilla