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What do you think is the most likely cause of undiagnosed severe abdominal pain?

60 yr old white male
Severe lower-right abdominal pain with metallic taste, no fever, no nausea. Everything to do with urination is normal. Painful to the touch
I've had all the tests, CT, MRI, gall bladder tests, blood tests, etc. All normal
Possible clues:
• When I have the pain I have a strong metallic taste in my mouth. Strangely, when the pain goes away, the metallic taste goes away
• I also get the metallic taste if I massage or press on the muscles/tissues in my legs, arms, etc. The metallic taste stops when I stop pressing. From what I've read, this sounds like "waste" products in the blood to me. Doctors don't agree, but don't know what it is
• Pain is in a very specific spot in the lower-right, but makes the whole area around it feel irritated or inflamed, down my right leg, under pelvis
• When I lay on my left side, the pain decreases
• Sometimes, but not always, when I see the physical therapist she can relieve a lot of the pain, but not the pain on the inside
• After many doctors they don't have an answer. I'm looking for someone's best guess at what this most likely is and how it might be treated to suggest to the doctors to see if they agree. I don't have anything to relieve the pain and I'm out of ideas. I've tried amitriptyline and it doesn't help at all, as all the doctors expected it would
• Other conditions I do have: type 2 diabetes with very low A1C 5.1%, coronary artery disease and stent, severe fatty liver
• Consistently normal blood tests for many years
I am extremely grateful for your suggestions.
Thank you.
1 Responses
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134578 tn?1716963197
Chronic low-grade problem with your appendix? Chronic low-grade problem with kidney? Complication of your fatty liver? Have all those been checked?
Helpful - 0
Thank you, I have asked about each of these and every doctor has dismissed them without even discussing them with me. They say the appendix is fine on the CT. The kidney blood tests are normal. Fatty liver doesn't cause symptoms. It's very frustrating.
It sounds like me when I had appendicitis. It wasn't acute, it was longstanding and ached. Have you been on a course of antibiotics for anything else, in the meantime?
I'd ask for a blood test for white cells, to see if you're carrying an infection. If you aren't, I'd suspect one of your internal bits in that area is malfunctioning but in a slower way than they would ordinarily see, so standard tests aren't picking it up. Try an internal-medicine doctor and maybe try an MRI of the abdomen. It's the gold standard.

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