Pain in the.... ?

October 13, 2007 7:34 PM

Abdominal Pain Filter: My girlfriend woke up last night with an excruiating stabbing pain throughout her lower abdomen. Thankfully, that's gone, but there is still a tender spot about 1 inch up from her belly button, and two inches to the right. I think it's too far up to be the appendix. What could it be?
posted by fvox13 to health (28 comments total)

I have no idea what it could be, but that is the area where the gallbladder is located, in case the two of you would like to explore that possibility further. There are tons of sites that give more info.
posted by iconomy at 7:43 PM on October 13, 2007

What could it be?

Something a doctor should look at.
posted by middleclasstool at 7:51 PM on October 13, 2007

probably gallbladder. get to a doctor.
posted by thinkingwoman at 7:53 PM on October 13, 2007

I would also check to see if it's a UTI.
posted by whoaali at 8:06 PM on October 13, 2007

My inclination would be to get thee to the ER to have them check things out - I was always told that in the case of appendicitis, it's when the pain stops that you need to start worrying, because that means the appendix has burst. But that may just be the alarmist perspective.
posted by jferg at 8:24 PM on October 13, 2007

jferg you are absolutely right about worrying when the pain stops. I kept waiting, hoping the pain would go away, and ended up being taken by ambulance for an emergency appendectomy for an appendix that was close to rupturing.

fvox13, that pain is right in the area that mine was - I had a nurse friend tell me that any abdominal pain should be evaluated by a doctor, so I would strongly suggest that.
posted by la petite marie at 9:07 PM on October 13, 2007

Gall bladder. Go to ER, or at least to a doctor. Do not eat any kind of fat whatsoever if you don't want the pain to come back.

Diagnosis will be by an ultrasound scan and vigorous poking of the tender spot. Try not to be fobbed off with blood tests.
posted by nowonmai at 9:10 PM on October 13, 2007

Referred pain.

A professional, as suggested, is the best course.
posted by Matt Oneiros at 9:27 PM on October 13, 2007

Doctor. NOW. These are not symptoms you trifle with.
posted by azpenguin at 9:33 PM on October 13, 2007

What could it be?

An excellent reason to go to a doctor immediately.

I had this exact symptom. In the following weeks we investigated the gall bladder, my liver, and the possibility of bowel cancer. It could be any of those things, or something else, maybe worse. Do not be messing about asking random strangers on the internet what it might be: take your GF to the doctor as soon as you possibly can.

PS: it was my gall bladder. The pain does not always go away; the gall bladder can get infected or the bile duct can get blocked; very bad things indeed can happen. Do not mess about.
posted by i_am_joe's_spleen at 9:48 PM on October 13, 2007

Definitely get this checked out right away. It could be serious, but she might get off relatively easy: I had the same thing happen (stabbing pain that went away, leaving only a dull throb in the middle of the abdomen) and went to the ER after a week. Turns out eating copious amounts of oatmeal without enough water will fill your colon with mighty amounts of immobile stool. Embarrassing, maybe, but considering the other things it could've been, I'm happy I got it checked out and taken care of (yum, magnesium citrate!).
posted by greatgefilte at 10:26 PM on October 13, 2007

My sister and I both had experiences where we woke up with a horrible, agonizing pain in that area. (I've never felt that much pain before...I thought my appendix had burst and that I'd be dead on the floor by the time anyone came home from work and found me, since I couldn't even move to the phone.)

My sister went to the hospital where they diagnosed an inflamed liver, but a second (far more extensive) opinion said that wasn't the case. It's still a mystery. Thus, I am bookmarking this thread, and requesting that you please post a follow-up once you've figured it out...maybe it can help us in the future.
posted by lhall at 10:48 PM on October 13, 2007

Also it seemed to happen mostly during times of extreme stress, in both our cases. Is your girlfriend going through anything serious?
posted by lhall at 10:50 PM on October 13, 2007

While going the doctor is always good advice, it often turns out that the pain has gone away (and thus is difficult to describe accurately) by the time you see a doctor, especially if you are in an emergency room in the middle of the night.

What helped my wife and I diagnose her middle of the night bouts of pain was the WebMD SymptomChecker.
Basically, we sat up one morning at 3am and went through the symptom checker questions (where does it hurt, etc.) and it came back with gallstones. As it turns out, she had just about every symptom on the gallstone checklist.
She took the printout to her doctor, showed her the list of symptoms and said "It hurts like this".
One radioactive tracer later and she was booked for surgery the next week. It's been over 2 years without any pain.

I should note that she'd been to 3 emergency rooms in two states with the same pain but, as I said, by the time you are seen (especially with gallstones) the attack has subsided. Since there was no bleeding or swelling, they'd hand her a few pills and send her on her way.

Of course, by the time we did the WebMD thing, she was somewhat jaded as doubling over in pain was a regular occurrence, but still, it would probably be very helpful to when you do see an actual doctor.
posted by madajb at 10:56 PM on October 13, 2007

1) Doctor.

2) Nthing gallbladder.
posted by Justinian at 11:18 PM on October 13, 2007

I'm seconding/thirding/fourthing/whatever the gallbladder. But I'm surprised nobody has mentioned intestinal gas. It does sound funny, but there is strong overlap between appendicitis and gas, and differentiating the two is something that ER physicians routinely have to do.
posted by rolypolyman at 1:02 AM on October 14, 2007

There's like twenty things it could be, but over half of them require medical attention from a professional.
posted by BrotherCaine at 3:28 AM on October 14, 2007

If she's getting discomfort between/across her shoulder blades, then it's definitely the gallbladder.

madajb said: "I should note that she'd been to 3 emergency rooms in two states with the same pain but, as I said, by the time you are seen (especially with gallstones) the attack has subsided. Since there was no bleeding or swelling, they'd hand her a few pills and send her on her way."

This was my experience. It took three months of increasingly painful attacks (and trust me, they can get really bad and cripple your life) for me to just get diagnosed. And then, because it's not life threatening, it's very easy for them to place you as a low priority (which is understandable) instead of just sending you over to have an operation that requires a 24 hour maximum stay in hospital for an operation to remove the sucker.

"The pain does not always go away; the gall bladder can get infected or the bile duct can get blocked; very bad things indeed can happen. Do not mess about."

I ended up with a blocked bile duct and peritonitis, attacks that lasted over 8 hours, more than 50lbs of weightloss (I was overweight to begin with, so that wasn't exactly a terrible thing), a stash of painkillers that didn't work and in the last week I couldn't eat anything, not even dry toast, without vomiting. My mum told me that she thought I was going to die. I always tell people who have a sick gallbladder to get it out, and get it out ASAP. It's too useless to keep around to cause so much hassle.

Having said that, I hope it's not her gallbladder, I wouldn't wish that on anyone. If it is, apple juice will help in the meantime.
posted by saturnine at 5:29 AM on October 14, 2007

med student: I'm claiming McBurney's point--like you said, up and to the right form the umbilicus--I'm claiming appendix, esp w/the history. Let us know what it ends up being!!
posted by uncballzer at 6:29 AM on October 14, 2007

Here's an article on the differential diagnosis of abdominal pain. It's, appropriately, a huge pain.

For a handy summary, scroll down to the image
posted by a robot made out of meat at 7:13 AM on October 14, 2007 [2 favorites]

My vote for gallbladder -- same thing happened to me... On the third occasion I went to the hospital and eventually had it removed. One caveat: X-rays didn't reveal the problem in my case... it took ultrasound.
posted by AJaffe at 9:51 AM on October 14, 2007

Stabbing pain in the abdomen always equals doctor visit. Period. The serious stuff it could be is serious enough that you do not want to mess around.
posted by jennyjenny at 1:00 PM on October 14, 2007

Sure does sound like the gallbladder to me. But as someone who is at this very moment recovering from having an appendix removed, I will add my voice to the chorus that says "just go in and get it checked out. Be safe."

I did know someone without medical insurance who lived with ongoing gallbladder problems for years. She just avoided certain foods to avoid flare-ups. But, having lived through that pain myself (I had the gallbladder out a long time ago) I really don't recommend that if at all possible. And, reading saturnine's post, I really really don't recommend it.
posted by litlnemo at 1:23 PM on October 14, 2007

I had several bouts of severe abominal pain that subsided over the course of some hours. One was bad enough and long enough to send me to the ER, where the pain went away while I was in the waiting room, and I went home. So when the same pain turned up one night last spring I figured I'd wait it out. (I also self-diagnosed using the internet and figured it was ulcers.) After about 15 hours of gradually increasing agony I went back to that same ER, was diagnosed with appendicitis and had surgery; the resident said it was the ugliest appendix she'd ever seen, gangrenous but not burst.

Afterward I learned from the surgeon that there is some evidence for chronic appendicitis, i.e., the appendix flares up temporarily, causing pain, and then subsides. But because abdominal pain is so problematic to diagnose no one's certain that the condition exists.
posted by stargell at 2:09 PM on October 14, 2007

What was it?
posted by ikkyu2 at 3:07 PM on October 14, 2007

gall bladder for sure, my wife had the same symptoms, pain, only at night after dinner - avoid fatty foods, and go get an ultrsound.
posted by robotot at 7:07 PM on October 14, 2007

It totally sounds like gallbladder -- the middle-of-the-night thing is typical, as is the location. I had gallbladder surgery just about two weeks ago. Hope that your girlfriend has been to the doctor by now -- my attacks were more painful and lasted longer every night for four days. Feel free to e-mail me if it's gallbladder and she wants the lowdown on the surgery.
posted by desuetude at 6:54 AM on October 15, 2007

Ruptured cyst on the ovary? I had one. Which can or can not be serious, depending. She obviously needs to be checked out.
posted by agregoli at 11:13 AM on October 15, 2007