Mystery abdominal pain
June 1, 2011 2:04 PM   Subscribe

(Warning - graphic details about my GI tract inside!)

Hello Metafilter,

I cannot believe I'm using my question for one of these things that will (rightly) just get a lot of responses to go to a doc. But here I go.

I should preface by saying that I have had stomach issues since birth (literally - as a newborn, I had blood in my stool and puzzled doctors before they figured out what was wrong). My stomach acts up whenever I am hungry full, happy, sad, and especially stressed and anxious. Constipation, diarrhea, etc. etc. This is the norm for me.

For about the last month, I have had a strange nagging pelvic pain. It's definitely related somehow to my menstrual cycle, as it's located around my uterus and really flared up during ovulation and during my PMS. However, it still hasn't gone away now that I've started my period and my normal menstrual cramps have passed. Furthermore, this whole month I have also had some rather, er, loose stools - no matter what I eat, I seem to be either constipated or have diarrhea. My diet hasn't changed significantly. Finally, just a few days ago, I had some blood and, er, mucus (sorryyy) in my stool, which didn't freak me out because I do have hemorrhoids occasionally. But I know I probably ought to get it checked out, especially because I still have this pain and this is a pretty long time for it to be going on.

The pain is not particularly sharp, and I have had it off and on for about six weeks, so it seems like it is probably not something like appendicitis (and no rebound tenderness, as I've discovered by poking myself incessantly). I had an ovarian cyst once and that was MUCH more acutely painful - I was writhing in pain and unable to get comfortable. It also really feels much lower than my appendix - pelvic area, sometimes radiating down to my lower back. I am normally totally prepared to chalk everything up to my looming anxiety - I am about to leave my job and city to begin grad school and live closer to my SO, so all of the change would certainly do a number on my system. But it sort of worries me that it has lasted this long and doesn't really seem to be getting any better. (Plus, um, would anxiety cause blood in my stool?)

I am trying to get a referral to a GI and get an appointment ASAP, so I promise I will get a professional medical opinion, but I wanted to see if this collection of symptoms rang a bell with anyone. (Crohn's? Celiac? Cancer? etc.) I am so used to being told that all of these things are in my head, so any tips for how to approach the doc and avoid such a brush-off, if possible, would also be appreciated.

Thanks, y'all, as always.
posted by bookgirl18 to Health & Fitness (20 answers total) 3 users marked this as a favorite
The only thing that people will be able to do for you here is give you possibilities that may get you thinking about things you shouldn't worry about. Let your doctor do that for you; they'll be infinitely more qualified.
posted by ZaneJ. at 2:07 PM on June 1, 2011

Gall bladder? I also had stomach issues from birth. Saw so many doctors I can't even count them all. When I was 22 my gall bladder almost burst just a few weeks after seeing the last round of doctors who told me my symptoms were caused by stress. They were very apologetic in the recovery room, telling me they never checked my gall bladder due to my age and otherwise healthy condition. The problem was found with an ultrasound.
posted by raisingsand at 2:11 PM on June 1, 2011

The only potentially useful thing I can tell you is to keep a diary of symptoms, food, elimination, menstrual cycle, and circumstances. That way you'll have probably a couple of months of data by the time you get in to see a specialist.

Real information will (okay, should) get you taken more seriously. It just carries more weight to say "the pain increased sharply two days before my period started" than to try to remember six weeks later what the circumstances around any particular incident were. It's also a lot harder to blow you off if you have everything written down.
posted by Lyn Never at 2:18 PM on June 1, 2011

Have you contacted your primary care physician about this? Abdominal pain can be a whole bunch of things both GI and totally not GI. You might get the ball rolling there and see what s/he recommends as far as follow-up with a specialist.
posted by goggie at 2:27 PM on June 1, 2011

If you have a history of hemorrhoids and the blood is bright red then I'd assume that's likely still it, particularly if you're having all this loose output and if it's more time pooping than you usually spend. Not to say you should ignore it, but I'd bet on the more pedestrian past reasoning.

If you're continuing to have the runs then I'd think it's most likely some sort of bacterial thing. Do you feel good otherwise? Is this just loose when you do go or are you going a lot more? If you're prone to nervous stomach then certainly it could be a case where your stress is exacerbating whatever is the root cause.

I'm with goggie - why not hit up your GP rather than go for a specialist? The time for the GI specialist is when your doc doesn't find an obvious thing and/or it resists treatment.
posted by phearlez at 2:30 PM on June 1, 2011

What you've described sounds an awful lot like my celiac's symptoms. Go to a doctor yes, but why not try cutting out the gluten in the meantime? What could it hurt?
posted by aretesophist at 2:36 PM on June 1, 2011

I have similar pain that's connected to my menstrual cycle. I don't have the rest of your symptoms, but they may not be related to ovulation. Ovulation pain can last so long that it never quite goes away. It increases around ovulation, and then ebbs away, but doesn't quite leave before the next month. Most of the information I've found online says that it should go away within a few days. My doctor told me that for some women, it can last a lot longer.
posted by Tooty McTootsalot at 2:52 PM on June 1, 2011

If you do think it's Celiac or gluten related, do not cut the gluten out of your diet. If you go gluten-free now it could cause false negatives on tests when you do see the doctor.

I too have Celiac Disease, and you do indeed sound like me. The other thing is that I also get ovarian cysts. The cysts don't always have the doubled over "OMG childbirth wasn't this bad" pain. When they are still little they are just like you describe: off and on twinges, back pain, worse during ovulation and PMS, but doesn't go away after my period is over.

I was told that with cysts most of the time they resolve themselves within 90 days or three menstrual cycles. That seems to be pretty true with me, mine seem to only last two cycles. So I don't freak out and go to the doctor unless I've been feeling pains that last longer than three periods, or it turns into that really bad pain like I mentioned above.
posted by TooFewShoes at 2:55 PM on June 1, 2011

Recent stomach changes might be due to heat--I get a nervous stomach when it's really hot out.

If I were you, I'd make an appointment with a GI specialist and my gynecologist. I had some pelvic pain a few years ago, and after some poking and prodding my doctor thought it might be fibroids. I got an ultrasound, and no--I just have an unusually large uterus. (Why yes, internet public, I have an unusually large uterus.) But that might be something you want to look into. Better safe than sorry.

Don't be afraid to be aggressive in pursuing a diagnosis. See the specialists. See multiple specialists if you have to. Good luck.
posted by phunniemee at 2:57 PM on June 1, 2011

I agree that it sounds like Celiac, which I also have, but TooFewShoes is right -- don't stop eating gluten. If you can get into see a GI doc, the first line of testing is a simple blood test. Before I went gluten free I had lots of abdominal pain. And not to be gross, but the mucus is definitely a symptom.

It might also be that the abdominal pain and the GI issues are separate.
posted by sugarfish at 3:00 PM on June 1, 2011 [1 favorite]

Could be fibroids. They get loose and attach to random things outside the uterus, but it still react to your cyclical hormones. I have a fibroid that not only aches through PMS, but I also get constipation and kidney symptoms, because the little monsters are adhering in places they don't belong.
posted by headspace at 3:06 PM on June 1, 2011

Was it bright red blood? Or dark blood? That is the major question.

If you are having issues with both types of stool problems, my prime thought would that it is something that is not dietary but immune related.

Until you can see a GI specialist, and a Gyn, try reducing your diet down to white rice and chicken. Cut out everything you can that might be bothering you, or that you might be sensitive to.
posted by strixus at 3:37 PM on June 1, 2011

Sounds very much like the issues I have with Celiac as well. Do you have also perhaps floating diarrhea, itchy scaly sore spots that start as pimples, arthritic pain in your joints?

Get in and get the antibody test done, and then drop the gluten. If that's the cause you will be feeling a million times better in short order. I suffered with symptoms for 20 years before I figured it out and I'm like a new person now.

Say good-bye to pizza and beer. It's a bitch, but you gotta do what you gotta do.

Good luck.
posted by humboldt32 at 3:37 PM on June 1, 2011 [1 favorite]

Just thought it's worth mentioning that while the symptoms sound like celiac, there is another food intolerance that has similar symptoms but gets diagnosed less: fructose intolerance. Like celiac, it's managed via diet. Lucky me, I have fructose, lactose, and gluten intolerances, and when I am careless and allow any of these things sneak into my food, I end up with similar GI problems.
posted by chez shoes at 3:55 PM on June 1, 2011

(You don't have to give up pizza and beer! I have homemade pizza every week and I can get several types of gf beer at my local liquor mega-mart.)
posted by sugarfish at 4:30 PM on June 1, 2011

How about fibroids or endometriosis? Is it possible that the GI symptoms are unrelated -- or, given your current circumstance, both have been exacerbated by stress?
posted by lulu68 at 6:46 PM on June 1, 2011

Wow, thanks all - a whole lot of votes for celiac in this here thread. And googling it actually reveals that a whole lot of other, seemingly unrelated things like my skin may even be related to it. Wow.
Now I'm having more constipation than diarrhea. And the blood is red. (Ew. I'm so sorry.) I don't have fever or serious sickness symptoms, but I do feel kind of exhausted and a little icky.
I didn't have a GP at all until earlier this year - she is someone I have been to once before for a routine physical and bloodwork. This is why I was thinking I would just try to head straight to the specialist, if possible. Boy, can doctors take forever.
Thanks so much - I promise that my next question will be about something so much cuter and less gross. :p
posted by bookgirl18 at 8:50 PM on June 1, 2011

Just as a heads-up, don't count on it being celiac, autoimmune GI disorders all have fairly similar symptoms that require specialists to sort out (unless you remove gluten from your diet and the symptoms instantly disappear, of course.) My colitis, for example, is just the same - red blood and mucus. And don't worry, nobody is too grossed out. (I hope, anyway.) Mefi needs spoiler tags, but for things like Portal 2 threads, not regular old medical problems.
posted by marakesh at 1:52 AM on June 2, 2011

Update: Last night's experimental pasta dinner has not ended well. I'm going to see a GI specialist this afternoon (apparently the phrase "blood in my stool" opens many doors). We'll see! Thanks again, guys.
posted by bookgirl18 at 8:25 AM on June 2, 2011

One final update: It's not celiac, and my symptoms seem to have calmed down. (Leaning towards more hemorrhoids where the blood is concerned.) I'm trying to watch what I eat more carefully to see what might set me off. Many many thanks for listening :)
(And if anyone needs a gastroenterologist in the NYC area, I found a great one!)
posted by bookgirl18 at 10:46 AM on June 14, 2011

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