Can anyone relate to this abdominal pain symptom?
September 26, 2014 8:02 PM Subscribe
Trying to figure out an undiagnosed and refractory pain in my tummy.
I know that most of you are not doctors and certainly no one is my doctor, but I am wondering if the nature of my pain sounds familiar to anyone else. A few days after finishing a round of antibiotics last year (Pylera), I developed an acute upper abdominal pain that never goes away (although it does fluctuate in intensity). It starts on my right side just below the ribcage and stretches down towards my belly-button. It feels like some sort of compression/stricture/pinching sensation. It also feels very tense and tender to the touch, almost like a muscular pain (although all the muscle relaxers I've tried have done nothing for me (bentyl, baclofen, levsin, etc.). Strangely, but I think importantly, it almost totally disappears when I bend at the waist or if I'm swimming/floating on my stomach.
I've been given a diagnosis of "functional pain syndrome" by the "world famous" (intended with a bit of sarcasm) Dr. Drossman. I've tried Savella, and now 100 mg. of Desipramine for my pain. The desipramine has helped with an overall feeling of epigastric burning/diffuse pain with eating, but it hasn't touched the acute pain described above. Has anyone experienced this type of pain before? Was it eventually diagnosed/treated/managed?
I've been evaluated for GP, Chron's, Celiac, abdominal wall pain and SMA syndrome (all negative). Such an acute pain that is constant except for when I bend over just doesn't seem to fit the bill of functional pain or something caused by a visceral hypersensitivy. Maybe I'm wrong, but it just seems also that the desipramine would have helped even a little if this were the case.
Thoughts? Thanks in advance
I know that most of you are not doctors and certainly no one is my doctor, but I am wondering if the nature of my pain sounds familiar to anyone else. A few days after finishing a round of antibiotics last year (Pylera), I developed an acute upper abdominal pain that never goes away (although it does fluctuate in intensity). It starts on my right side just below the ribcage and stretches down towards my belly-button. It feels like some sort of compression/stricture/pinching sensation. It also feels very tense and tender to the touch, almost like a muscular pain (although all the muscle relaxers I've tried have done nothing for me (bentyl, baclofen, levsin, etc.). Strangely, but I think importantly, it almost totally disappears when I bend at the waist or if I'm swimming/floating on my stomach.
I've been given a diagnosis of "functional pain syndrome" by the "world famous" (intended with a bit of sarcasm) Dr. Drossman. I've tried Savella, and now 100 mg. of Desipramine for my pain. The desipramine has helped with an overall feeling of epigastric burning/diffuse pain with eating, but it hasn't touched the acute pain described above. Has anyone experienced this type of pain before? Was it eventually diagnosed/treated/managed?
I've been evaluated for GP, Chron's, Celiac, abdominal wall pain and SMA syndrome (all negative). Such an acute pain that is constant except for when I bend over just doesn't seem to fit the bill of functional pain or something caused by a visceral hypersensitivy. Maybe I'm wrong, but it just seems also that the desipramine would have helped even a little if this were the case.
Thoughts? Thanks in advance
Response by poster: yes, they did a ct, hida scan and ultrasound. no sign of gallstones.
posted by shrimpsmalls at 8:25 PM on September 26, 2014
posted by shrimpsmalls at 8:25 PM on September 26, 2014
Have they done a barium swallow and a barium enema to X-ray your GI system?
posted by MsMolly at 8:29 PM on September 26, 2014
posted by MsMolly at 8:29 PM on September 26, 2014
Response by poster: yeah, that's how they checked for SMA. I showed slow motility on the follow through and had a "vertical, flaccid" stomach and a teeny diverticula but otherwise no sign of obstruction. The CT did show some thickening in the jejunum, but otherwise normal.
posted by shrimpsmalls at 8:52 PM on September 26, 2014
posted by shrimpsmalls at 8:52 PM on September 26, 2014
GERD is a possibility. Try OTC omeprazole for a couple weeks and see if your symptoms improve.
posted by a lungful of dragon at 12:01 AM on September 27, 2014 [1 favorite]
posted by a lungful of dragon at 12:01 AM on September 27, 2014 [1 favorite]
If you feel like it might be some sort of heartburn as a lungful of dragon suggests, my easy fix was to raise the head of my bed a few inches. Seriously, it helped so much more than it sounds like it would. Feel better!
posted by Beti at 3:56 AM on September 27, 2014
posted by Beti at 3:56 AM on September 27, 2014
It's not exactly the same, but for a couple of years I couldn't lie flat on my back or stomach. It was uncomfortable after about 20 minutes, and if I accidentally fell asleep like that, I would wake up in excruciating pain, although it was lower in my abdomen, round my belly button. I had to lie either with my knees supported, or with a rolled up towel underneath my pelvis to keep flexed.
It really did feel gastro-intestinal, but I think it must've been related to developmental hip dysplasia, because I haven't had that pain again after my bilateral periacetabular osteotomies.
I also had groin pain when walking or standing, which you don't mention, so this is a long shot ... Hope you find relief.
posted by mgrrl at 4:17 AM on September 27, 2014
It really did feel gastro-intestinal, but I think it must've been related to developmental hip dysplasia, because I haven't had that pain again after my bilateral periacetabular osteotomies.
I also had groin pain when walking or standing, which you don't mention, so this is a long shot ... Hope you find relief.
posted by mgrrl at 4:17 AM on September 27, 2014
How much does this pain affect your quality of life? Do OTC analgesics like Tylenol or Advil help?
posted by telegraph at 5:37 AM on September 27, 2014
posted by telegraph at 5:37 AM on September 27, 2014
Response by poster: Sorry, forgot to say that I am taking Omeprazole; it helps a little, but even high doses don't touch the pain. It greatly affects my quality of life - I was on TPN for 7 months bc I had lost so much weight due to not being able to eat from the pain. We had to postpone our wedding last year, and I took some leave from work. I've had a lot of work up, but no real answers. I was just hoping someone could relate. Oh, and Tylenol/Advil don't help.
Thanks so much for your responses.
posted by shrimpsmalls at 5:46 AM on September 27, 2014 [1 favorite]
Thanks so much for your responses.
posted by shrimpsmalls at 5:46 AM on September 27, 2014 [1 favorite]
I'm assuming you wouldn't have gotten a functional pain diagnosis without it, but did you have upper/lower endoscopy? Have you tried probiotics? Tried gluten free diet?
posted by treehorn+bunny at 6:34 AM on September 27, 2014 [1 favorite]
posted by treehorn+bunny at 6:34 AM on September 27, 2014 [1 favorite]
Response by poster: yes, yes, and yes. Sadly, it's responded to nothing so far.
posted by shrimpsmalls at 9:51 AM on September 27, 2014
posted by shrimpsmalls at 9:51 AM on September 27, 2014
Possibly an duodenal ulcer? The description fits what I had. The fact that omeprazole helps a little - an acid reducer - also fits. You might want to get checked for h pylori, which can cause ulcers. May want to have stool sample checked for blood in case its a bleeding ulcer. Also ulcers can be caused by NSAID pain meds and if you are using these you could be exacerbating the problem.
posted by ecorrocio at 12:13 PM on September 27, 2014 [1 favorite]
posted by ecorrocio at 12:13 PM on September 27, 2014 [1 favorite]
Have you tried enteric coated peppermint oil?
posted by Bentobox Humperdinck at 8:44 PM on September 27, 2014
posted by Bentobox Humperdinck at 8:44 PM on September 27, 2014
It sounds like you have been through a lot of different treatment avenues (which is good! but bad in that you've tried a lot of the things AskMe can recommend). So instead of different treatments, have you thought about different doctors?
The first thing that came to my mind when you described your complaint is going to the Mayo for evaluation. The (seemingly rare) thing about the Mayo Clinics is that they evaluate you as a whole patient--which can be very helpful for a diffuse pain complaint--and can put you in discussions with a huge number of specialists all in the same day. I always think of my former colleague's son, who had an incredibly complex eye issue that complicated his entire quality of life, and how Mayo (the Rochester one) worked with him to improve it.
I can also recommend my incredibly qualified, actually a world-famous expert GI if you'd like a second opinion that will take you well out of state (Texas). In general, though, it seems like you have a tricky to diagnose and/or tricky to treat issue that is going to require specialist treatment which you may or may not have received yet.
posted by librarylis at 12:58 PM on September 28, 2014
The first thing that came to my mind when you described your complaint is going to the Mayo for evaluation. The (seemingly rare) thing about the Mayo Clinics is that they evaluate you as a whole patient--which can be very helpful for a diffuse pain complaint--and can put you in discussions with a huge number of specialists all in the same day. I always think of my former colleague's son, who had an incredibly complex eye issue that complicated his entire quality of life, and how Mayo (the Rochester one) worked with him to improve it.
I can also recommend my incredibly qualified, actually a world-famous expert GI if you'd like a second opinion that will take you well out of state (Texas). In general, though, it seems like you have a tricky to diagnose and/or tricky to treat issue that is going to require specialist treatment which you may or may not have received yet.
posted by librarylis at 12:58 PM on September 28, 2014
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posted by heathrowga at 8:10 PM on September 26, 2014