Mysterious abdominal and back pain; next steps?
July 25, 2016 6:26 AM   Subscribe

For the last 5 days I've had really horrid abdominal and back pain on my left side; tests show no signs of infection. What do I need to talk to my doctor about to get to the bottom of this?

Wednesday night I suddenly had a really strong pain in my stomach and back, on my left side, roughly in line with my navel. I had diarrhoea and then was up through the night vomiting, with the pain staying almost constant. I phoned the out of hours GP, who suggested paracetamol or ibuprofen. I have now been treating with ibuprofen, but before the 4 hr dosage window is up, I'm feeling enough pain that I often take another dose early, and I'm definitely not sticking to their '6 tablets in a 24 hr period' rule.

The vomiting stopped by Wednesday morning, but the pain has not gone away, and sometimes I feel nausea alongside the pain. On Saturday I went to urgent care because the pain hadn't abated (and it's also the only time I could be sure to have my husband around to look after our two young children), but after spending most of the day there, they sent me home without any real answers. My urine and blood were tested and there were no signs of anything obvious (eg. a kidney infection or ectopic pregnancy). The doctor I saw gave a possible diagnosis of a viral infection, I guess because of the diarrhoea and vomiting, but this doesn't feel like any virus I've ever had, the pain has far outlasted the other stuff, and nobody else in the family has caught it (which is what normally happens in our household with anything viral).

The pain is very localised most of the time, but there have been moments when it was so bad that it felt as if it was radiating to my side and down into my gut. It feels too high to be gynecological, and certainly doesn't feel like menstrual pain (I had a baby 3 months ago and my period hasn't returned yet anyway). If I weren't passing wind, I'd characterise the pain as really similar to trapped wind. I've now made an appointment with my GP in a couple of days - what do I need to ask about so I can stop feeling like this? I don't have the childcare resources or energy to keep chasing this up - what should I be hoping to walk out of his office with? A referral to somebody? An appointment for a scan?
posted by catch as catch can to Health & Fitness (17 answers total)
Ohhhhhh man this is sounding familiar.

I'd get back to urgent care and ask for a sonogram to explore whether this is ovarian torsion, or even just some kind of weird thing with a cyst. My own case of ovarian torsion was similarly frustrating to diagnose - I was in an emergency room for 9 straight hours, with the doctors' various theories of "etopic pregnancy? appendicitis? bowel obstruction? kidney stone?...." all getting shot down when each test they did came up negative. They finally sent me to get a sonogram which is how someone finally saw "oh hey, the ovary isn't supposed to look like that...." and then they took care of it.

My case hurt like a mofo, but it was kind of an extreme case - otherwise your symptoms sound really familiar.
posted by EmpressCallipygos at 6:39 AM on July 25, 2016 [4 favorites]

Somewhat similar to what EmpressCallipygos suggests, this sounds like very much like the symptoms I had from an ovarian cyst. Mine was more associated with diarrhea than vomiting, but definitely had GI symptoms and severe pain. In my case they diagnosed with an MRI and confirmed with an ultrasound (the transvaginal kind, no fun but it did detect the problem). I would definitely ask about an abdominal MRI or some other type of scan...this does not sound normal!
posted by rainbowbrite at 7:03 AM on July 25, 2016 [1 favorite]

Do you have, e.g., a walk-in health care centre with ultrasound facilities & techs on-site, where you could get a TV ultrasound the same day? If so, I'd go there - early in the morning (so you can get the scan the same day). Failing that, would go to the ER or an urgent care centre that has ultrasound on-site (but check to see if they have people who do that on the day you go). GP visit isn't for a few days, scan might take another few, depending on where you are... it could be dangerous if it is a ruptured cyst. (Also pain can be "referred" from the damaged site to nearby places.)
posted by cotton dress sock at 7:12 AM on July 25, 2016

Mine was also an ovarian cyst with torsion. It took forever to diagnose (months) while I got weaker and weaker. You want an ultrasound. The good news is, the surgery is easy to recover from.
posted by Valancy Rachel at 7:48 AM on July 25, 2016

I don't know what this is, but in my experience, Urgent Care is more likely to falsely diagnose you with food poisoning than accurately diagnose you with anything more serious. I'd suggest saying all of this but at the emergency room. This is not normal.
posted by samthemander at 7:57 AM on July 25, 2016

Kidney stone?
posted by mdrew at 8:23 AM on July 25, 2016

I don't want to panic you, so let me stress that this should merely be a consideration if you don't get it diagnosed as discussed above, but, while ovarian torsion is definitely a considerably more likely possibility, this can also be a result of having pancreatic cysts, which can mean a pre-malignant neoplasm or possibly cancer. It doesn't sound like they did any kind of imaging, and at any rate they are notoriously hard to pick up and probably won't show on an ultrasound. If following up on ovarian torsion with an ultrasound doesn't yield any results, I would try to get a CT scan to rule that out.
posted by praemunire at 8:43 AM on July 25, 2016

a kidney infection

While a lot less common; you can have an infection of the Kidney without bacteria in urine or other UTI symptoms. I've had one and it wasn't caught early, I ended up in hospital for a while. Mine was caught with an ultrasound and a blood draw.
posted by French Fry at 8:48 AM on July 25, 2016

For what it's worth, I've had stomach bugs/food poisoning that have left me with abdominal pain and general misery that took a few weeks to REALLY go away completely. Sometimes food poisoning especially can cause what they call post-infectious IBS, which isn't fun, but which will generally go away with time. These kinds of illnesses can also deplete your body of the enzymes necessary to digest dairy; cutting out dairy completely and taking probiotics should help the healing process, if that is indeed the problem. It can't hurt.

With that said, an ultrasound to check your ovaries/an overall check on your reproductive system is a very good idea.
posted by Amy93 at 9:29 AM on July 25, 2016

Also, potentially gallstones, which an ultrasound would also detect.
posted by Sophie1 at 11:58 AM on July 25, 2016 [1 favorite]

Did they rule out appendicitis?
posted by ocherdraco at 12:24 PM on July 25, 2016

(I know you said it was left-sided pain, but while pain from appendicitis is most commonly right-sided, left-sided pain is not impossible.)
posted by ocherdraco at 12:28 PM on July 25, 2016

I also had similar symptoms with an ovarian cyst with torsion. It hurt like hell on earth. I was lucky that my doctor was a great diagnostician and figured it out very quickly.
posted by Dolley at 1:07 PM on July 25, 2016

That reaaaally sounds like a kidney stone. They're super common and utterly miserable. Vomiting incessantly is often part and parcel of the experience. A urinalysis may not show infection; mine did not.

Did anyone do an ultrasound or CT? Stones will show up on either.
posted by Janissa11 at 10:26 AM on July 26, 2016

I would go back to urgent care now. Or to an emergency room where they may be better equipped and prone to do sonograms and CT scans. This is not viral and is potentially very serious.
posted by SLC Mom at 12:16 PM on July 26, 2016

Pancreatic cysts are generally painless; however your symptoms are somewhat concerning for pancreatitis if pyelonephritis has already been ruled out via urinalysis.

That being said, ovarian hemorrhagic cysts and torsion are apparently more common on the left side, in my limited gynecological experience.

An abdominal ultrasound or CT would shed more light on a definitive diagnosis.
posted by hobo gitano de queretaro at 8:22 PM on July 26, 2016

Hi - is everything okay? Did you get the pain checked out?
posted by EmpressCallipygos at 6:20 PM on September 25, 2016

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