Headaches and Abdominal Pain: When to See a Neurologist

Diagnosis and Etiology

I apologize for the inconvenience, and I sincerely seek your advice.
My father recently experienced a headache (not the kind associated with a cold) after cleaning the water tank.
Following that, he had difficulty urinating and experienced intermittent abdominal pain (the kind that comes and goes).
At night, the pain became so severe that he couldn't sleep.
I took him to Min-Sheng Hospital to see a urologist, where his urine analysis came back normal.
An ultrasound revealed that there was still some residual urine in the bladder after he urinated, and his kidney size was normal.
We are scheduled to review the blood test results in a week.
However, the doctor mentioned that the headache and abdominal pain were not related.
He noted that my father's abdomen felt bloated upon examination and prescribed medication to help with urination and to relieve bloating.
After returning home, my father took a few of the bloating pills, but the headache and abdominal pain persisted.
I would like to ask the physician what this could possibly indicate and which specialty should be consulted to resolve these issues.
I feel like I have been going to the wrong departments; before seeing the urologist, we visited a family medicine clinic, but they only provided pain relief medication.
Thank you for your guidance; should I consider seeing a neurologist?

Yi Lin, 30~39 year old female. Ask Date: 2016/04/22

Dr. Jiang Junyi reply Neurology

Hello, based on your description, it is unclear whether your father's cervical spine has degeneration causing nerve compression, which in turn could affect the autonomic nervous system, leading to symptoms such as bloating or urinary difficulties.
Additionally, some muscle relaxants can also cause similar symptoms.
It is advisable for the elderly population to minimize visits to different hospitals to avoid polypharmacy (for instance, receiving treatment at a hospital and then at a clinic).
Consulting different specialists within the same hospital may provide a more comprehensive diagnosis and treatment.
Wishing you good health, peace, and happiness.

Reply Date: 2016/04/22

More Info

When it comes to understanding headaches and abdominal pain, it is essential to consider the various potential causes and the appropriate specialists to consult. Your father's symptoms, including the headache, difficulty urinating, and abdominal pain, warrant a thorough evaluation to determine the underlying issues.

Headaches can arise from a multitude of factors, including tension, migraines, cluster headaches, or even secondary causes related to other medical conditions. The nature of the headache is crucial in determining its cause. For instance, if the headache is severe and sudden, it could indicate a more serious condition, such as a subarachnoid hemorrhage or meningitis. On the other hand, tension-type headaches are often associated with stress and muscle tension, while migraines may present with additional symptoms such as nausea and sensitivity to light.

In your father's case, the headache described as "painful" and not typical of a cold suggests that it may not be a simple tension headache. The fact that he is experiencing abdominal pain alongside the headache raises the possibility of a systemic issue. Abdominal pain that "jumps" or is intermittent can be indicative of various gastrointestinal issues, such as irritable bowel syndrome (IBS), gastritis, or even more serious conditions like appendicitis or pancreatitis.

The initial evaluation by the urologist, which included urine tests and an ultrasound, is a good start, especially since urinary issues can sometimes manifest alongside abdominal pain. However, if the headache persists and the abdominal pain continues, it may be beneficial to consult a neurologist. Neurologists specialize in disorders of the nervous system, which includes headaches and any neurological symptoms that may arise from other conditions.

Additionally, if the abdominal pain is severe and persistent, it may also be worthwhile to consult a gastroenterologist. This specialist focuses on digestive system disorders and can provide further evaluation of the abdominal symptoms, especially if they are not resolving with the medications prescribed.

In summary, given the complexity of your father's symptoms, it may be prudent to pursue consultations with both a neurologist and a gastroenterologist. The neurologist can assess the headache's nature and any potential neurological implications, while the gastroenterologist can delve deeper into the abdominal pain and urinary issues. It is essential to keep track of all symptoms, their onset, duration, and any associated factors, as this information will be invaluable for the healthcare providers in diagnosing and managing your father's condition effectively.

In conclusion, while it may seem like a challenge to navigate through the healthcare system, seeking the right specialists based on the symptoms presented is crucial. If the symptoms persist or worsen, do not hesitate to seek further medical advice or a second opinion. Early intervention can often lead to better outcomes, especially when dealing with complex symptoms that may have multiple underlying causes.

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