Persistent Abdominal Pain: Seeking the Right Specialist for Relief

Abdominal pain has not improved?

Hello doctor, about a month ago I started experiencing intermittent sharp pains in my abdomen.
The location is not fixed; sometimes it's around my navel, other times on both sides of my waist, and sometimes in my lower abdomen.
When I first noticed it, I consulted a gastroenterologist who diagnosed me with acute gastroenteritis.
However, my diet has remained the same and light, and I haven't experienced any diarrhea, but after taking the medication, there was no improvement.
A week later, my menstrual period started, but the flow was very light, significantly different from my usual pattern.
During this time, I also experienced sharp pains, but I thought it might just be menstrual cramps and didn't think much of it.
However, by the third week, the sharp pains persisted, so I visited a gynecologist.
The doctor suggested it might be pelvic inflammatory disease, but I have no external itching or pain.
Despite taking the prescribed medication, there has been no improvement.
I would like to know which specialist I should see next.
Currently, I am experiencing pain in my abdomen and lower abdomen, with a pinpoint sharp pain that occurs throughout the day, sometimes more intensely.
My bowel movements are normal, and I haven't consumed fried or spicy foods.

Meizi, 20~29 year old female. Ask Date: 2019/10/23

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is recommended to return for follow-up examinations at the obstetrics and gynecology outpatient clinic.

Reply Date: 2019/10/23

More Info

Persistent abdominal pain can be a complex issue, especially when it involves multiple areas and has not responded to initial treatments. Given your symptoms and the various specialists you have already consulted, it’s important to consider a few key points to help guide you toward the right diagnosis and treatment.

Firstly, the nature of your pain is crucial. You mentioned that the pain is sharp and can occur in various locations, including around the navel, the sides of your waist, and the lower abdomen. This type of pain can be indicative of several underlying conditions. Since you have already seen a gastroenterologist and a gynecologist, it may be beneficial to explore other potential causes that could be contributing to your discomfort.

1. Re-evaluate Gastrointestinal Issues: Although you were diagnosed with acute gastroenteritis initially, it’s worth considering other gastrointestinal disorders. Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even functional dyspepsia could present with similar symptoms. A referral to a gastroenterologist for further evaluation, including possibly an endoscopy or colonoscopy, might be warranted if you haven't had these tests yet.

2. Consider Urological Issues: Given that your pain is persistent and has not improved with gynecological treatment, it may be worthwhile to consult a urologist. Conditions such as interstitial cystitis or urinary tract infections (UTIs) can sometimes present with abdominal pain and may not always show typical symptoms like burning during urination.

3. Musculoskeletal Causes: Sometimes, abdominal pain can be referred pain from musculoskeletal issues, such as a hernia or muscle strain. A physical examination by an orthopedic specialist or a physical therapist could help rule out these possibilities.

4. Chronic Pelvic Pain Syndrome: Since you have been diagnosed with pelvic inflammatory disease (PID), it’s essential to consider that chronic pelvic pain syndrome could be a factor. This condition can persist even after the initial infection has been treated, leading to ongoing discomfort.

5. Psychosomatic Factors: Lastly, it’s important to acknowledge the role of stress and anxiety in chronic pain. Psychological factors can exacerbate physical symptoms, and addressing any underlying anxiety or stress through therapy or counseling may provide some relief.

In terms of next steps, I recommend scheduling an appointment with a multidisciplinary pain management clinic or a specialist in chronic pain. These clinics often have a team of healthcare providers, including pain specialists, physical therapists, and psychologists, who can work together to develop a comprehensive treatment plan tailored to your needs.

In summary, your persistent abdominal pain requires a thorough evaluation that may involve multiple specialties. Keep advocating for your health, and don’t hesitate to seek a second opinion if you feel your concerns are not being addressed adequately. It’s crucial to find a healthcare provider who will listen to your symptoms and work with you to uncover the underlying cause of your pain.

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