Which Specialist Should I See for My Persistent Abdominal Pain?

Q: Which Specialist Should I See for My Persistent Abdominal Pain?

Hello： Based on the situation you described, it appears to be a urinary tract infection. <br>However, whether it is related to gynecological issues causing the symptoms still needs to be diagnosed by specialists in obstetrics and gynecology as well as urology.

Which medical specialty should I consult?

Hello, Vice Dean Chen.
Since April, I have been experiencing persistent lower abdominal pain and lower back discomfort, so I have visited a gynecology clinic multiple times.
Although the medications prescribed alleviate the pain, it only lasts for about two weeks before the symptoms recur.
The clinic conducted urine tests, which consistently indicated inflammation.
One night, I noticed my urine appeared pink, and I found blood on several occasions after wiping, prompting me to rush to a large hospital to see a urologist.
They performed a urine culture and X-rays, which showed no stones but indicated a bacterial infection.
There was some increased discharge, but after taking their medication, I did not fully recover.
While the hematuria has resolved, the pain has become less frequent.
After four visits, the urologist suggested that since I have already tried several medications, I should be improving.
If not, it might be a gynecological issue.
However, the gynecology department at this hospital believes it is a urological problem since I have not engaged in sexual intercourse.
During the internal examination, they only assessed the external appearance and performed an abdominal ultrasound, both of which showed no issues.
Yet, I still face problems with frequent urination, lower abdominal pain, lower back pain, and irregular bowel movements.
(By the way, I have noticed that my stool has been a very dark green color on several occasions, leading to a test for occult blood, which came back negative.) Additionally, I have increased discharge and occasionally experience sharp pain when using the restroom, regardless of whether it is for urination or defecation.
I am at a loss as to which specialty I should consult.
Based on your experience, could you please advise me on which department I should see?

Miss Lin, 20~29 year old female. Ask Date: 2006/08/23

Dr. Chen Nengjin reply Obstetrics and Gynecology

Hello: Based on the situation you described, it appears to be a urinary tract infection.
However, whether it is related to gynecological issues causing the symptoms still needs to be diagnosed by specialists in obstetrics and gynecology as well as urology.

Reply Date: 2006/08/23

More Info

When dealing with persistent abdominal pain, especially in the context of a complex medical history like yours, it is crucial to approach the situation methodically. Given your symptoms, which include lower abdominal pain, back pain, urinary issues, and changes in bowel habits, it is essential to consider multiple potential causes and the appropriate specialists to consult.

Understanding Your Symptoms
1. Abdominal Pain: Your ongoing lower abdominal pain could be related to several conditions, including gastrointestinal issues (like irritable bowel syndrome or inflammatory bowel disease), gynecological problems (such as ovarian cysts or endometriosis), or urinary tract issues (like infections or interstitial cystitis).

2. Urinary Symptoms: The presence of blood in your urine, along with frequent urination and pain during urination, suggests a possible urinary tract infection (UTI) or other urinary tract issues. Even though you have been treated for a UTI, the persistence of your symptoms indicates that there may be an underlying issue that has not been addressed.

3. Bowel Changes: The mention of dark green stools and occasional constipation could indicate dietary factors, but they may also suggest gastrointestinal issues that need further evaluation.

Recommended Specialists
Given the complexity of your symptoms, here are the specialists you should consider consulting:
1. Gastroenterologist: Since you are experiencing abdominal pain and changes in bowel habits, a gastroenterologist can perform further evaluations, such as a colonoscopy or advanced imaging studies, to rule out conditions like inflammatory bowel disease, diverticulitis, or other gastrointestinal disorders.

2. Urologist: Since you have had issues with blood in your urine and persistent urinary symptoms, a urologist can conduct a thorough evaluation of your urinary tract. This may include imaging studies like a CT scan or cystoscopy to check for any abnormalities in the bladder or urethra.

3. Gynecologist: Given your lower abdominal pain, it is also wise to consult a gynecologist to rule out any gynecological conditions that could be contributing to your symptoms, such as ovarian cysts or pelvic inflammatory disease.

Next Steps
1. Comprehensive Evaluation: Prepare for your appointments by compiling all relevant medical records, including previous test results and treatments. This will help your specialists understand your medical history and the progression of your symptoms.

2. Diagnostic Testing: Be open to undergoing further diagnostic tests as recommended by your specialists. This may include blood tests, urine cultures, imaging studies (like ultrasounds or CT scans), and possibly endoscopic procedures.

3. Symptom Tracking: Keep a detailed diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare providers in diagnosing your condition.

4. Holistic Approach: Consider discussing your symptoms with a primary care physician who can coordinate care among specialists and ensure that all aspects of your health are being addressed.

Conclusion
Navigating persistent abdominal pain and associated symptoms can be challenging, especially when multiple specialists are involved. By consulting a gastroenterologist, urologist, and gynecologist, you can ensure a comprehensive evaluation of your symptoms. Remember to advocate for yourself, ask questions, and seek clarity on any diagnoses or treatment plans. Your health is paramount, and finding the right specialists will be key to uncovering the underlying causes of your discomfort and achieving relief.

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