Abdominal and Back Pain: A Guide to Gastrointestinal Issues

Abdominal pain and lower back pain?

I'm sorry, doctor, but I don't have an email address and I'm wondering if I can use my MSN account instead.
I have been experiencing symptoms for many years, and even though I used to have severe pain during my menstrual periods, I didn't seek medical attention.
However, the pain has become increasingly severe.
I previously consulted a gynecologist who said it was unlikely for the pain to be in the upper left abdomen.
Later, I saw a gastroenterologist who performed a colonoscopy and said everything was fine.
A family medicine doctor suggested that I might have irritable bowel syndrome and prescribed medication, but after taking it about 5 or 6 times, I still experience pain that prevents me from sleeping, and I feel uncomfortable all day.
The pain is in my entire left abdomen and lower back, and I also feel sharp pain in the bladder area.
I don't understand why I feel pain whether I eat or not; I currently have no appetite and find eating very uncomfortable.
Before the colonoscopy, I usually didn't have pain in the bladder area, but now it constantly hurts.
I'm concerned that there might be other issues, such as kidney problems or diabetes.
I was diagnosed with fatty liver at a nearby hospital, and the family medicine doctor ordered an X-ray, which showed no significant issues.
I have also had blood and urine tests done, but I still feel very uncomfortable.
Should I go to a larger hospital for further examination? I'm in so much pain that I feel like crying, and I can't even eat.
The medications prescribed by the family doctor are Gascon 40mg, Strocain, Paracetamol, and Erispan 0.25.

Xiao Ying, 20~29 year old female. Ask Date: 2009/10/26

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, you are experiencing left abdominal pain, lower back pain, or abdominal pain that occurs whether you eat or not.
You have undergone some examinations that showed no issues.
It is recommended to follow up with a gastroenterology outpatient clinic, where the physician will conduct an appropriate assessment and management based on your condition.
Wishing you good health.
Sincerely, Dr.
Lin Ming-Hui, Taoyuan Hospital, Department of Health.

Reply Date: 2009/10/26

More Info

I'm sorry to hear about the ongoing abdominal and back pain you're experiencing. It sounds like you've been through a lot of medical evaluations and treatments without finding relief. Based on your description, it seems that you may be dealing with a complex interplay of gastrointestinal issues, possibly exacerbated by stress or anxiety.

Understanding Your Symptoms
1. Abdominal Pain: The pain you're experiencing in your left abdomen and back could be related to several gastrointestinal conditions. Given that you've had a colonoscopy with no significant findings, conditions like Irritable Bowel Syndrome (IBS) could be a possibility. IBS is characterized by abdominal pain and changes in bowel habits (diarrhea, constipation, or both). Stress and diet can significantly influence IBS symptoms.

2. Gastroesophageal Reflux Disease (GERD): Your mention of discomfort after eating and the sensation of something stuck in your throat could indicate GERD. This condition occurs when stomach acid frequently flows back into the esophagus, leading to irritation and pain.

3. Gallbladder Issues: Although your previous tests may not have indicated gallbladder problems, pain in the upper left abdomen, especially after eating, can sometimes be related to gallbladder dysfunction or gallstones.

4. Kidney Issues: The stabbing pain near your bladder could suggest a urinary tract infection or kidney stones, especially if you have a history of kidney issues. It's essential to rule out these conditions, particularly since you mentioned pain in the bladder area.

5. Fatty Liver Disease: You mentioned being diagnosed with fatty liver disease, which can sometimes lead to discomfort in the upper abdomen. While it may not directly cause severe pain, it can be associated with other gastrointestinal symptoms.

Recommendations for Further Evaluation
1. Consult a Gastroenterologist: Given the complexity of your symptoms, it may be beneficial to seek a second opinion from a gastroenterologist, preferably one affiliated with a larger medical center that can provide comprehensive care.

2. Additional Testing: You might consider asking for further diagnostic tests, such as:
- Upper Endoscopy: To evaluate for esophageal or gastric issues.

- Ultrasound or CT Scan: To check for gallbladder or kidney problems.

- Stool Tests: To rule out infections or malabsorption issues.

3. Dietary Modifications: Keeping a food diary may help identify any triggers for your symptoms. Consider working with a dietitian who specializes in gastrointestinal health to develop a diet plan that minimizes discomfort.

4. Stress Management: Since stress can exacerbate gastrointestinal symptoms, exploring stress management techniques such as mindfulness, yoga, or cognitive-behavioral therapy may be beneficial.

5. Medication Review: Discuss the medications you are currently taking with your healthcare provider. Sometimes, medications can have side effects that contribute to gastrointestinal discomfort.

Conclusion
Your symptoms are complex and may require a multifaceted approach to diagnosis and treatment. It's crucial to advocate for yourself and seek further evaluations if your current treatment plan isn't providing relief. Remember, you deserve to feel better, and with the right care, there is hope for improvement in your quality of life. Don't hesitate to reach out to healthcare professionals who can provide the support and guidance you need.

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