Abdominal Pain: When to Seek Gastroenterology Help - Gastroenterology and Hepatology

More Info

---

When it comes to understanding abdominal pain, especially when it has been persistent and multifaceted, it is crucial to approach the situation methodically. Your symptoms, which include pain that shifts between different areas of the abdomen, discomfort in the lower back, and a tendency to bruise easily, warrant a thorough evaluation by a healthcare professional. Here’s a breakdown of your concerns and some insights into potential underlying causes.

1. Abdominal Pain and Its Relation to Other Symptoms: The fact that your abdominal pain has migrated from the right lower quadrant to the left and now includes upper abdominal pain and back discomfort suggests a complex issue. Abdominal pain can indeed refer to other areas, including the back, due to shared nerve pathways. Conditions such as irritable bowel syndrome (IBS), which you mentioned being treated for, can cause a variety of symptoms, including abdominal pain, bloating, and discomfort that may radiate to the back. However, the presence of systemic symptoms like easy bruising and pain upon touch raises the possibility of other underlying conditions.

2. Bruising and Systemic Symptoms: Easy bruising and generalized pain upon touch could indicate a hematological issue or a connective tissue disorder. Conditions such as thrombocytopenia (low platelet count), which can lead to easy bruising, or vasculitis, which can cause systemic inflammation and pain, should be considered. These conditions may not be directly related to gastrointestinal issues but could coexist with them. A hematologist would be the appropriate specialist to evaluate these symptoms further.

3. Potential for Other Conditions: You mentioned the possibility of purpura, which can be associated with various conditions, including autoimmune diseases, infections, or even certain medications. A thorough evaluation by a rheumatologist or a hematologist may be warranted to rule out conditions like vasculitis or other autoimmune disorders that could explain both your abdominal symptoms and the bruising.

4. When to Seek Gastroenterology Help: Given that you have already undergone extensive gastrointestinal evaluations, including endoscopy and imaging studies, and have not found any significant abnormalities, it may be time to consider a multidisciplinary approach. If your gastrointestinal symptoms persist despite treatment, a referral back to a gastroenterologist for further evaluation or a second opinion may be beneficial. They might consider functional gastrointestinal disorders or even less common conditions that may not have been initially suspected.

5. Next Steps: It is essential to communicate all your symptoms clearly to your healthcare provider. Keeping a symptom diary that tracks when the pain occurs, its intensity, any associated symptoms (like bruising), and what alleviates or exacerbates the pain can provide valuable information for your doctors.
In summary, while gastrointestinal issues can certainly cause abdominal and back pain, the additional symptoms you are experiencing suggest that a broader evaluation may be necessary. Consulting with a hematologist regarding the bruising and systemic pain, alongside continued follow-up with a gastroenterologist, could help in identifying the underlying cause of your symptoms. It’s important to advocate for your health and ensure that all potential avenues are explored to find the right diagnosis and treatment plan.