Chronic Abdominal Pain: Seeking Answers for Unexplained Symptoms

Q: Chronic Abdominal Pain: Seeking Answers for Unexplained Symptoms

Hello： Based on the information you provided, it is somewhat insufficient, and without the ability to conduct a clinical examination or diagnostic assessment, it is difficult to provide a definitive answer to your question. <br>If all tests are normal as you described, and you ar

Worries..?

The following situation has already affected my life...
I have been seeing doctors for over a year without any results...
I experience long-term, intermittent abdominal pain.
When the abdominal pain starts, I almost have constant pain in my lower back to the front and back of my ribs every day, along with a feeling of pressure, tightness, and an indescribable sense of discomfort.
The abdominal pain is not constant, but the discomfort from my lower back to my ribs is daily.
I often have unexplained bruises without any impact, and my body has developed some black moles, which also started when the abdominal pain began.
The discomfort in the lower back to the ribs is not fixed; it tends to be in the same area for several consecutive days before moving to another area.
Sometimes it is in the front of the right lower back, sometimes in the front of the left lower back, sometimes in both lower backs, sometimes in the back of the right lower back, sometimes in the back of the left lower back, and sometimes in both lower backs.
It can also be in the front of the left rib, the front of the right rib, the back of the left rib, or the back of the right rib.
In summary, the discomfort is not localized.
This situation has persisted for over a year, and while the abdominal pain has lasted for more than a year, it is not constant.
The discomfort in my lower back to my ribs has been daily since the abdominal pain began, which was not the case before.
I have seen specialists in gastroenterology, gynecology, urology, and allergy/rheumatology, but no issues were found.
The gastroenterologist diagnosed me with irritable bowel syndrome, but after taking medication for over a year, there has been no improvement in the abdominal pain or the discomfort in my lower back.
The gastroenterologist stated that he could not determine whether the discomfort from my lower back to my ribs was related to gastrointestinal issues.
I have undergone a gastroscopy, barium enema, abdominal ultrasound, and stool tests, all of which were normal.
I am currently being evaluated by a neurologist, who finds my condition quite strange.
I would like to ask for professional medical advice: 1.
What should I do if all tests come back normal? The medication for irritable bowel syndrome has not improved my condition.
2.
What should I do about the discomfort in my lower back to my ribs? 3.
Is there a connection between the unexplained bruises and black moles, which started when the abdominal pain began?

BV, 20~29 year old female. Ask Date: 2012/09/21

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Based on the information you provided, it is somewhat insufficient, and without the ability to conduct a clinical examination or diagnostic assessment, it is difficult to provide a definitive answer to your question.
If all tests are normal as you described, and you are still experiencing pain, it is advisable to prioritize investigating musculoskeletal and neurological issues based on the current recommendations from the neurology department.
Regarding whether the bruises and moles are directly related to your abdominal pain, the current information does not allow for a conclusive answer on that matter.
Changhua Hospital is concerned about your health.
Dr.
Tsai An-Shun.

Reply Date: 2012/09/21

More Info

Chronic abdominal pain can be a perplexing and distressing condition, especially when it persists for an extended period without a clear diagnosis. Your symptoms, which include ongoing abdominal pain, discomfort in the lower back and rib area, and the presence of bruises and new moles, warrant a thorough and systematic approach to diagnosis and management.

1. Understanding Chronic Abdominal Pain: Chronic abdominal pain can arise from various sources, including gastrointestinal, musculoskeletal, neurological, and even psychological factors. Given that you have already undergone extensive evaluations by specialists in gastroenterology, gynecology, urology, and rheumatology without definitive findings, it is crucial to consider less common causes. Conditions such as functional gastrointestinal disorders (like irritable bowel syndrome), myofascial pain syndrome, or even psychosomatic disorders could be contributing to your symptoms.

2. The Role of Psychological Factors: Chronic pain can often be exacerbated by psychological factors such as anxiety and stress. These can lead to muscle tension and increased sensitivity to pain. If you have a history of anxiety or stress, it may be beneficial to explore cognitive-behavioral therapy or other forms of psychological support as part of your treatment plan.

3. Investigating Other Causes: The presence of unexplained bruising and new moles is concerning and should not be overlooked. These symptoms could indicate underlying hematological issues or dermatological conditions that may need further investigation. It would be prudent to consult a hematologist to evaluate your blood clotting factors and platelet function, as well as a dermatologist for the new moles.

4. Next Steps in Management:
- Comprehensive Evaluation: Since you are currently being evaluated by a neurologist, it is essential to continue this process. Neuropathic pain or nerve entrapment syndromes could be contributing to your symptoms. A thorough neurological examination, possibly including imaging studies like MRI, may help identify any nerve-related issues.

- Pain Management: In the meantime, consider discussing pain management strategies with your healthcare provider. This could include medications, physical therapy, or alternative therapies such as acupuncture or biofeedback.

- Lifestyle Modifications: Implementing lifestyle changes such as dietary adjustments, regular exercise, and stress management techniques can also play a significant role in alleviating symptoms. Keeping a symptom diary may help identify triggers and patterns in your pain.

5. Collaboration with Specialists: Given the complexity of your symptoms, a multidisciplinary approach may be beneficial. Collaborating with various specialists, including pain management experts, physical therapists, and mental health professionals, can provide a more comprehensive treatment plan.

In summary, while the journey to find the cause of chronic abdominal pain can be frustrating, it is essential to remain proactive in seeking answers. Continue to advocate for your health, and do not hesitate to seek second opinions or explore new avenues of care. Your symptoms deserve thorough investigation, and with persistence, you may find the answers and relief you seek.

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Hello: Based on the information you provided, it is somewhat insufficient, and without the ability to conduct a clinical examination or physical assessment, it is difficult to provide a definitive answer to your question. If all tests are normal as you described and you are exper...