Chronic Abdominal Pain and Unexplained Symptoms: Seeking Answers

Q: Chronic Abdominal Pain and Unexplained Symptoms: Seeking Answers

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. <br>If all tests are normal as you described and you are e

Brain confusion

Supplementing from the previous post, the following conditions have already affected my daily life...
I have been seeing doctors for over a year without results...
I experience long-term intermittent abdominal pain, which started over a year ago.
After the onset of abdominal pain, I have almost constant pain in my lower back to the front and back of my ribcage, with a feeling of pressure, tightness, and an indescribable sense of discomfort.
The abdominal pain is not constant 24 hours a day, but the discomfort from my lower back to the ribcage is daily.
I often have unexplained bruises without any trauma, and my body has developed some black moles, which also began with the onset of abdominal pain.
The discomfort in my lower back to ribcage is not fixed; it occurs in the same area for several consecutive days before shifting to another location.
Sometimes it is in the front of the right lower back, sometimes in the front of the left lower back, and sometimes in both.
It can also be in the back of the right lower back, the back of the left lower back, or both.
Occasionally, it is 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 in various locations and has been ongoing for over a year.
The abdominal pain has also persisted for over a year, but it is not constant.
The discomfort in the lower back began with the abdominal pain, which I did not experience before.
I have consulted gastroenterology, gynecology, urology, and allergy/rheumatology, all of which found no issues.
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 lower back discomfort.
The gastroenterologist stated that he cannot determine if the discomfort from the lower back to the ribcage is related to gastrointestinal issues.
I have undergone gastroscopy, barium enema, abdominal ultrasound, and stool tests, all of which returned normal results.
I am currently being evaluated by a neurologist, who mentioned that my condition is quite unusual.

I would like to ask for professional medical advice on the following:
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 ribcage area?
3.
Is there a connection between the unexplained bruising and the black moles that started with the abdominal pain?
4.
Is it concerning that I have started to develop black moles? (My family is worried that the appearance of black moles may indicate a problem.)

HBF, 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 physical assessment, it is difficult to provide a definitive answer to your question.
If all tests are normal as you described and you are experiencing pain, it would be advisable to prioritize investigating musculoskeletal and neurological issues as per the current recommendations from the neurology department.
Regarding whether the bruises and moles are directly related to your abdominal pain, I cannot determine a direct correlation based on the current information.
Changhua Hospital is concerned about your health.
Dr.
Tsai An-shun.

Reply Date: 2012/09/21

More Info

Chronic abdominal pain and unexplained symptoms can be incredibly challenging to navigate, especially when they significantly impact your daily life. Based on your description, it seems you have been experiencing a range of symptoms for over a year, including persistent discomfort in the abdominal area, lower back, and ribcage, as well as unexplained bruising and the emergence of new moles. Given the complexity of your situation, it’s essential to approach this systematically.

1. Understanding Chronic Abdominal Pain: Chronic abdominal pain can arise from various sources, including gastrointestinal, musculoskeletal, neurological, or even psychological factors. Since you have already consulted multiple specialists, including gastroenterologists, urologists, and rheumatologists, and have undergone various tests (endoscopy, colonoscopy, imaging studies), it’s crucial to consider less common causes. Conditions such as irritable bowel syndrome (IBS), which you mentioned was diagnosed, can sometimes be resistant to treatment, and symptoms can fluctuate widely.

2. Back and Rib Pain: The persistent discomfort in your lower back and ribcage could be related to musculoskeletal issues, such as muscle strain or spinal problems. However, given the chronic nature and the fact that it coincides with your abdominal pain, it may also be worth exploring referred pain from abdominal organs or even nerve-related issues. Conditions like fibromyalgia or myofascial pain syndrome can cause widespread pain and may not always be easily diagnosed.

3. Unexplained Bruising and New Moles: The appearance of unexplained bruising and new moles is concerning and warrants further investigation. Unexplained bruising can sometimes indicate a bleeding disorder or issues with blood clotting. The emergence of new moles or changes in existing moles should be evaluated by a dermatologist, as they can be indicative of skin conditions, including melanoma. It’s essential to have a thorough skin examination, especially if there is a family history of skin cancer.

4. Next Steps: Given that you have seen various specialists without a clear diagnosis, it may be beneficial to seek a multidisciplinary approach. Consider consulting a pain management specialist who can help address your chronic pain from a holistic perspective. They may recommend physical therapy, cognitive behavioral therapy, or alternative treatments such as acupuncture or chiropractic care.

5. Psychological Factors: Chronic pain can often be exacerbated by psychological factors, including anxiety and depression. If you have a history of anxiety, it might be worthwhile to explore this aspect further. Stress and anxiety can manifest physically, leading to increased pain perception. A mental health professional can help you develop coping strategies and address any underlying psychological issues.

6. Monitoring Symptoms: Keep a detailed diary of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable for your healthcare providers in understanding your condition better.

7. Advocacy for Your Health: If you feel that your concerns are not being adequately addressed, don’t hesitate to seek a second opinion. Sometimes, a fresh perspective from a new physician can lead to new insights or diagnoses.

In conclusion, while it can be frustrating to deal with chronic symptoms without a clear diagnosis, persistence in seeking answers is crucial. Collaborate closely with your healthcare team, advocate for yourself, and consider a holistic approach to managing your symptoms. Your health is paramount, and finding the right path to relief may take time and patience.

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