Chronic Abdominal Pain and Unexplained Symptoms: Seeking Answers

Long-term... issues?

Supplementing from the previous post, the following conditions have already affected my daily life...
After more than a year of consultations, there have been no results...
I have been experiencing intermittent abdominal pain for a long time.
Once the abdominal pain starts, I almost have constant pain in my lower back to the ribs, both front and back, every day, with a feeling of pressure, tightness, and an indescribable sense of discomfort.
The abdominal pain does not occur every day for 24 hours, but the discomfort from the lower back to the 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 from the lower back to the ribs is not fixed; however, it consistently occurs in the same area for several 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, 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 in various locations and is not fixed.
This situation has persisted for over a year, with abdominal pain also lasting more than a year, but the abdominal pain does not occur every day.
The discomfort from the lower back to the ribs is a daily issue, which started after the abdominal pain began.
Previously, I had no such issues.
I have consulted gastroenterology, gynecology, urology, and allergy/rheumatology, but no problems 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 the lower back.
The gastroenterologist stated that he could not determine whether the discomfort from the lower back to the 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 mentioned that my condition is quite unusual.
I would like to ask for professional medical advice: 1.
What should I do if no tests have revealed anything? The medication for irritable bowel syndrome has not improved my condition.
2.
What should I do about the discomfort in my lower back to the ribs? 3.
Is there a connection between the bruising and the black moles that started with the abdominal pain? 4.
Is it concerning that I have started developing black moles? (My family is worried that the appearance of black moles may indicate a problem.)

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

Dr. Yu Mingchang reply Surgery

Hello^^ After reviewing various specialties, there are no abnormalities.
At your age, you are at the peak of your physiological strength, and these symptoms should not be present.
I recommend that you exercise more; after some time, these symptoms may resolve.
Thank you!!

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, including constant discomfort in the lower back and rib area, unexplained bruising, and the appearance of new moles, warrant a thorough investigation. Here’s a comprehensive approach to understanding your situation and potential next steps.

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 consulted multiple specialists, including gastroenterologists, urologists, and rheumatologists, and have undergone numerous tests (endoscopy, X-rays, ultrasounds), it’s essential to consider less common causes.

2. Possible Causes of Your Symptoms
- Visceral Pain: This type of pain originates from internal organs and can be challenging to pinpoint. Conditions like irritable bowel syndrome (IBS) can cause chronic abdominal pain, but if medications have not alleviated your symptoms, further exploration is necessary.

- Musculoskeletal Issues: Given your description of pain radiating from the lower back to the rib area, consider whether there might be a musculoskeletal component, such as muscle strain or spinal issues. Physical therapy or a consultation with an orthopedic specialist may provide insights.

- Neurological Factors: Since you mentioned that you are currently being evaluated by a neurologist, it’s crucial to explore nerve-related issues. Conditions like fibromyalgia or neuropathic pain can manifest as widespread discomfort and may not show up on standard imaging or tests.

- Psychological Factors: Chronic pain can sometimes be exacerbated by anxiety or depression. Stress and emotional factors can amplify the perception of pain, leading to a cycle of discomfort that is hard to break.

3. Addressing the Bruising and New Moles
The appearance of unexplained bruising and new moles is concerning and should not be overlooked.
- Bruising: Frequent bruising can indicate underlying issues such as clotting disorders or vascular problems. It’s essential to discuss this with your healthcare provider, who may recommend blood tests to evaluate your clotting factors.

- New Moles: The development of new moles, especially if they change in size, shape, or color, should be evaluated by a dermatologist. While many moles are benign, changes can sometimes indicate skin cancer, so it’s wise to err on the side of caution.

4. Next Steps
- Comprehensive Evaluation: Given the complexity of your symptoms, consider seeking a multidisciplinary approach. A pain management specialist, who can coordinate care across various specialties, might help in developing a comprehensive treatment plan.

- Lifestyle Modifications: Sometimes, dietary changes, stress management techniques, and physical therapy can significantly impact chronic pain. Keeping a symptom diary may help identify triggers or patterns related to your pain.

- Follow-Up Testing: If your current evaluations do not yield results, you might discuss further imaging studies (like MRI) or referrals to specialists in pain management or functional medicine.

5. Conclusion
Chronic abdominal pain and associated symptoms can be frustrating and debilitating. It’s crucial to maintain open communication with your healthcare providers and advocate for your health. If you feel your concerns are not being addressed, seeking a second opinion or consulting a specialist in chronic pain may provide new insights. Remember, you are not alone in this journey, and with persistence, you can find the answers and relief you seek.

Similar Q&A

Unexplained Abdominal Pain: Understanding Symptoms and Causes

Hello Dr. Chen, I have been experiencing continuous abdominal pain for the past two weeks. The pain is not localized and I haven't had diarrhea or anything like that. I have already undergone X-rays and an ultrasound, both of which showed no issues or stones. Over the last t...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
It is recommended to undergo a sigmoidoscopy (anorectal surgery) and a barium enema (which can be scheduled through either anorectal surgery or gastroenterology) for examination. If no significant findings are observed, it may be related to functional disorders. Wishing you good ...

Unexplained Abdominal Pain: Understanding Ongoing Discomfort

Hello, I have been experiencing pain in my lower left abdomen for over four months now (specifically, four finger widths to the left of my navel and four finger widths down). The pain is intermittent and cramp-like. I have undergone a complete gynecological examination and was fo...

Dr. Liao Yaopan reply Family Medicine
Hello, it is indeed necessary to conduct a differential diagnosis for lower abdominal pain to rule out possible causes, whether they are structural abnormalities or functional issues. It is recommended to seek evaluation from a general surgeon. Please note that online consultatio...

Chronic Abdominal Pain and Unexplained Symptoms: Seeking Answers

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...

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 exper...

Chronic Abdominal Pain: Understanding Complications and Treatment Options

Hello, doctor. Since February of last year, I have been experiencing abdominal pain every night, and sometimes I have to rush to the bathroom in the middle of the night. At that time, my bowel movements had a fishy odor, the color was abnormal, and they were not well-formed. Howe...

Dr. Chen Shidian reply Gastroenterology and Hepatology
If the weight is normal, irritable bowel syndrome (IBS) may be the most likely cause. In addition to using gastrointestinal medications for management, a stool occult blood test can be conducted. If necessary, a referral to a mental health specialist may help with anxiety control...