Chronic Abdominal Pain: Is It Related to Gastrointestinal Issues?

Q: Chronic Abdominal Pain: Is It Related to Gastrointestinal Issues?

Hello： It is recommended to provide your height, weight (from one year ago, six months ago, two months ago, and your current weight), frequency of pain, duration of pain, past medical history, current medications, bowel movement frequency, and urine output. <br>This information w

Is it related?!

I have been experiencing intermittent lower abdominal pain for almost two years now.
The abdominal pain has become almost daily, and I feel discomfort around my ribs, which feels strange and uncomfortable, accompanied by a sensation of pressure, bloating, and sharp pain.
Occasionally, I also feel discomfort in my right lower back, but it is not as frequent.
I have undergone various tests in gastroenterology, including stool tests, gastroscopy, liver and gallbladder ultrasound, and barium enema X-rays, all of which returned normal results.
The gastroenterologist diagnosed me with irritable bowel syndrome (IBS).
While my abdominal symptoms have improved, the discomfort around my ribs has not, and it seems to be getting worse.
I consulted with a gastroenterology associate, who provided a conclusion, but the rib discomfort remains unexplained.
I have also seen specialists in rheumatology, pulmonology, urology, and neurology, all of whom found no issues.
However, the internist suggested that lumbar degeneration might be contributing to my discomfort in the lower back and ribs.
Despite taking medication prescribed by the neurologist, the rib discomfort persists.
I would like to ask if gastrointestinal issues can cause persistent sensations of pressure, bloating, constriction, and sharp pain in the rib area.
I have been troubled by this for a long time.
What should I do?

H, 20~29 year old female. Ask Date: 2012/10/22

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: It is recommended to provide your height, weight (from one year ago, six months ago, two months ago, and your current weight), frequency of pain, duration of pain, past medical history, current medications, bowel movement frequency, and urine output.
This information will facilitate further analysis.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2012/10/22

More Info

Chronic abdominal pain can be a complex and frustrating issue, especially when it persists for an extended period, as in your case. Given that you've undergone a variety of tests—including stool tests, endoscopy, liver and gallbladder ultrasounds, and barium X-rays—all of which returned normal results, it seems that a definitive physical cause for your pain has not been identified. This can lead to feelings of confusion and anxiety, particularly when the pain continues to disrupt your daily life.

From your description, it appears that your symptoms have evolved over time. Initially, you experienced intermittent lower abdominal pain, which has now progressed to a more constant discomfort in the rib area, accompanied by sensations of pressure, bloating, and cramping. You also mentioned occasional pain in your lower back, which may be related to your spinal health, as suggested by the internal medicine specialist.

One potential explanation for your symptoms could be Irritable Bowel Syndrome (IBS), which is a functional gastrointestinal disorder characterized by a combination of abdominal pain and altered bowel habits. IBS can manifest with symptoms such as cramping, bloating, and changes in bowel frequency, and it is often exacerbated by stress or dietary factors. While you mentioned that your gastrointestinal specialist diagnosed you with IBS and noted some improvement, it is important to recognize that IBS can also lead to referred pain in other areas, including the ribcage and back, due to the interconnected nature of the body's systems.

The sensation of pressure and discomfort in the rib area could also be related to musculoskeletal issues. Chronic abdominal pain can lead to muscle tension and spasms in the abdominal and back muscles, which can create a sensation of discomfort in the ribcage. This is particularly relevant if you have been compensating for pain by altering your posture or movement patterns, which can strain the muscles in your back and rib area.

Additionally, anxiety and stress can play a significant role in exacerbating gastrointestinal symptoms and may contribute to the perception of pain in other areas of the body. The mind-body connection is powerful, and emotional distress can manifest physically, leading to increased sensitivity to pain.

Given the complexity of your symptoms and the fact that multiple specialists have not found a clear cause, it may be beneficial to consider a multidisciplinary approach to your treatment. This could include:
1. Cognitive Behavioral Therapy (CBT): This form of therapy can help address the psychological aspects of chronic pain, teaching you coping strategies and ways to manage stress and anxiety.

2. Physical Therapy: A physical therapist can work with you to improve your posture, strengthen core muscles, and alleviate any musculoskeletal pain that may be contributing to your discomfort.

3. Dietary Modifications: Keeping a food diary to identify potential triggers for your symptoms can be helpful. Some individuals with IBS find relief by following a low-FODMAP diet, which reduces certain fermentable carbohydrates that can exacerbate symptoms.

4. Medication: If your symptoms are significantly impacting your quality of life, discussing medication options with your healthcare provider may be worthwhile. This could include antispasmodics for abdominal cramping or medications to address anxiety.

5. Regular Follow-ups: Continue to communicate with your healthcare providers about your symptoms. If your pain persists or worsens, further evaluation may be necessary to rule out any underlying conditions that may have been missed.

In summary, while your abdominal pain may not have a clear physical cause, it is essential to explore all potential contributing factors, including gastrointestinal, musculoskeletal, and psychological aspects. A comprehensive approach that addresses both the physical and emotional components of your pain may provide the best chance for relief and improved quality of life.

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