Abdominal discomfort/pain of unknown cause

[EricaL]

I am having some stomach problems and I am under the care of doctors, but they don't really have any answers for me yet, and I'm looking for ideas on what might be plaguing me... or find others with similar experiences that could share them.

I am a 31 year-old, married, mother of two daughters. I am a working, middle-class, caucasian woman. I'd rate my stress level as average under those conditions. I have had a history of migraines since age 12. I take Elavil/amitryptalline daily (50 mg) for prevention. I take Relpax and Phenergan PRN. I have taken lots of ibuprofen and naproxen in my past. (I  mention this because my first suspicion is that I may have an ulcer).

Anyway, about 4 or 5 months ago I started feeling poorly. I'd periodically feel dizzy or feel nauseaus and just have a sense of not feeling well. About 3 months ago I developed a very familiar sensation of a urinary tract infection, but it also had some upper right quadrant discomfort. I went to urgent care and because urinalysis showed signs of bloods and proteins they felt it was probably in my kidney and upper right discomfort was from that. They gave me an antibiotic. After 3 days my discomfort in the urinary tract was better, but the upper right quadrant pain remained. I went to my doctor and while urinalysis didn't show signs of infection, my white blood cell count was right on the edge of being high, so she switched my antibiotics. Eventually I felt better, but I still didn't feel well.

I scheduled a physical. I mentioned that I hadn't been feeling well and how I was getting upset stomach/nausea, because I have a history of heartburn/indigestion, she thought it could be related to that, though, I'd not had any flare ups recently. The tests performed at physical were all normal.

Three weeks ago, there was a day I wasn't feeling very well again. I decided I'd have some comfort food and went to Dairy Queen. I had not had any breakfast and had a milkshake and fried shrimp basket. Almost immediately my stomach began to hurt, felt like it was swelling and I had pain that radiated from below my ribcage up to middle of my upper stomach. The pain on that day was incredibly severe. Nothing relieved it, not milk, not prilosec, not food, not water, I stayed awake all night in pain. The following day I went to urgent care and they sent me to the hospital.

They gave me morphine and suspected my gall bladder. Ultrasound showed no stones. My liver was slightly enlarged but unremarkable. Blood tests showed normal range of enzymes, etc. Colon activity was normal. They discharged me to my doc. I met him the following day. He gave me vicodin, levsin, and phenergan and scheduled me for a hida scan. Since that time my stomach has continued to bother me. I get tightness and swelling in the middle. I have pain that will radiate from behind my rib cage and twinges of pain below my ribcage. I eat and feel sick... I don't eat and feel sick. If someone presses on the area where my duodenum is I feel like I need to vomit. I constantly feel like I need to stretch my back to curve my belly out. I always feel something constant, but the sensations kind of come and go, sometimes it's pain, sometimes it's burning, sometimes it's twinges, like cramps... and it feels like the area is larger than what bothered me 3 weeks ago. Then it was just below my ribcage and a small band up to my stomach... now it's pretty much my whole upper right side. No discomfort on the left side. No discomfort below the belly button.

The hida scan showed normal gall bladder activity. I have now gone to a gastroenterologist for consult and am under his care. I am scheduled for an upper endoscopy next week and if that doesn't show anything - then a cat scan. But, I'm feeling very frustrated though. So far all the tests show I'm normal and healthy, but I'm not imagining this pain and discomfort. What types of things don't show up on blood tests and xrays, ultrasounds, and hidascans?

I have been missing work and I really can't tell them anything. I feel foolish because the tests seem to say I'm fine. Then I start questioning myself. I feel like I'm wasting my time, my work's time, and doctor's time and maybe I should just ignore it and it'll go away.

Does this sound like anything to anyone?

[DJsmiles]

Erica you sound JUST like me. I had the abdominal pain for two years with ultrasounds, colonoscopies, HIDA scans  ALL coming back normal. I can totally relate to the feeling that you needed to arch to feel comfortable. It felt like 'something" was in there and wrong but I didn't know what.

2 weeks ago I went to the ER for abdominal pain, another Ultrasound was done and gallstones were found. I had my gallbladder out 4 days later.

I think though that I too may have some sort of SOD problem. I am taking a long time to recover and have some of the same pain as before surgery only worse. I dont think they would have looked for SOD though, prior to taking my GB out.

Good luck to you!
Darlene

[stigga100]

did the natural remedy route work ?? i have had an endoscopy, a n ultra sounds and been on domperidone and omeprazole for over 2 months - my pain is still there but the worst thing is the sick feeling in my throat which has led to me going home from work and strugglin to cope ... i so want this to go but everyone i am speaking to says just keep on with the tablets but i feel they arent doing much , can anyone help / advise ?? i dont know what tests there are left for me as everything is coming back normal - the gastroscopy simply said mild inflamation of the stomach and the duodenum but i the tablets ( omeprozole ) dont seem to be sorting it - its the sickness not the pain that im struggling to deal with - i also have a high count of billyrubins ...

Thanks anyone who can advise

[margypops]

Definatly sounds like a Gall Bladder Attack, I had 2 recently ,dont drink Milk or eat fish in fact put in 'Gall Bladder into 'the search engine and it will give you all sorts of Facts including what and what-not to eat, I printed it out and I found if I strayed from the diet back it came , I also wondered at the time if some Meds triggered it Advil Can also Aspirin it reads like you wre taking stuff they prescribed I opted to go the Natural Remedy route and find out for myself.

[EricaL]

Thank you for your thoughts. I'd not heard of SOD and will take a look at it. I've been cutting the fat down. The other day I had wheat grass and a Jamba Juice for breakfast and my lunch was a low-fat soup.... It didn't seem to make any difference, but I'm hoping maybe it will.

I'm trying to stay on fruits and vegetables and soups... The problem is just knowing which things will do what to me. But, it is good advice you have and I think I'll just focus on a low-fat/non-fat diet for a week or two and see if there is any improvement.

I would say waiting on the ERCP thing is definitely sound advice :) I'm happy to see if the Upper Endo show anything or the Catscan. But it's frustrating not knowing what to look for or do. Today I've not had any of the meds and only had a banana and the discomfort is pretty bad. Dinner last night was baked chicken and green beans and a salad... so it shouldn't have been too bad. I would hope.

But again, thank you so much for your thoughts and opinion. It's good to hear from people.

[CalGal]

It sounds a lot like gallbladder issues especially when you mention that the diary and fried shrimp caused a lot of problems. Many people can have gallbladder-like issues and all the tests can be normal, so it can be a difficult thing to try to track down. Have you considered following a very low fat diet to see if over time it will help?

There is also another condition that could be underlying some of the gallbladder-like discomfort that some have. It's called SOD, sphincter of Oddi dysfunction and it's typically not uncovered until the gallbladder is taken out. It's basically spasms of the common bile duct and/or sphincter. It can be extremely difficult to diagnose.

You may want to try the diet and also talk to your doc about trying some specific calcium channel blockers, anti-spasm meds or something like nitroglycerin (cuts spasms - not for the heart in this case) to see if it's effective in your case. For many with SOD, most narcotic or narcotic-like meds can actually make the pain worse as it raises pressures in the duct.

There is a test that can diagnose SOD but it's invasive and carries with it a fairly high risk of pancreatitis. It's the ERCP. But I don't think many docs will want to do it unless all other avenues have been exhausted.