Lower right quadrant abdominal pain (chronic)

[diana605]

I was hoping someone could help me. I have seen so many doctors and know one can seem to help me. I am 26 year old female. Over a year ago I got very sick. I was in excruitiating pain and thought I had an appendicitis. I went to the ER with a 103 degree temperature. They originally thought it was pelvic inflammatory disease, because all of my organs were inflammed upon examination. However, they could not find any bacteria or STD. They put me on an antibiotic. It did not work, my temp shot up days later, and they subsequently put me on Flagil. I was on that medicine for weeks and then finally slowely saw improvement. During that time I was weak, could barely walk by myself, it was really bad. After I got better i still had the pain in the lower right quadrant right by my appendix. It has not subsided in over a year. I have had a laporoscopy for possible endometriosis, colonoscopy, internal ultrasound, blood tests, and know one can help me. the laproscopy revealed nothing and the gyno said i was fine, I saw a gastroenterologist, urologist, and regular physician. They thought it was IBS for a while but the medicine did not work. I am currenly being treated with pain killers and going to see a surgeon soon. History of symptoms: sharp stabbing pain in the abdomen, pain after eating a big meal, pain with intercourse (in the specific area of the abdomen), dull achy pain all over abdomen in the morning. I also have just found out I have moderate heartburn. I have been to mexico twice in the last 2 years.  They have not suggested food allergies or any other possible diagnoses besides a possible idiopathic nerve probelm or a missed hernia. Please help! Your suggestions on what could be going on are greatly appreciated.

[diana605]

Im 26 years old. And they also suggested it could be something originating in my back. I feel like they are just guessing. they suggested an ultrasound and for me to go ahead with a colonic and see how i feel after that. any other problems that would present like a hernia or pid that are not those things?

[CalGal]

Diana, it could be a sipgelian hernia, and yes they can be very hard to detect They're what's called a ventral wall hernia and they're rare from what I understand - like 0.2% of all abdominal wall hernias.

I don't know how old you are, but they seem to 'hit' around in people about 50 or so.

Because they're typically small and in a screwy place portions of the bowel can get involved and cause problems.

From a doc's point of view the diagnosis of SH is more difficult than it's treatment. When they're found it's typically as a painful lump, lateral to the rectus muscle, below the level of the umbilicus. If they're large they can usually be seen and felt, but the small ones can be overlooked. And in women they can be covered over by fat. When that's happening, there can be tenderness at a specific point (along the linea semilunaris -area of connective tissue). That in addition to a 'tense' abdominal wall will 'suggest' a dianosis to a docter. Then they'll use imaging techniques like ultrasound, CT and MRI to try to back up what they feel the problem is.

Do the ultrasound and anything else they suggest to try to pin down what's going on.

[diana605]

I went to see a surgeon. They are saying it possibly sounds like a spiagellen hernia. Does that sound like it would fit the symptoms to you? Are these hard to detect? they want to do an ultrasound now.

Any thoughts? Or other ideas on what this could be?

[CalGal]

If you were on a lot of antibiotics you may want to consider trying some probiotics while you're trying to figure out what's going on. Antibiotics knock out the rotten bacteria, but they also kill off the good bacteria that we all need. There are a number of good products on the market including Culturelle, Digestive Advantage-IBS and FloraQ. It may help with some of the discomfort.

[diana605]

I also have lost weight. I got sick in March 2007 which was after I got back from mexico. It is a specific spot right on or near the appendix. When I touch the area sometimes I can feel a small bump that protrudes some, but that just may be the anatomy of my stomach area cause I have many of those (if I push in) in the right upper quadrant. Any other parisites it could be besides that one h. pylori? I dont have many of those symptoms. It is important to note, that I got sick alot before 2007, I had strep about 9 times in two years and was on lots and lots of antibiotics. And I am not sure if when they gave me the flagil to fix my stomach and the inflammation, if that fixed it or if it was just time. I was in excruitiating pain for weeks.

[diana605]

No. They said that the colonoscopy sample they took was fine. It just was weired it hurt me when they took it. Absolutely no family hx of any bowel issues.no celiacs disease. Only family history of hemochromatosis and some blood clots, but none in my immediate family. I have had no stomach problems before this. I asked my doctor if it could be a parasite from my trips out of the country and he ignored me. I am trying a colonic soon to see if that gives me relief. I also have horrible periods and pain with sex. So that is why they got confused and thought endometriosis. It hurts right near the appendix.

[CalGal]

Did you actually see the written reports from all of the tests and read them yourself? If you haven't, get them and do so. Small things can be overlooked. You also specifically need to take a close look at the results of the colonoscopy.

Have they checked you for H. pylori because of the heartburn? If not, do so.

Does anyone in your family have any form of inflammatory bowel issues? Or food intolerance issues like celiac disease?