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Ask Dr. Chip Your Own Question

Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22760
Experience:  Over 20 yrs of Family Practice
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I have excruciating abdominal pain that wakes me up at night

Customer Question

I have excruciating abdominal pain that wakes me up at night between midnite and two am, for several days a month. Pain is not related to ovulation.
The pain is slighty worse on the left side and radiates down my thigh. I is marginally relieved by passing flatus or stool. It usually responds well to pracetamol and codeine. Sometimes it disappears for months and some months it lasts for a whole week in a particular month.
I am forty seven years old and otherwise in good health. I have had several scans that are negative. I do not experience the same pain during the day.
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Chip replied 2 years ago.
Have you had colonoscopy? Any back pain with this?
Customer: replied 2 years ago.
No. Have not had colonoscopy. No back pain associated with this pain
Expert:  Dr. Chip replied 2 years ago.
So you haven't had an MRI of the lower spine? What diagnosis have your doctors proposed?
Customer: replied 2 years ago.
No MRI . Irritable bowel syndrome. What would MRI of spine show?
Expert:  Dr. Chip replied 2 years ago.
Tell me about the radiation of the pain down your spine. Have you not been prescribed any more specific medication for IBS?
Customer: replied 2 years ago.
I did not say spine. It radiates down my thigh. Have had domperidol an anti emetic,anti spasmodic.
Expert:  Dr. Chip replied 2 years ago.
Sorry--I meant thigh. What part of the thigh?
Customer: replied 2 years ago.
Front of thigh
Expert:  Dr. Chip replied 2 years ago.
OK--and you're questioning the IBS diagnosis?
Customer: replied 2 years ago.
Yes
Expert:  Dr. Chip replied 2 years ago.
OK--you said excruciating pain. Can you more fully describe the symptom?
Customer: replied 2 years ago.
Pain in the abdomen at night worse on left side radiates down thigh. Sharp pain
Expert:  Dr. Chip replied 2 years ago.
Was abdominal migraine ever considered?
Customer: replied 2 years ago.
No no nausea, or vomiting or pallor
Expert:  Dr. Chip replied 2 years ago.
Not the same as a typical migraine, but are saying the diagnosis wasn't considered?
Customer: replied 2 years ago.
It was considered and ruled out for lack of sufficient symptoms.
Expert:  Dr. Chip replied 2 years ago.
OK Was superior mesenteric artery syndrome considered?
Customer: replied 2 years ago.
No but the described symptoms don't seem to be very consistent with that
Expert:  Dr. Chip replied 2 years ago.
True, but I was just trying to go through the differential possibilties here. The unusual part is the radiation down the thigh which would suggest not an abdominal condition but possible a spinal problem as in a disk rupture or other structural changes. The other unsual part is the sporadic nature of this. Unless it's a malabsorption problem or a food allergy condition, even that wouldn't explain the periods of no pain. I suggest you ask about a spinal problem condition with your doctors.
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22760
Experience: Over 20 yrs of Family Practice
Dr. Chip and 5 other Health Specialists are ready to help you
Customer: replied 2 years ago.
Relist: Answer quality.
Expert:  Dr. Amir Javed replied 2 years ago.
I have noticed that you relisted the question thats why I am here. I would like to have few important details. You have any history of diarrhea or constipation? Any heart burns? Any relation of this stomach pain with meals? Any numbness or tingling sensations in the back or thigh?
Customer: replied 2 years ago.
No diarrhoea or constipation. No tingling sensation in the thigh. No heartburn at all. There is no relationship to meals whatsoever because the pain comes on four or five hours after supper, when I am asleep.
Customer: replied 2 years ago.
Negative to all above.
Expert:  Dr. Amir Javed replied 2 years ago.
Thanks for the details. I would like to say that there are few important possibilities which should be investigated such as acid-peptic disease with duodenal ulcer (long standing acid-peptic disease can makes the system hypersensitive), bacterial overgrowth, H.pylori infection with gastritis, IBS (some of your symptoms are pointing towards that). It is possible that you might have more then one possibility mentioned. I will suggest to see gastroenterologist and might need first to have upper GI endoscopy, colonoscopy later on, 24-hr esophageal ph manometry test, x-ray lower back. Treatment should be done accordingly. IBS is a disease of exclusion and important to rule out the possibilities which I mentioned before diagnosing that. Let me know if you have any further question. Best wishes.

Do accept the answer in this way I will be rewarded for my work and time here for you. Positive feedback & bonuses will be appreciated.

Best of luck and keep in touch
Dr. Amir Javed.

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