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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17548
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Chronic abdominal pain since late 2006. In late 2006, at

Customer Question

Chronic abdominal pain since late 2006. In late 2006, at work during a bowel movement, the pain became so bad that I was sweating and felt like I was going to pass out. Called 911. I later was diagnosed with gallbladder disease February 2007, gallbladder was removed. The small incision method was used. After the surgery in 2007, I felt great for about a month, then it felt like my gallbladder grew back. I have been dealing with this since 2007 and I need to resolve it. I have had 4 different gastro Doctors and every test they could think of and everything is normal. Radiation Safety Officer when I was in the Navy. I worked in the Radiology Departments in 2007 - 2008, Naval Hospital Camp Pendleton. I have had GI studies MRI and CTs, all exams were normal. Ruled out Crohn's. I do not know when I will have a flare up. Pain Management Doctor, I am on hydroco and have had a few nerve blocks. The very bad pain during BM. After BM, I feel much better. HELP, Please
Submitted: 8 months ago.
Category: Medical
Expert:  Dr. D. Love replied 8 months ago.

Hello from JustAnswer.

I am sorry that you are feeling so miserable.

Could you describe your pain in more detail? Type of pain? Location within the abdomen?

Is there anything besides a bowel movement that makes the pain better or worse?

I assume that the GI doctors have done an EGD and colonoscopy, correct?

Do you know what lab work has been done?

Have you had any surgeries in the abdomen other than the gallbladder surgery?

Customer: replied 8 months ago.
Could you describe your pain in more detail? Type of pain? Location within the abdomen?Type of pain - The constant pain is more of a cramping aching, not very bad but enough so it makes it hard to concentrate on work or anything else.
Location within the abdomen - Lower left side.below theIs there anything besides a bowel movement that makes the pain better or worse?The nerve blocks helped but they do not always work and stop working after a few days or weeks. The hydroco makes the pain to where I can tolerate it. Now if I have to go to the bathroom, the pain is very bad during the bowel movement but the hydroco takes the edge off, most of the time. I had a very bad episode about two weeks ago. I had taken the hydroco but the pain was so bad that I felt like I was going to pass out. I called by co-worker. I work for the Texas Department of State Health Services in Radioactive Material Licensing. The Agency that license Emergency Services are in our building. When we called 911 in 2006 they told us to call them before calling 911. The episode 2 weeks ago we called them, they came down and then they called 911. By the time they arrived I had finished the bowel movement and was feeling much better. The Paramedics gave me the option of going to the hospital or taking the rest of the day off. I went home, I felt much better a few hours later. I can feel the flare ups starting, and I will either go to work late or lave work early. If I an lay down for a while I feel better. I can feel the flare up starting. It feels like I need to go to the toilet but a regular go feels different from the start of a flare up. I do not plan anything because I do not know when a flare up will hit. Most of the time I am ok early in the morning. For an example, we made a*****last week. We got up and left at 7 am so I could make the drive before a flare up hit. We made the trip ok. I also know that I could wake up tomorrow morning and not feel like going to work. When I do go to work I do not do very well because I am in constant pain at work. Hard to concentrate on work when in painI assume that the GI doctors have done an EGD and colonoscopy, correct?I think I have had three or four endoscopy and colonoscopy. They found h-pylori bacteria back in 2006 or 2007 which I was treated for. Nothing to explain the lower abdominal pain and the very bad pain during bowel movement.Do you know what lab work has been done?Ruled out Crohn's about 5 or 6 years. I can request my records from all of my doctors. Are there any labs that you suggest? My PCM is great and said that she is open to any suggestions. At this point I am willing to try anything that may give me my life back. Before this happened, I would think nothing of making a day trip of the 287 mile to visit my brother and sister. I cannot do that now.Have you had any surgeries in the abdomen other than the gallbladder surgery?
No
Expert:  Dr. D. Love replied 8 months ago.

Thank you for the additional information.

There are many different causes of abdominal pain, although most of the common causes of abdominal pain have been excluded by evaluation that has been done to this point.

One of the common causes of chronic abdominal pain cannot be diagnosed by any test, which is irritable bowel syndrome, or IBS. IBS is very common, occurring in about 20-30% of people. It usually does not cause acute, severe pain, but it can do so. It is due to altered muscular activity of the gut, which can be either increased or decreased muscular activity.

In someone with normal diagnostic studies, it is also fairly common to have chronic recurrent abdominal pain because of scarring or adhesions in the abdominal cavity. This most often happens after abdominal surgery, but since your first attack preceded your first abdominal surgery, that would not be a possibility. Scarring or adhesions can also occur after certain infections in the abdomen.

Other issues to consider would be chronic panceatitis, and the usual test for this would be blood tests of the pancreas, such as amylase or lipase. Celiac disease also can cause chronic abdominal pain, and there is a blood test to look for this. Certain metabolic conditions also can cause abdominal pain, such as porphyria or sickle cell anemia, but these usually cause less frequent episode of acute abdominal pain and also usually have other associated symptoms, so are not a common cause of just chronic abdominal pain.

If the above blood tests have been done, then the most likely cause of chronic lower abdominal pain that is associated with bowel movements would be IBS, but scarring/adhesions would also be a possibility.

Customer: replied 8 months ago.
Dr. Love, I just got home. I made a short video that may better explain my symptomshttps://www.youtube.com/watch?v=XLWe3HOI0JQThank you
Expert:  Dr. D. Love replied 8 months ago.

Youtube says that the video is private and will not allow me to view it.

Customer: replied 8 months ago.
Sorry about that, I reset the settings. I am going to request my records to see which test I have had. I apologize, I should have done that before asking the question. I should have all of them later this week including the radiology reports. I will create a summary over the weekend. I will send the summary as soon as I finish it. I apologize for taking so long
Expert:  Dr. D. Love replied 8 months ago.

I reviewed the video. The area on the abdomen to which you pointed initially is in the upper left. This still could be the conditions I noted above, and pancreatic disease would be more of a concern. Pancreatic disease can cause pain in any location in the abdomen, but it is more often causing pain in the upper abdomen. The blood tests would be the key component of the evaluation to assess pancreatic disease. It also would be appropriate to consider whether there could be kidney disease in someone with abdominal pain in this location that is also associated with back pain. The usual approach to look for kidney conditions that can cause pain would be an imaging test, and if the CT that was done included images of the kidney, that would be appropriate to exclude these kidney conditions.

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