Lower left abdominal pain???

[Ihurt]

Hi everyone,

I have not posted in awhile, just been busy dealing with health issues. I have a few health issues and have been having some gut issues for the last three and half years. I have had tests that did not confirm anything( colonoscopy, MRE of small bowel, CT scan, ultrasounds, Abdominal ultrasounds).

This past Sunday on Easter I started getting this crampy like pain in my lower left abdomen/pelvis. I did not sleep well that night. It continued to get worse over the next couple days. The pain is like crampy, shooting pain that is on the lower left abdomen that even radiates down my front left thigh and around to my lower back. I finally caved and went to the ER yesterday after three nights with little sleep from the pain and discomfort.

At the ER I only got to see a Nurse practitioner. She did a pelvic exam and pressed around on my abdomen. Then she ordered a pelvic ultrasound and vaginal ultrasound thinking maybe it was ovarian related. The ultrasound did not show any ovarian issues but did show multiple uterine fibroids ( 3 of them to b e exact). One the report it just says there were multiple fibroids in seen, one specifically sits adjacent to the endometrium, and sub mucosal extension cannot be excluded, whatever that means. I asked the Nurse practitioner about it possibly being like diverticulitis since she said there were a couple things that can cause lower left abdominal pain and one was ovarian and the other diverticulitis. She said because I had a colonoscopy 2 years ago that was normal she was not thinking It would be that. She said because I did not cry out when she pressed that area, she did not feel it was that tender! WTH?? I am sorry, but just because I did not cry out in pain does not mean I am not in agony. I happen to deal with a very debilitating health issue that causes me severe pain daily so I am use to dealing with awful pain. I think it has just raised my pain tolerance.

I feel this pain is coming from my intestines. I do not have diarrhea or constipation, but I do feel worse pain after I eat. The pain radiates down my left front thigh and to my lower back. I am worried and do not know what to think. If my colonoscopy I had two years ago did not show diverticulosis, could I have developed it between then and now? I have been suffering with on and off intestinal issues for awhile now and have not been diagnosed with anything yet( just IBS). They like to tell everyone they have IBS when they cannot figure it out it seems.

Could I have an abscess or something? What would be the symptoms? Would I typically have a fever and high White blood count? The Nurse practitioner there said fever and High white blood count would likely be there if the intestines were severely inflamed. Any ideas?? I was less than happy with my care at that ER! I asked about a CT scan and she said she spoke with the doctor and they felt due to my not having a fever or elevated WBC's that they did not feel a CT was necessary at this point. So basically they discharged me still in pain with no help. Any ideas what this could be? Does one typically have fever and elevated WBC's if there is diverticulitis or intestinal inflammation??

 

[UnXmas]

Hi Ihurt, I just wanted to say it's nice to see you posting again, though I'm sorry that it's pain that's brought you here. I don't have much advice, I'm afraid, mainly because I know you've already been through so many tests without answers.

Are you taking any painkillers? If doctors can't find the cause of your pain they can at least try to treat the pain itself.

 

[Ihurt]

Hi Unxmas!!,

How are you doing? Yeah, I have been struggling for sure. I have tramadol for pain, my regular doctor gave me that for my IC bladder pain which is so debilitating. I am at a loss as to what to do. I have been struggling with my IC bladder now for the last year. I have tried all treatments there are for it to no avail. Antibiotics are the only thing that helps it but I am unable to take them due to the severe reactions I get from them. I was taking a medication called uribel and it really helps my bladder pain ( it is a urinary med that turns your pee blue). It contains like 4 different medications( methenamine, methylene blue, phenyl salicylate, hyoscyamine.) Well I think the phenyl salicylate has an aspirin component to it and I think that is messing up my whole stomach and intestines as well. I am so sensitive it sucks. I mean I believe the dosage of the Phenyl salicylate is only like 36mg in one capsule, and I was only taking one capsule for two and three days and then would take a couple days break. It really blows when you find something that helps but then it hurts something else. That seems to be the story of my life .

 

[Muppetgirl]

Sorry you are stuck in pain without relief. Just wanted to chip in on the fibroid front. There are different types; serosal, mucosal etc. It sounds like they are suggesting that the one in the endometrial cavity may also extend into the uterine wall. But what I was going to say was did they tell you the size of the fibroids? Depending on location, size and number they can make the uterus enlarged or bulky and this can cause pressure symptoms on bowel and bladder like urgency, frequency and pain. So I wondered whether it might be worth a gynae consult just to check their opinion. As they are benign tumours they usually leave well alone unless causing symptoms, but it might be useful. Good luck with the rest of it.

 

[UnXmas]

Maybe you've found this site already, Ihurt, but if not people posting there may be able to recommend things that those of us with Crohn's don't know about: http://www.ic-network.com/forum/forum.php

It looks like there are all sorts of surgeries and other treatment options that might help your IC.

I also tried Tramadol recently and it didn't help my pain either, and it gave me blurred vision. Why is finding the right treatment so hard?

 

[Ihurt]

Thanks for the replies Muppetgirl and Unxmas.

Unxmas, yes I belong to the IC Network, but thanks for looking into it for me. I have tried all the treatments really aside from actual surgery. They have some less invasive surgeries like Interstim placement, but that does not work for bladder pain at all, it works more so for the frequency for some people.

I mentioned wanting my bladder removed( cystectomy) and every doctor I mention it to say " no way, you don't want to do that, it is a very serious surgery!". Yeah, but they don't have IC either and have to live with all the severe pain. I guess to have the bladder removed completely they have to actually cut away part of your small bowel to use it as a conduit to create a stoma in order to let the urine out of the body. It takes like 9 months or more to completely heal from the surgery and there is room for tons of complications( especially to the kidneys and bowel). They say it is like a very last resort surgery and most surgeons wont do it. I know another lady who has severe IC. She was to a point where she had to wear a permanent catheter because her bladder had shrunk to the size of a walnut due to the chronic inflammation. She went to like three surgeons who all turned her down for bladder removal. She finally found a surgeon to agree to do it though after so many years of fighting to get it out. I mean she had all the criteria for bladder removal. Shrunken scarred bladders are usually the first criteria they look for in terms of end stage IC where the bladder needs to go. She had that and they still denied her until she finally found someone to agree to do it. It is scary because I am sure I will have an even harder time since my bladder is not the size of a walnut( I pray it does not get that way either!). But with my IC, I have severe debilitating pain. It has robbed me of my life, literally. I also get UTI's a lot and that even further assaults my already damaged bladder. It is like I cannot win. Having gut issues and bladder issues together really sucks!

Ugh, sorry the tramadol did not help you and caused you blurred vision. My pain specialist talked about a pain med called Nucynta. I have not heard of it. Have you ever heard of this one?

 

[UnXmas]

I've not heard of Nucynta, but I'll google it in a bit. I actually have a very effective pain med schedule at the moment of codeine during the day and amitriptyline at night. But the problem is that I'm becoming more and tolerant to the effects of codeine, and my various pains are becoming more and more severe (pain wasn't that much of an issue for me until relatively recently). So now I'm taking over the recommended amounts of codeine, but obviously I can't just go on increasing it and so I need something else.

I hope you can find a doctor who understands your need for treatment. I saw one doctor who told me an ileostomy would be a terrible idea, but I wouldn't ever want to be without my ileostomy now. Not that I haven't had complications, but I don't for one minute regret having the surgery. Have you searched online for surgeons or asked others with IC for doctor recommendations? Maybe you can find a surgeon who's happy to operate for IC, not necessarily to ask him/her for bladder removal, but to at least discuss the various surgical options available and the likelyhood they could help you.

 

[buttER]

Hi Ihurt
What treatment are you taking for your intestines? When you describe the pain I immediately thought of pain from the sigmoid area. I also thought about the UT, although when I have bladder/UT problems the pain tends to be deeper and more diffuse, although in my case also on the left side.

The colon can change so quickly, 2 years ago was a long time ago for a colonoscopy. How about having a sigmoidoscopy at least, just to be sure there is no problem down there?

 

[UnXmas]

Is it possible this pain is also from your IC? The nature/location of the pain can change over time and can radiate. If you don't have diarrhoea or constipation, it's odd that doctors have diagnosed you with IBS. Maybe more of your pain is bladder-related and not bowel-related.

This website lists the locations to which IC can radiate: http://www.patient.co.uk/doctor/interstitial-cystitis-pro