Severe Lower left abdomen/pelvic pain

[kristihelene]

I had posted last week about trying to decide whether or not to go into ER for pain management. I did - stayed a few days. They did a small bowel follow through = normal. They sent me home w/morphine pills, but I am almost out of those now. My GI is saying because the small bowel follow through is normal (and back in Dec when I was admitted they did colonoscopy, endoscopy, and pill endoscopy) and my levels aren't really elevated, that it must not be my crohn's. I saw gyne today (as I feel a pressure on my bladder making me have to pee more frequently, and pressure "down there") and after an internal ultrasound and exam, he said its definitely not a gyne issue. (The internal ultrasound of uterus did show some bowel distension in the radiologist's opinion). My gyne is frustrated with my GI saying that where my pain is during the exam and where I am pointing to is where my descending colon is. He ordered a CT with contrast and wants to see for himself if there is any signs of distension in that area, even though he is gyne and not GI. In the mean time, he recommended seeking a second opinion GI. Now technically, I've seen 3 GI's in the past month - my regular outpatient GI, and two different inpatient GI's, however they are all from the same group. My gyne is recommending I go to a practice in a totally different health system, which I don't disagree with. In the mean time, what in the world do I do about this severe pain? My GI will not write for any narcotics, and this morphine (besides being almost gone) barely touches it. I had left over percocets which also didn't help the pain. Its intermittent, and when its not there I am more ore less at baseline, but it comes at least a few times an hour and completely stops me in my tracks, makes me curl up in a ball, makes me dizzy/nauseous, etc. I have totally accepted a long time ago that with my crohn's, I will have daily/constant baseline pain. THIS IS NOT BASELINE! It's at least an 8/10, and something I just cant continue coping with. Should I go to a different ER in a different health system to get a fresh set of eyes on me? Will insurance be an issue since I was just inpatient last week at a different hospital? I don't know what to do... advice?

 

[afidz]

If you can go to a different hospital, I would. Having Crohn's, our pain tolerance levels are very different than everyone elses. If you put your self between 8-10, then its probably something to be concerned with. Does it feel like really intense cramps or is it a different pain? Can you go to the bathroom ok? In the mean time, a heating pad or a hot bath might help a little bit, or at teh very least, comfort you. Keep this thread updated if you go to the ER
Feel Better :hug:

 

[kristihelene]

Does it feel like really intense cramps or is it a different pain? Can you go to the bathroom ok?
Feel Better :hug:

No, not intense cramps. It is like a sharp, stabbing pain that grabs me. BMs are happening but more frequent with less output, but I am not eating the same as eating causes increased pain so that may be the reason for that change. Doesn't feel like my past blockages. It feels more like the pain from my adhesions in the past, but the small bowel follow through would have shown any small bowel adhesions so I'm hoping the CT will show if there's any distension/narrowing/intussception which would suggest adhesions on large bowel... I will keep this updated. I think I've decided that if my pain is the same in the morning (its been 10 days now so I am guessing it will be) then I will probably go to the ER at the hospital my gyne suggested that is the different health system from my normal ER/GI docs... Hoping 'sleeping on it' will give me some clarity as to what I should do!

 

[afidz]

did they only do a small bowel follow through? I agree with your gyne, sounds like it could be your distending bowel. If you are going frequently but not putting out as much as you should, then it could be something with your large intestine like a partial blockage or something. When I was in the hospital in November (everything was compacted in my large bowel) I felt pressure and pain in my uterus and I was in a lot of pain and what you have described sounds similar. I don't see it resolving over night, but its your choice to wait or not. Have you tried taking a stool softener or laxative to see if you can clear your bowels a little easier?

 

[kristihelene]

did they only do a small bowel follow through? I agree with your gyne, sounds like it could be your distending bowel. If you are going frequently but not putting out as much as you should, then it could be something with your large intestine like a partial blockage or something. When I was in the hospital in November (everything was compacted in my large bowel) I felt pressure and pain in my uterus and I was in a lot of pain and what you have described sounds similar. I don't see it resolving over night, but its your choice to wait or not. Have you tried taking a stool softener or laxative to see if you can clear your bowels a little easier?

This time, yes, other than bloodwork the only test was the small bowel follow thru. When I was inpatient in December they did endoscopy, colonoscopy, and pill endoscopy, and CT w/contrast. Prior to that, I was inpatient in October and had a CT with contrast which led to the finding of the intusseception and therefore the surgery in Nov. I have not tried a stool softener or laxative just because that seems to be resolving just adding a little fat back into my diet yesterday and today (I think I was just not eating the "right" foods for things to move thru since I was trying to avoid the pain after eating).

Interesting that your large bowel was pusing on your uterus - what did they end up doing, and how did they figure that out/diagnose that?

 

[afidz]

I was given a laxative, after about 45 minutes I was able to go (the flood gates opened) and I felt so much better. The only reason they admitted me was because my blood counts were very elevated, but once I was finally able to go, my counts dropped, I think I stayed 3 days for them to monitor my levels, output and pain. HOWEVER, I still do have troubles being able to go to the bathroom, it just hasn't gotten as extreme as it did at that point. I am going to be talking to my GI about it next week to try and figure out a game plan.

 

[kristihelene]

Wow, I am so sorry that continues to be an issue for you! I'm definitely still outputting a normal amount by the end of the day, its just over a more frequent span if that makes sense... I hope you get a game plan together!

 

[kristihelene]

Went to new ER today and currently in waiting room now..

 

[afidz]

Good. Hope they figure out what is causing your pain. Keep us updated

 

[kristihelene]

Got admitted. Saw new GI team today. Getting a repeat colonoscopy tomorrow and then will reconvene to formulate a new plan... Hopeful they'll keep their word and work hard to figure this out!

 

[afidz]

Glad you have doctors trying to help. Good luck with the scope tomorrow! Feel better!

 

[Josephine]

I am similar issue but pain is not everyday.