Question Title: 38 Year old "pain in the gut"

1971-1990--After my last child was born I expected the pain to go away for good. (Up until then I had never had it except when pregnant.) But this time it did not go away although it did decrease for a time. But over the years it increased in frequency and severity until a surgeon agreed that at least exploatory surgery was indicated. She removed my gall bladder which she said was severly and chronically inflamed (no stones however).

1990-present--I really did feel better than I had in a long time for about 6-8 months and then the pain started returning. It was rather insidious at first but increasing, so now it hurts on some level virtually all the time.

WHAT'S BEEN TRIED--Over the years I have had more tests and seen more doctors about this problem than I can reconstruct. I have seen GPs, Internists, OB-GYNs, surgeons, gastroenterologists, a psychiatrist, and a nuerologist. I've also tried accupunture and homeopathy as well as a variety of prescription, OTC and herbal type remedies. Despite all this expertise and effort, the problem rolls on.

I have tried to connect the onset or escalation of pain to any number of things over the years. It seems to have little (if any) connection to anything I eat. Being normal or overweight is not predictive. The only genuine predictor that I am aware of is movement, especially sustained and or repetitive movement--bending, reaching,lifting, twisting, kneading, pulling, stirring, etc., etc. These days it takes less time for these actions to hurt and for the hurting to be more intense. Being tired also greatly intensifies (but does not cause) the pain.

What is new on the scene? The constantness of the pain this summer is most unwelcome. It also now seems to involve a larger area for much, but not all of the time. It still seems based or centered pretty much in the same place where it has always been. However now it often radiates about 2" up under my ribs and about 2" toward the mid-line and also just a little bit to the right. Very occassionally it radiates into my back. The pain at the core often stings or is sharp while the rest of it is more like a large and tender bruise and more diffuse. This month I have also periodically (but infrequesntly) had a "mirrored point of pain" on the left side???? Activity (and increasingly little activity at that is the surest predictor of intensity and escalation of the pain. At present on a scale of 1-10, with 10 being high, this pain is usually between a 2-3, but sometimes 4-6. While this may not seem like much, the constantness is truly wearing. I am increasingly guarding against this pain. It is interfering with my life! I'm feeling more depressed about this than I ever remember before.

Earlier this year I had a BE Colon Air Contrast exam. The only potentially interesting notes from this say, "Reflux into the terminal ileum could not be obtained. . . . mild to moderate diverticulosis. . . . no ulcer within the limits of this test"---- I do think I may have some other digestive system concerns but they still don't explain this over-riding concern. This year I was also treated (on what seemed rather filmsy rational) for H. pylori.

I have wondered about adhesions, or a blocked bile duct, or a blocked or twisted something else. I am really discouraged and frustrated. Any help or ideas would be GREATLY appreciated.
Thanks

P.S. I inadvertently first posted this under the H. Pylori topic. I don't think it really belongs there, but I'm not sure where it really does belong.

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Dera Marj,
Your frustration with this pain and the inability of the physicians to find a diagnosis is certainly understandable. With regard to the recent barium enema,, failure to reflux barium into the ileum does not have any significant clinical implications.

Your description of the pain is very complete. Unfortunately, there are no other symptoms to direct the evaluation. Have you lost weight? had a change in appetite? nausea? vomiting? What is your pattern of defecation and has there been any change? This information may allow directed workup of the causes for the pain.

If you have not had a recent evaluation, except for the barium enema, you may want to discuss a repeat series of tests. Evaluation of the pancreas and bile ducts should probably be one of the studies. Additionally, evaluation for gastroparesis should be included.

This information is presented for educational purposes only. Always consult your personal physician for specific medical questions.

HFHSM.D.-rf
*keywords: abdominal pain
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