Abdominal/ pelvic pain please help

Signs and symptoms
1

Hello everyone I'm hoping that someone can shed some light on what's going on with me.

I have been in pain for now two months straight, the pain is mainly in my pelvic region more so on the left side, bloating and blood in urine but no uti! I had a transvaginal ultrasound (normal) colonoscopy (normal) 2 ct scans (One showed diverticulosis) The other did not even mention that. I have done a uterine byipsy (normal). my Gastro doctor seems to think it's gynecological in nature my gyni Dr. Seems to think it's Gastro related. I am in so much pain and I don't know what's going on as my doctors really don't know either anyone with the same situation as mine? I have tried gluten-free diet but has not been over any difference. Any advice?

2

Sorry you are in so much pain. Is your back ok? I have spinal stenosis and recurrent herniated disks and I get horrible abdominal pain from my L2-3 nightmare (only left sided abdominal pain). Has your gyno recommended a pelvic floor specialist? I'd still be concerned the gyno or GI might be missing something though. Did you get any second opinions?

Hoping for comfort to come your way.

Rebecca

3

Hi Rebecca! Thank you for your concern, my back is OK, I am not sure if here in the US we have pelvic floor specialists, I am thinking of asking my gynecologist to do a laparoscopy, I wonder if this could be some kind of endometriosis but I am 44 and the doctor told me it's a little late in the game for that. My primary doc said it could be bladder related too but honestly he told me he has no idea why I have also hematiria in urine. Puzzling!!

4

sorry to hear that you are in pain.

Will keep you in my prayers

I too have pelvic pain. so far, urologists didn't diagnose with anything. 

5

Thank you!!

6

I forgot- I also had endometriosis from Age 40-48. I had several surgeries for it and they eventually took my left ovary. My pain did start on the left side. The symptoms stopped when I went into menopause. Like your Dr.,my first gyno thought I was too old to have new symptoms of endometriosis. So, I went to another one who was willing to take a look. I was a mess! So painful throughout my cycle. It never let up except after surgery to remove all the tissue and eventually when menopause hit.

I live in the United States and yes, we have pelvic floor specialists. If you ever go that route, just make sure they are board certified in it.

Keep us posted. I'd encourage you to get a second opinion:-). Prayers for relief are coming your way!

Rebecca

7

Has your doc explained as to why the CTs scan differ and from colonoscopy?

(one should have a look at the pics, where diverticulosis was seen and point it out. I really would make the radiologists revisit both CTs and come to a conclusion and correct interpretation.)

Can diverticulosis be a misdiagnosis as not seen in other CT even (I can understand maybe not seen in colonoscopy due to looking for a small hole only, but two different CT reports within samish time frame?)

I would really ask the doc not knowing if diverticulosis was now an issue or not.

Was your 'blood in urine' visible in colour or due to lab result -

if lab: dipstick AND microscopically-whole red blood cells seen?

(You are entitled to a print out of your results)

(Microhematurie - invisible to naked eye, not enough to change colour in urine)

This can be a coincidental finding

and not neccessarily related to the pain.  But can be, too, of course.

Many adults have microhematuria without any pain symptoms since 'benign' causes can cause 'blood' to leak into urine.

But need to be checked for sure, repeat urine and then do further tests if positive again and again, to not miss any real underlying cause, that needed treatment.

Infection is one, viral illness another that can cause red blood cells to come out.

Menstruation and vigorous exercise or any urological procedure have to be excluded.

Some taken medication can cause microhematuria (so called medical renal disease), check taken meds for side effects.

Was that all checked?

I would take some multi vitamine capsules or VitC for a few days to get those levels up for sure, since low VitC can cause leakage, but VitC in urine for testing can mask presence of red blood cells.

So yes to vitamine supplement taking, but a no to it 2 days prior sample giving.

If this is all eliminated as a cause and retested positive, the renal function should be checked.

(calculated eGRF, creatinine, and BUN),

cystoscopy is usually then always performed in patients over 35 and no obvious reason found (as mentioned above) for macro or microhematuria.

Multi-phasic computed tomography (CT) urography or MR urography are also possibilities.

It's always the same, if the most common reason is not found (infection), you find yourself with shoulder shrugging and often giving up docs. Duh.

But no, blood in urine is not normal and needs to be checked if false positive

(like exercise) or contamination (like trauma, shaving, menstruation), list any meds in case and go from there, at least reapeat the test if it was just a one off, that has 'healed'.

The urine needs to be fresh, because red blood cells can and will burst depending on osmotic pressure of urine (or shrink, which doesn't matter since still visible as little star cells under microscope).

It is always an estimate because urine can be concentrated or very diluted, hence the cell count per field is highly variable, the number not really relevant, but if seen, it's positive so or so.

All the best!!!!!

(Please don't take a multivitamin capsule prior urine test (VitC is interferring a lot), stay 2 days off additional vitamine supplement intake prior sample please, you don't want to mask it by false neg reaction.)

 

8

Wow!! I should take you along with me to doctor visits! You are so knowledgeable, I am going to bring up all these points to my doctor. Thank you so much for your post I really appreciate it!

9

Haha, you are funny.

Basic urine testing (be it dipstick and/or under microscope) is a standard 1000-and-more times procedure per year and the smallest part of any medical lab,  that I worked in,

BUT nevertheless has its problems with true and false positive and negative results.

Docs do the interpretation, and I always found it very frustrating that hardly anyone would mention if the patient had taken VitC supplements or not, if the patient was menstruating or not, if it was a propper mid stream urine or not in order to warn of false results

or ask for repeat in case they didn't think of it themselves. It's not expensive testing and not invasive to get a sample, so... a repeat really easy.

Just make sure from your end, if any low vitamine, contamination or exercise or medication could have caused red blood cell leakage (benign reasons).

It is not normal to have red bloodcells in urine, but it can have very benign explanations, infection the easiest culprit. But that's between you and your doc.

The minimum is to repeat the simple urine test when being blood positive (without having done a run, shaving, being far off any spot bleeding, doing a good mid stream urine btw -never use the first drops that come out-)

and

to ask why you got 2 different CT reports regarding diverticulosis,

if this was now the case or not.

I think that is your right to know: Do I have diverticulosis?

And then go from there once those two issues were clarified.

I find it so frustrating, but also understand, when things don't add up.

Wishing you all the best

and better don't take me to the doc,

I can be quite upfront and direct (also due to my native language backround, where a direct translation of a neutral sentence in my language is seen as 'rude' in English)

and some docs do not cope well with it, some do beautifully though.

There are also sometimes very rare causes taking years to be diagnosed and sometimes it's all on a molecular basis or nerve basis, that reason never can be found and just 'fixed', especially not quickly fixed.

(I envied everybody who simply had an appendicitis and could be 'fixed' and pain over, just weeks of recovery.)

After obvious reason exclusions like obvious infection, obvious appendicitis, obvious huge cyst, obvious trauma, obvious tumor, one is quickly being put in a 'draw' of 'done and dusted' and has to fight to get things done since exclusion is also diagnostic and peace of mind.

Best of luck!!

10

You are incredible Sanya! My native language is Italian so I can have language barrier too with the docs!

Are you a doctor or nurse? You are so thorough in your answer, are you suffering too from some strange unidentifiable diagnosis?

Thank you for taking the time to write back it made my day, i have been feeling quite lonely and sad lately and your post actually made me happy!

It's frustrating how the docs can't pinpoint if it is bowel related or gyno related, I am going to bring up all your points at my next doc appointment!! Thank you Sanya! I will let you know how it goes!!

11

Med scientist.

German speaking as direct as one is said to be by prejudice. ;-)

Docs and nurses do have the basic knowledge of mistakes that can happen upon sample taking

(instructions/taking/storing a sample correctly is the first step to a correct result! It's often taken too lightly, depends also on parameter to be tested though),

but of course not to the extend than lab people (should) have.

But we lab people miss the clinical on-site symptoms and experience/training for interpretation, the whole pic.

We just know, what could have gone wrong from sampling to testing, especially chemically and what else to order to clarify;

what is very frustrating though, that many lab results are taken as a 100% statement by docs, but harldy anything is 100%, there are diagnostic windows, false reactions, what is 'normal' is in some parameters very individual and just a statistic to provide a 'range' and so on.

Also frustrating,

if their interpretation for a lab result doesn't match (like your red blood cells or blood hemoglobin in urine, which might have been myoglobin, I haven't done the testing or sampling),

often docs do give up already instead of retesting or finding an answer for that part, which might lead to the answer of whole issue.

(e.g. I had elevated liver parameters and had destinct better, lower values all the years before, so it was not my personal normal range or slow aging impact, a clear jump in all 3 and repeated, once the 'have you drunk alcohol?' did not provide the explanation for elevation, the shoulders were shrugged. 2 years later after a move same thing in prophylaxis check up happened and doc ordered an upper abdo ultrasound just to be sure since 'alcohol' or 'active hepatitis' couldn't provide answer.

There was a liver tumor (benign, all good, no probs) squeezing the liver and stomach, that was the answer. I had no symptoms, but would have gotten big ones if not removed at that size. After removal everything returned to normal. That's what frustrates me so much, this overquick 'draw' and shoulder shrugging without a bit more investigation)

Same with imaging, just because one protocol of MRI or CT was run of a body area, doesn't mean that everything there was looked at, and also the mistake of human eye can happen if changes are small....things get overlooked or overinterpreted (artefacts).

So with 'diverticulosis' on CT it depends if the one radiologist overinterpreted something or the other one was too fast overlooking or the pics actually really showing some bumps and the other didn't, which is odd.

I really think you need to know the correct interpretation and if it needed a barium colon xray for confirmation. I can understand how two different results could happen, it's human, it's normal, but you need to know under the line now: which one? is correct to take dietary precautions and know risks and do and don'ts. Many are asymptomatic btw.

Yes, good luck in clarifying the quite important 'diverticulosis' statement

and

getting the urine re-checked making sure, you have the best non-influenced sample for a correct result.

And yes, ask for printed versions of your results. It doesn't matter if you can read them or not, it is easier to ask someone about it or to show for a second look at different doc.

I always keep all or results, I can read them, but also to have them and show relevant results when visiting another doc.

Good luck with your quest for an answer! 

12

Sanya

I just got back from nurse station, my doctor wanted me to repeat urine test. I made sure I drank plenty of water and did not take any vitamins for a week. Urine was clear but the stick picked up RBC at 10+.

I don't know what it means, no sign of bacteria. Yet I am in so much pelvic pain! It seems it is from uterus or left ovary but uterine byopsy was negative, ultrasound and ct of ovaries was good.

Last time my RBC said 2+ but I am not sure that's just from the dip stick or lab. Nurse was puzzled and said she will give the sample to lab. I am worried about the 10+ number.

I go see the gyno doc tomorrow and might ask for a laparoscopy. My thoughts are endometriosis, pelvic inflammatory disease (tested negative for gonorrehea and clamydia ) so he doesn't think so

I just want this pain and bloating gone!! Now I have to worry about blood in urine too??

My mom died of melanoma 2 years ago at age 62, the dermatologist kept on saying let's keep a watch on it until a year later when they finally did a byopsy of the mole and of course it was too late in the game to save her! So I have this fear about the docs missing something big and me dying of it

Thanks for listening to me I feel quite lonely on this journey!

13

I am a guy, and I did not read this entire blog posting, but I can tell you that there is a condition called Pelvic Congestion Syndrome which causes severe pelvic pain. It is important to know that if this is the cause of your ailment, you want to go see a different type of doctor, an Interventional Radiologist (IR for short) who specializes in a good procedure for this condition. DO NOT expect your ObGyn or gastro doctors to tell you to go see an IR, because you as a patient are worth a lot of money to these other doctors and they dont want to lose that revenue. This means you might get a procedure done by another type of doctor that may be the best, or it may be lousy for you. I suggest to all female pelvic pain readers to do their research and see if they might benefit from the IR procedure. You should know that IR procedures do not cut you open. IRs specialize in going through veins and arteries to the source of the problem and fixing it non-invasively. This is a heck of a lot better than some major surgery. Good luck!

PS I am no medical professional, I just know a lot about IRs because of ailments I have had through the years. I wish someone had told me about IR's and all the good procedures they do a long time ago.

PPS I do see some people from time to time saying they had an IR procedure and are in pain or it hasn't worked. I don't know why, but definitely recommend you go see top IR doctors who have performed the type of procedure you need many many times so you have confidence in his or her ability to do it correctly (this is true of any profession)

14

Wow! I meantioned that to my docs and told me it's very rare and there is nothing you can do for it! Yet it makes sense to me because I have varicose veins, hemmorroids, and vulvar varicose veins! I feel like I have such a big weight down in that region! I am in the us and I need a referral for RI that my doctor won't give me!!!

15

Hi I am 26 years old and have had exactly the same pain consistently for nearly 3 months.

Please keep us updated with your progress as I am having such a frustrating time going through all similar tests and not having any results come through for diagnosis yet the pain continues. The constant unexplained bloating is making me depressed

16

Anyone else ever feel like their uterus is being scraped from the inside with a rusted spoon?