I have severe abdominal pain in the gallbladder and lower pelvic area. Please help.

Question

Hello doctor,

I went to the ER for severe upper abdomen pain. All tests came back clear. So my GI suggested another CT scan with contrast. As I had a CT two years prior for the same pains. Also, I had an endoscopy two years prior as well. Now after a couple of months of being on these stomach spasm pills, I was a little better for a week or two then the pain came back with the same symptoms. Pain is now in the upper near the gallbladder area and lower near pelvic bone. All my blood work and test have come back clear. I have changed my diet completely and went from weighing 172 pounds to still loosing weight and now am at 157 pounds.

I am currently on Dicyclomine and Omeprazole.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand these symptoms of pain for such a long duration must be very annoying and upsetting you.

Well, since you have already preliminary testing including a CT (computed tomography) scan, which apparently came normal make me think some rare and often nonorganic causes for this pain.

1. Acute intermittent porphyria. This is a problem with the blood hemoglobin synthesis, with the accumulation of some toxic byproducts which lead to frequent episodic pain.

2. Lead poisoning. It is otherwise uncommon especially in countries where there is more use of plastic piping for water supplies. Although lead can contaminate water supplies of the home and can accumulate in blood to cause recurrent pain.

3. Adrenal insufficiency. An abnormal under-functioning of adrenal glands. The adrenal gland sits on the kindneys bilaterally.

4. Functional abdominal pain syndrome. This is basically a hypersensitivity of the nerves of the abdomen.

5. Nerve entrapment syndrome. Compression of nerves within muscles of the belly.

You see among all the above causes, the investigation you had done, can come normal. These require a high level of suspicion. I will write down the testing for the above possibilities, kindly get it done, or if already done, upload them as I can read them. You could also read about the above condition to have an idea that how they may be related in your case.

If I keep the above list apart, there are still many conditions, where CT scans and other preliminary blood investigations can come normal. It is essential that an expert in radiology has reviewed the films of your CAT (computed axial tomography) scan otherwise the minor things can often be missed in not dealt, or read by an expert in it.

Get the following tests and see me in one week, we would start from there. You can provide as much information as you can like endoscopic findings or particular CT scan finding. Or it would be easy for you, if you could upload the all investigations, as I can interpret them with reference to your symptoms.