severe umbilical intermittent pain

I wish that I could offer you some insight into the possible cause(s) of your chronic abdominal symptoms. However, it is unlikely that any physician is going to be able to provide you with a specific and accurate diagnosis over the Internet when all of your exhaustive work-ups, and by multiple GI doctors, have, to date, failed to provide a diagnosis.

If you are experiencing frequent diarrhea, constipation, or/and blood in the stool (or dark black stools in the absence of iron supplements), then a colonoscopy is certainly warranted. (Given your already extensive work-up for your abdominal and GI complaints, I am actually a bit surprised that you have not had a colonoscopy already.)

In patients with severe gluten intolerance, even minimal exposure to gluten-containing foods may be enough to cause continued GI symptoms.

I am also assuming that your multiple CT scans, ultrasounds, and abdominal examinations have not revealed any abdominal wall hernias, or a fetal remnant known as a urachal cyst.

If your abominal pain is worse around the time of your menstrual period, then it might also be worthwhile for your gynecologist to consider a diagnostic laparoscopy to rule-out endometriosis. If there is no relationship between your symptoms and your periods, however, then endometriosis is a far less likely diagnosis.

Finally, if no "organic" cause for your symptoms can be identified following a thorough GI and abdominal work-up, you should probably also be evaluated for any psychoemotional factors, such as chronic stress or depression, which may be manifesting as abdominal pain.

Sincerely/ Roebrt A. Wascher, MD, FACS

http://doctorwascher.com

Dear Dr. Wascher,

I thank you for your reply.

Yes, I do agree it is a bit wierd I have not yet had a colonoscopy, but the things I think a colonoscopy would show are Chrons and colitis, both of which, if I can remember from school, are not normally found in a young female, which is why maybe I havent had one yet? I am not sure. In the next few days I will be searching for a new GI doc (just got new insurance) and hopefully I can find a proactive doc this time instead of a reactive one like the ones I have come across these past many years.

As far as the following suggestions you have made:
1 - gluten intolerance: it still baffles me of how I am mostly gluten free now and the pains are more severe and more frequent now more than ever. Maybe this is just some wierd new onset of gluten intolerance (?)

2- The urachal cyst is an interesting thought...would they see that on my one CT scan (I have only had one) if they were not looking for it?

3 - As far as endometriosis, that is interesting too, because my mom and her sister suffered from this and other GYN issues. Would I have to ask for a specific test at my GYN for this? I did recently have a transvaginal ultrasound, but it was normal. (I am in a cancer screening program because of my family history of breast and uterine cancers).

4 - And your last suggestion, the psychoemotional factors - is interesting, because when my parents first took me to my pediatrician as a 6 year year old with these similar symptoms, the doc said I was "stressed", which was so weird because I had a lovely childhood. Although I do find myself stressed more than most, (I just graduated med school!), I cannot imagine my stress being much more than anyone elses...

At my age I just cannot let this go and chalk it up to stress, for it is now just about affecting my ADL. When I was in school it was ok to miss a class or two, but it is not ok to miss a day or two from work here and then...so it is becoming a problem now. And the symptoms are lasting longer and are much more frequent, which are now affecting my social life as well (yoga class, dinner and a movie with friends, etc.)

I do appreciate any other offers of advice/suggestions you may have. Thank you

I noticed your post is over a year old now. Have you had any success in finding a diagnosis? I am curious because I have a 6 year old daughter who exhibits the same symptoms you have and we are about to start down the same path you have with her...I feel so sorry for her and her mother feels helpless. She is very intelligent and fun loving but regularly complains of stomach pain "like when her stomach wants to throw up, but she doesn't need to". She typically has to spend more that 15 minutes in the bathroom to have a bowel movement, which causes her great distress. She is a sensitive girl and is constantly questioning everything, which seems to cause her a lot of stress as well.

Anyway, I hope everything worked out well for you, if you (or anyone else) has advice for us, that would be appreciated.