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abdominal pain worsens when I eat...

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I'm a 21 year old female with severe abdominal pain. My pain started on June 27th 2011. It started with sharp stabbing pains below the center of my ribs, the beginning of my stomach and would last for a couple of seconds and would start back up every 5 minutes for a couple of hours. I went to my doctor two days later (6/29/11) from there they ordered a couple of blood tests and an ultra sound. Tests came back normal/negative. The pain then spread to my whole abdomen. My symptoms are: abdominal pain, everywhere and only one section at a time, ranging from upper middle near the center of the ribs, under ribs left and right side, and whole lower section from pelvic bone to belly button. The pain worsens when I eat, no particular type of food, even water hurts at times. Nausea mostly all day and vomiting a couple times a week. Painful when I sneeze, burp, and hiccup. At times when I burp and hiccup I’ve thrown up. Always tired / fatigue. Headaches throughout the week. The sun/heat worsens my pain. Excessive body temp changes. When I inhale deeply through my noise I smell ammonia. Weekly intestinal spasms. Bowel movements are every 2-3 days so usually constipated. Pains will range from stabbing, to throbbing, and burning pain. Occasional chest pains from lower left and right under breast, middle chest pain that will shoot straight back to my shoulder blade. I’ve had blood in my stools a couple times with streaks of blood and once with a ball of blood. I do not have acid reflux and have not been diagnosed with anything. The only medications are ortho evra birth control patch. I do not take any other medicines not even pain killers. I have lost weight (unintentional) 11 lbs. the first month but I’ve been trying to maintain it.
I’ve had 2 ultra sound, 2 hidas, xrays, ct, small bowel series, gastric emptying study, an endoscopy, and a colonoscopy. All came back clear/negative.
This has disrupted my life. I had to drop out of college because of the pain. I just want to know what this is. I had my colonoscopy done yesterday (came back normal)and my doctor is now referring me to a surgeon possibly exploratory surgery? I’m not sure what to do next or what to ask for. Please help!
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replied September 29th, 2011
Especially eHealthy

Sorry about your problems. It is sometimes very difficult to determine the cause of such diffuse and nonspecific abdominal pain. Abdominal pain can be caused by so many different things, from the benign to the severe. Unfortunately, pain that migrates all over the place doesn't help much as a symptom, to be able to determine its etiology.

Now days, exploratory surgery is very rarely done and only as a "last ditch" effort. With all of the imaging studies now available such as the MRI and CT scans, the use of an Ex-Lap for diagnosis has almost fallen out of use. The main reason being, that though you would think that opening someone up and looking, the surgeon would be able to see everything. But it is actually the opposite. The imaging studies can actually "see" things better.

The use of the laproscope has decreased the morbidity of doing an Ex-Lap, but this is still a major operation. Surgeons are loath to operate, without solid indications. The chance of causing more problems is quite high, compared to the beneficial information that could be obtained. Besides the usual acute risks/complications of any major abdominal procedure, there is the possibility of developing adhesions inside the perotineal cavity down the road. Adhesions can cause severe problems, including bowel obstruction. So, again, surgeons do not want to cause more harm, so they try to avoid doing any procedure not absolutely indicated. But, it may come to that down the road.

You are obviously under a lot of stress from all of this. Stress should not just be dismissed as inconsequential. It can cause many health problems itself. It can lead to depression and anxiety, both of which are significant medical problems. Since you have lost a substantial amount of weight, without trying, you may already have depression from this whole mess. I am in no way saying that the abdominal pain in not real, that it is in your head. It is real, it is in your abdomen. But, you also need to take care of the stress that it is causing.

If you aren't already, you should probably talk with someone. It does not necessarily need to be a mental health specialist, just someone you trust, who can help you with the stress.

So, as you continue to look for an etiology of the abdominal pain, take care of yourself also. Hope you find your answers soon. Good luck.
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