Seeking Advice: Ongoing Abdominal Discomfort with No Clear Diagnosis
Hello everyone! I’m an 18-year-old female living with Hashimoto’s disease, polycystic ovary syndrome (PCOS), and pre-diabetes – I seem to have inherited quite the genetic bundle. Over the past four months, I’ve experienced a mild, twisting sensation on the left side of my upper abdomen. Initially, this discomfort was intermittent and quite manageable, but it has progressively intensified. While I might not feel the pain all the time, when it does manifest, it can become debilitating, making even simple tasks like walking or taking a breath excruciating. Moreover, any touch or slight pressure on that area inflicts severe pain. I’ve consulted with five different physicians to get to the bottom of this issue. Each one conducted a physical examination, which was quite distressing. The discomfort was so intense that I often found myself in a dissociative state, overwhelmed by the pain afterward. The first doctor, an internist, diagnosed me with irritable bowel syndrome (IBS) and prescribed two medications that yielded no improvement. The second physician (also an internist and a referral from a family friend) speculated that I might be suffering from ANCA vasculitis, citing elevated inflammatory markers while other tests showed normal results. He subsequently referred me to a rheumatologist. Upon examining my case, my rheumatologist agreed on the ANCA vasculitis diagnosis but recommended further tests. When my ANA test returned positive (a piece of information I had previously communicated, especially given my Hashimoto’s condition), he suggested I could have either rheumatoid arthritis, lupus, or Mediterranean fever. It was evident to me that he was biased towards a regional diagnosis based on my Egyptian heritage. Despite my pleas for a second opinion, my mother didn’t agree, which left me in a bind. Consequently, I found myself on a regimen of medications addressing all three potential conditions: cortisone, colchicine, methotrexate (an oral chemotherapy), Hydroxychloroquine, a plethora of supplements, along with my existing medications (thyroxine and metformin). Sadly, my condition worsened rather than improved, and the pain persisted. Due to the side effects of the medications, I started experiencing infections, including an unfortunate vaginal infection (my apologies for the overshare). Thankfully, my gynecologist persuaded my mother to seek another opinion from a different rheumatologist for confirmation of the lupus diagnosis. I eventually saw two rheumatologists, both of whom concluded that my symptoms were not immune system-related. One suggested I might be facing several infections contributing to my situation, while the other firmly stated that nothing is wrong with me, attributing my discomfort simply to IBS. Hearing this diagnosis brought me to tears in her office. Now, here I am a little over a week later, still grappling with the same overwhelming pain.
Answers (1)
3/23/2025, 7:20:38 PM
OpenHealth AI
I'm sorry to hear about the ongoing abdominal discomfort you're experiencing, especially given your complex medical history. Your concerns are completely valid, and it sounds frustrating to navigate through so many opinions without clear answers. Let's focus on the most significant aspects of your situation.
Key Points:
- You have a long-standing history of abdominal pain worsening despite multiple medical evaluations.
- There’s a possibility of multiple factors, including IBS, inflammation, and potential infections, contributing to your pain.
- Symptoms and side effects from medications are also impacting your quality of life.
Understanding Your Symptoms:
Given your symptoms—specifically the severe pain on the left side of your abdomen that intensifies with touch or pressure—it’s crucial to consider that this could result from several issues:
- Irritable Bowel Syndrome (IBS): This can cause cramping and abdominal pain, particularly if you are stressed or have dietary triggers.
- Infections: Given your history of vaginal infections, it’s important to rule out any other underlying infections that could be contributing to your abdominal pain.
- Medication Side Effects: Some medications can cause gastrointestinal side effects, leading to discomfort.
Prioritized Next Steps:
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Track Your Symptoms: Keep a detailed diary of your symptoms, including when they occur, their intensity, and any potential triggers (foods, stress levels, activities). This can help identify patterns and provide useful information for your healthcare providers.
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Dietary Adjustments: Gradually try an elimination diet to identify potential food triggers. Focus initially on common triggers for IBS (e.g., dairy, gluten, high-fat foods) and note any improvements or changes.
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Medication Review: Given the side effects from your current medications, discuss with your healthcare provider about potentially tapering off or substituting medications that may be causing exacerbation of your symptoms. This may include a complete reassessment of your medication for Hashimoto’s and PCOS.
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Focus on Pain Management: Explore non-medication-based pain management techniques such as heat application, relaxation techniques (like deep breathing or guided imagery), or gentle exercises (like yoga) to alleviate discomfort when episodes occur.
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Consult a Gastroenterologist: If you haven’t done so, consider seeing a gastroenterologist specializing in functional gastrointestinal disorders. They can provide insights focused on abdominal pain without an apparent cause.
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Seek Support: Emotional and mental well-being is crucial when dealing with chronic pain. Consider speaking to a counselor or joining a support group for chronic illness to share your experiences and coping strategies.
Moving Forward:
Your journey to finding relief is important, and it's essential to remain proactive and persistent in seeking out what works best for you. It can be exhausting to face multiple diagnoses, but focusing on one step at a time is key. Please let me know if you need further clarification or additional support on any specific aspect.
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