Seeking Relief from Ongoing Health Issues
I’m a 21-year-old woman, standing at 5'5" (165cm) and weighing 130lbs. My health journey has included struggles with iron deficiency anemia and bulimia, and I'm currently on Zofran and using a birth control patch. Since 2019, I’ve been experiencing sharp pain in my right lower abdomen. This pain flares up during movements, coughing, or sneezing, prompting numerous trips to the emergency room, as my primary care physician suspects appendicitis due to the tenderness I exhibit and the positive reactions to the obturator and Rovsing's signs. However, despite the visits, all tests have returned negative results. Notably, my C-reactive protein (CRP) levels have been elevated (around 38-48), and ultrasounds consistently show nonspecific free fluid in the RLQ/pelvic area. This abdominal pain saga began in 2019 and has recurred multiple times, including twice in 2024 and once in 2025. In 2024, my health took a complicated turn. After undergoing wisdom tooth extraction, I developed numerous canker sores—which the dental specialists have ruled out as related to the surgery. I also faced significant epigastric discomfort for which I required six months of omeprazole. Additionally, I was diagnosed with an eating disorder early in the year, and while I started recovering by August, I experienced episodes of nausea starting in the afternoons and extending into the evenings, though without any vomiting. This period was marked by severe fatigue, culminating in another emergency room visit in November due to the recurring RLQ pain. The week following my ER visit in November, I met with a gastroenterologist. The extensive tests—including a colonoscopy, endoscopy, ultrasound, magnetic resonance enterography (MRE), and various lab tests—yielded negative results for anything significant except my ongoing anemia, for which I've started receiving iron infusions as of 2025, and my CRP levels were normal at that checkup. It puzzles me why my CRP only spikes during these episodes. After consulting a different gastroenterologist, I was informed that my symptoms could align with a disorder like cyclical vomiting syndrome, noting that I exhibit no serious ailments in between episodes, implying a functional pain issue. As for my gynecological concerns, I’m on birth control and my menstruation is typically manageable with light bleeding. He recommended a neuromodulator for treatment, but I am hesitant about committing to a daily tricyclic antidepressant for the long term. Recently, I've also begun experiencing sporadic pain in my right upper abdomen, especially after meals, which exacerbates with movement, but ultrasound results appeared normal. Additionally, I have developed eczema on my hands and feet. Ultimately, I just want to feel normal again. The thought of having another episode while at school or work is daunting. Am I overreacting to all of this? Thank you for taking the time to read my post; any advice or insights would be greatly appreciated!
Answers (1)
6/26/2025, 1:20:46 PM
OpenHealth AI
It sounds like you've been through a challenging health journey, and it’s completely understandable to feel overwhelmed. Your symptoms, particularly the recurring abdominal pain and the underlying issues with anemia and a past eating disorder, are understandably causing distress. Let’s focus on what can be done to help you manage your symptoms and improve your sense of well-being.
Key Points
- Recurring Abdominal Pain: Your sharp pain in the right lower abdomen, along with elevated CRP levels during flare-ups, suggests there may be a functional gastrointestinal issue at play.
- Nausea and Fatigue: The episodes of nausea and fatigue that recur in the afternoons indicate a pattern that needs addressing, especially with your worry about them disrupting daily life.
- Psychological Considerations: The impact of your previous eating disorder on your physical symptoms can't be overlooked, and mental health support might be beneficial.
- Skin Issues: The eczema on your hands and feet requires attention as it can contribute to your overall discomfort.
Explanation
Your experience of sharp abdominal pain during movement and the flaring of symptoms could indicate a functional condition rather than structural issues, especially since extensive testing hasn't pointed to a specific solution. Cyclical vomiting syndrome or other functional gastrointestinal disorders, which often don't show up on imaging, can indeed lead to episodes of nausea and pain. Your changing symptoms, like the additional pain in your right upper abdomen, suggest a need for continual monitoring.
Next Steps
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Symptom Tracking: Keep a detailed diary of your symptoms, noting timing, triggers (like food intake or activities), and duration. This can help identify patterns and serve as a useful tool in discussions with healthcare providers.
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Nutrition Focus: Since you're experiencing issues with anemia and potentially related gastrointestinal disturbances, consider working with a registered dietitian who understands your history with eating disorders. They can help create a plan that promotes nutritional balance while avoiding triggers for your symptoms.
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Mental Health Support: Addressing the psychological component of your health is vital. Consider seeking therapy that specializes in chronic pain and eating disorders, which can provide coping strategies for managing anxiety related to your symptoms.
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Gradual Medication Review: If you're hesitant about starting a neuromodulator, discuss the possibility of starting at a lower dose, with close monitoring to assess its impact. Explore alternative treatments with your healthcare provider, such as lifestyle modifications or short-term use of anti-nausea medications when you feel symptoms beginning.
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Addressing Eczema: For the eczema on your hands and feet, moisturizing regularly and identifying potential allergens or irritants are crucial. You may need topical steroid creams or specialized skin-care products – consider consulting a dermatologist for targeted treatment.
Reassurance
You’re not overreacting; feeling “normal” is a worthy goal, and your symptoms deserve careful attention. You're taking steps to understand your health, which is crucial. Continue to advocate for yourself, and prioritize open communication with your healthcare teams. Remember, it's okay to seek second opinions if you feel something needs further exploration.
If you have further specific questions or need clarifications on any of these steps, don't hesitate to ask.
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