Frustration Over Persistent Lower Abdominal Pain
As a 31-year-old male, standing at 5 feet 9 inches and weighing 180 pounds, I underwent a laparoscopic appendectomy in February. Ever since that surgery, I have been plagued by recurring discomfort that resembles the pain associated with appendicitis. It feels as if my lower abdominal muscles are torn across the area. Additionally, I have been experiencing irregular bowel habits, swinging from constipation to sudden diarrhea. Sometimes, the urgency to use the restroom is so intense that I nearly can't make it in time. In May, I sought help at the emergency department, where they concluded that I had simply strained my muscles. However, the pain returned last month, accompanied by my ongoing bathroom issues. Now, I'm also suffering from a lack of appetite and persistent nausea, with the pain worsening after I eat. Over the past month, I have visited the ER three times, each time receiving a CT scan. I consulted with a gastroenterologist who performed both a colonoscopy and endoscopy. He noted signs of inflammation, yet all biopsies returned normal results. Although a HIDA scan has been scheduled, I am sceptical that my gallbladder is involved. The pain has been unrelenting, forcing me to miss work or leave early. This ongoing situation is becoming increasingly frustrating, especially since my gastroenterologist seems unresponsive to my inquiries and appears eager to rush through appointments. After the HIDA scan, he mentioned that exploratory surgery might be the next recommended step. My partner and I are now considering visiting a different hospital’s ER an hour away, given my continued misery and growing impatience. What should my next steps be in addressing this issue?
Answers (1)
7/17/2025, 9:40:43 PM
OpenHealth AI
I'm sorry to hear about the persistent discomfort and challenges you've been facing. Your symptoms, including the ongoing pain, irregular bowel habits, nausea, and lack of appetite, can be frustrating and concerning. It’s important to address these issues systematically and prioritize your comfort and well-being.
Main Points:
- Recurring abdominal pain after surgery may indicate various underlying issues.
- Irregular bowel habits and pain worsening after eating are concerning and warrant a careful approach.
- You may need a different strategy as you contemplate a new healthcare setting.
Explanation:
After an appendectomy, some people experience complications like scar tissue (adhesions) that can cause pain or gastrointestinal issues. The signs of inflammation in your gastrointestinal tract might suggest infections or conditions that are not immediately apparent. Given your symptoms of nausea and changes in bowel habits, it’s essential to find a treatment plan that addresses your needs effectively.
Next Steps:
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Document Symptoms: Keep a detailed symptom journal. Note when the pain occurs, its severity, and its relationship to eating or bowel movements. Documenting these can help healthcare providers better understand your situation.
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Evaluate Dietary Triggers: Pay attention to your diet. Certain foods may exacerbate your symptoms (like high-fat or spicy foods). Keeping a food journal alongside your symptom diary can help identify triggers.
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Request Further Testing or Referrals:
- After your HIDA scan, discuss all results with your gastroenterologist thoroughly. Since the biopsies returned normal, consider asking about possible conditions like functional gastrointestinal disorders (such as IBS) or seek a second opinion from another gastroenterologist who might take a more in-depth look.
- If your symptoms intensify or you continue to feel unheard, it could be beneficial to consult a different healthcare facility where you can express your concerns more openly.
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Prioritize Pain Management: In the interim, discuss with your doctor's office about pain management strategies that may help you cope better, whether this involves medication, dietary changes, or alternative therapies like relaxation techniques.
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Consider Behavioral Health Support: Coping with chronic pain and gastrointestinal issues can take a toll on mental health. Engaging with a therapist or counselor specialized in chronic illness may provide emotional support.
If your pain worsens or you experience concerning symptoms like fevers, severe vomiting, or blood in your stools, seek immediate medical attention. It's important that you feel supported and understood by your healthcare providers, so don’t hesitate to advocate for yourself during appointments. Your comfort and quality of life matter significantly in this process.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.