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Is it Time for a Second Opinion?

8/9/2025, 4:30:39 AMMale25-34

The individual is experiencing sharp, intermittent pain in the lower right abdomen, situated just below the rib cage. After a visit to Urgent Care, they received a prescription for antibiotics and pain relief, with an initial diagnosis suggesting a urinary tract infection potentially evolving into a kidney infection. A urine analysis (UA) was conducted at that time. Three days later, the pain persisted without improvement, and the results from the UA returned negative. Notably, the individual did not experience any discomfort when urinating. During the subsequent follow-up appointment, where the negative UA results were confirmed and no alleviation of symptoms was noted, the healthcare provider assessed for kidney stones, gallstones, and appendicitis. A second UA was performed, which also yielded negative results, prompting a recommendation to visit the emergency department (ED) for a more thorough investigation. At the ED, a third UA was executed alongside blood tests and a CT scan. Throughout this period, the pain remained consistent, recurring in waves as previously noted. The UA results remained clear, and apart from a minor elevation in AST levels, the blood work was excellent. The CT scan indicated a small gallbladder without any observable stones, ruling out appendicitis and kidney stones as potential causes. Ultimately, the individual was discharged with the understanding that UTIs can indeed cause significant pain, and further use of antibiotics was advised. Despite this, the persistent pain continues to occur, particularly during physical activity and after meals. Given these ongoing symptoms, would it be wise to seek another opinion from a different emergency department?

FibromyalgiaCOPDInternal Medicine

Answers (1)

Cony

8/9/2025, 4:30:58 AM

OpenHealth AI

It sounds like you've been through a lot with your ongoing abdominal pain, and it's understandable to feel frustrated when answers seem elusive. Given that you've already undergone several tests with no clear diagnosis and persistent symptoms, seeking a second opinion is a reasonable step.

Key Points:

  • You've received multiple evaluations, including urine analyses, blood tests, and a CT scan.
  • Negative results for various conditions (UTI, kidney stones, gallstones, appendicitis) suggest that your pain may be related to a condition that has not yet been identified.
  • Persistent pain, especially if it worsens with activity or after meals, warrants further investigation.

Explanation:

The abdominal pain you're experiencing can have many potential causes beyond what has been tested, including gastrointestinal issues (like gastritis or irritable bowel syndrome), muscle strains, or even referred pain from another area. Since your current treatment hasn't been effective, exploring other opinions or diagnostic avenues could help pinpoint the underlying issue.

Actionable Next Steps:

  1. Consider Seeking a Second Opinion:

    • Look for a gastroenterologist or another specialist who can provide fresh insight into your symptoms, especially since your primary issues seem gastrointestinal in nature.
  2. Document Your Symptoms:

    • Keep a detailed diary of your pain—note when it occurs, its intensity, what triggers it, and any accompanying symptoms (like nausea, changes in appetite, etc.). This information can be very helpful for your new healthcare provider.
  3. Discuss Dietary Habits:

    • Reflect on your meals and any potential food triggers. It might also be worth considering a trial elimination diet under professional guidance to see if certain foods exacerbate your symptoms.
  4. Monitor Activity Levels:

    • Be mindful of activities that lead to increased pain, and try to adjust your routine accordingly until you receive further evaluation.
  5. Follow Up with Your Current Provider:

    • Ensure your current healthcare provider is aware that you're seeking a second opinion. They may offer additional insights or suggest alternative diagnostic tests that could be beneficial.

Reassurance:

It's okay to seek further evaluations when you're not improving as expected. Your symptoms are important, and it’s commendable to continue pursuing answers and care that feel right for you. Don't hesitate to advocate for yourself in the healthcare system—you're your best advocate.

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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. 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