Managing Abdominal Pain in a 52-Year-Old MS Patient
My mother, aged 52, received a diagnosis of Multiple Sclerosis (MS) back in 2008. Since 2018, she has not undergone any treatments for the condition. Within the confines of our home, she can manage short walks with the aid of walls and furniture; however, she relies on a wheelchair for mobility outdoors. Much of her day is spent either resting in bed or watching television. Her current medications include baclofen, vitamin D, and previously bromazepam. In the past year, she has started experiencing persistent discomfort in her lower left abdomen. Typically, this manifests as a steady dull pain, although there are instances of sharp, fleeting sensations. We have sought medical advice from a range of specialists, including a gynecologist, a gastroenterologist, an emergency room physician, a neurologist, and an internal medicine doctor. She has undergone an extensive series of tests, including a comprehensive blood panel, urinalyses, ultrasounds, X-rays, and MRIs of both her abdomen and brain. An attempt to perform a colonoscopy was made but was unsuccessful due to concerns regarding the safety of anesthesia in light of her MS, which left her unable to tolerate the procedure without it. All test results thus far have yielded normal findings. Despite trying various laxatives, she has not found relief. The gastroenterologist suggested pancreatin, while the neurologist substituted bromazepam with diazepam and introduced pregabalin into her regimen. Unfortunately, the abdominal pain remains, though she notes it feels slightly less severe than at the onset of her symptoms; still, it continues to disrupt her daily life since we began seeking medical assistance in November 2024. The neurologist indicated that the pain might be associated with her MS, suggesting that pain management could be the primary approach moving forward. I would love to hear any suggestions for further actions we might consider or additional specialists we could consult. We are open to any further tests or screenings that might clarify her diagnosis. As a 25-year-old in my final year of pharmacy school, any insights would be incredibly helpful.
Answers (1)
8/9/2025, 10:40:44 PM
OpenHealth AI
It sounds like your mother is experiencing challenging and persistent abdominal pain, especially considering her Multiple Sclerosis (MS) diagnosis. Despite comprehensive evaluations and a variety of specialists involved, it's understandable to seek further guidance for management and relief.
Key Points
- Persistent Abdominal Pain in MS Context: Her pain may be associated with MS, which can sometimes cause neuropathic pain or gastrointestinal issues.
- Pain Management Focus: Since testing has ruled out many immediate causes, focusing on pain management is crucial.
- Actionable Steps: There are practical strategies you can explore to further manage her symptoms and improve her quality of life.
Explanation
Multiple Sclerosis can have a range of effects on the body, including nerve pain and gut-related symptoms. Given that your mother has undergone thorough testing and many results have come back normal, it's possible that her discomfort might be linked to nerve involvement from her MS. Pain can also be more complex in individuals with limited mobility due to MS, potentially causing discomfort as muscle groups and posture change.
Next Steps
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Medication Adjustments: Discuss the effectiveness of the current medications (pregabalin and diazepam) with her healthcare team. Adjustments, such as increasing the dose of pregabalin or trying a different neuropathic pain medication (like gabapentin or a topical lidocaine patch), might provide better relief.
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Physical Therapy: Consider engaging a physical therapist who specializes in MS. They can recommend exercises that might help relieve tension and improve her comfort, potentially through gentle stretching or muscle relaxation techniques.
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Dietary Modifications: Since she has tried various laxatives without relief, assessing her diet for any possible irritants (like gluten or lactose) could be valuable. A registered dietitian with experience in MS could provide tailored dietary recommendations.
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Pain Management Clinic: Consulting a pain management specialist could provide access to advanced pain relief methods, such as nerve blocks or other interventions that are not dependent on anesthesia.
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Keep a Pain Diary: Track the daily pattern of her pain, noting any triggers, intensity, and any relief measures that provide her comfort. This can help healthcare providers better understand her situation and tailor management strategies.
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Support Groups: Connecting with MS support groups could provide emotional support and additional coping strategies from peers who understand what she is experiencing.
By exploring these options, you may uncover pathways to better manage her abdominal pain while ensuring she's comfortable and supported. Always keep an open line of communication with her healthcare providers about the effectiveness of any new strategies you implement.
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