OpenHealth Q&A

Seeking Additional Insight on Persistent Abdominal Discomfort

Greetings! This is my inaugural contribution to this forum. While I have already consulted several medical professionals, I'm seeking additional perspectives regarding my treatment options and to alleviate some concerns I have. I'm a 33-year-old, assigned male at birth but identify as non-binary. My weight is currently 156 pounds, and I stand at 5 feet 7 inches tall. I do not consume alcohol or tobacco, and I take beta-blockers to manage arrhythmia. For the past nine days, I have been dealing with abdominal discomfort, and I’ve taken several steps to address the issue: - After one day of pain, I visited an urgent care facility where they suggested it could be a viral infection. They recommended testing through my primary care provider (PCP) and provided medication for symptom relief, which I opted not to take to avoid interference with test results. - Two days later, I had a follow-up with my PCP, who ordered various tests, including blood work, an H. pylori screening, and an ultrasound. The blood tests (such as bilirubin, creatinine, and serum) returned normal, and the H. pylori test was negative. I am still waiting for the ultrasound results. - Continuing to experience symptoms, I sought a specialist appointment yesterday. Unfortunately, this physician largely attributed my symptoms to stress without thoroughly reviewing my entire medical history. However, upon mentioning my recent weight loss, primarily due to dietary changes and exercise, he ordered an abdominal CT scan with and without contrast. I feel apprehensive about undergoing another CT scan, especially since I had one earlier this year for a separate issue (which turned out to be an infection). I am also wary of the iodine contrast agent due to its potential links to an increased risk of dementia within a decade. I am keen to explore non-toxic and non-radiative diagnostic options before resorting to a CT scan. In terms of my abdominal discomfort, I had a brief episode of stomach pain in late January diagnosed as gastritis, which responded well to Omeprazole within a few days. I experienced two minor bouts of discomfort in May and July that resolved similarly, leading me to attribute them to indigestion. However, the current abdominal pain, which began a week ago, has remained steady, fluctuating from a 3 to 5 out of 10. It has also extended to my sides, and today I noticed it radiating to my lower back (currently a 1 out of 10). I feel slightly nauseous but have not vomited and haven't observed any blood in my stool. I find slight relief after having a bowel movement (with two instances of diarrhea, the rest being normal). My appetite remains unaffected, as I can eat without any discomfort, though the pain seems localized in my intestines rather than in my stomach. Regarding weight changes, I managed to lose about 20 pounds between late January and late August by adopting a healthier routine (I started at 184 pounds). This included skipping breakfast, cycling to work, engaging in additional exercise on weekends, and consuming smaller meals. This isn't the first time I've lost a significant amount of weight in a year; I did so previously in 2023 through similar lifestyle adjustments. By March, I weighed around 180 pounds, but after reaching 160 pounds, my diet reverted somewhat, leading to my current weight of 156 pounds. Occasionally, I forget to eat even when hungry, compounded by considerable stress at work, which may account for additional weight fluctuations. In light of this situation, what inquiries should I pose to my PCP and the specialist to determine if a CT scan is warranted, or if alternative, non-radiative diagnostic methods can be utilized? Should I be worried about serious conditions such as cancer, or could this be related to an infection? Would it be prudent to seek a different specialist's opinion? I'm eager to make the most informed decisions moving forward, and finances are not an issue; I am prepared to pay out-of-pocket if needed.

Answers (1)

8/26/2025, 7:22:24 PM

OpenHealth AI

Thank you for sharing your detailed history regarding your abdominal discomfort. It's clear that you are actively engaged in managing your health and seeking the best diagnostic approach possible.

Main Points:

1. Your persistent abdominal discomfort for nine days with a fluctuation in pain levels may warrant careful consideration before proceeding with a CT scan.
2. It’s important to explore questions related to alternative diagnostic methods and to address concerns about serious underlying conditions with your healthcare providers.

Explanation

The abdominal pain you're experiencing has various possible origins, ranging from functional issues such as gastritis or stress to more serious conditions. You have already taken proactive steps by consulting multiple healthcare professionals and getting various tests done. The persistence of your symptoms, coupled with the slight radiating pain and associated nausea, makes it important to understand the full picture before deciding on further radiologic testing.

Your previous weight loss, recent dietary changes, and stressful lifestyle may also contribute to your current discomfort. It is completely valid to want to consider non-radiative options due to concerns about the CT scan and possible long-term effects of iodinated contrast agents.

Next Steps

Here’s how you can approach your next discussions with your PCP and specialist:

1. Questions for Your PCP/Specialist:

   • Alternative Diagnostic Options: Ask if there are non-radiation tests available, such as MRI (if costs allow), endoscopy, or other imaging that does not involve radiation to further evaluate your symptoms.
   • Follow-up on Symptoms: Given your history with gastritis, inquire whether a trial of a different medication (like a stronger PPI or antacids) might help alleviate symptoms before considering a CT scan.
   • Stress Management: Since stress was mentioned, ask about potential stress relief strategies or referrals to mental health services that could assist with its management.
   • Nutritional Guidance: Discuss potential dietary adjustments or a referral to a dietitian to help manage your intake and develop better eating habits amidst your stressful work environment.

2. Monitoring Your Symptoms:

   • Keep a detailed symptom diary, noting any changes in pain, any new symptoms, or patterns related to food intake or activity levels. This can be helpful for your healthcare providers.
   • Maintain hydration and consider gentle dietary changes that may ease your discomfort (like smaller, more frequent meals), especially if you've experienced relief after bowel movements.

3. Seeking a Second Opinion:

   • If you feel your concerns are not being sufficiently addressed, it’s perfectly reasonable to seek a second opinion from another specialist, particularly one who might have a different approach or more experience with your symptoms.

4. Watch for Red Flags:

   • Since you've reported symptoms of nausea and changes in bowel habits, it’s important to monitor for any concerning signs such as persistent high levels of pain, weight loss beyond what's noted, or any new alarming symptoms (like vomiting or blood in the stool).

By prioritizing these inquiries and engaging in self-monitoring, you can take informed steps in managing your abdominal discomfort while minimizing unnecessary procedures. Remember, your health is paramount, and advocating for yourself is crucial, especially when navigating specialists' opinions. Don't hesitate to follow up with any additional questions or concerns as you continue this journey.