Struggling with Persistent Pain: Seeking Insight
I'm looking for perspectives on a health issue I've encountered rather than medical advice. Here’s my situation: I’m a 33-year-old male, standing at 5'11" and weighing 380 pounds. Due to a new job, my physical activity has been moderate. I don’t smoke, I’m not on any medications, and my health record has been fairly unremarkable until the onset of my current issues. To keep it concise, I'll summarize: In July of last year, I awoke with discomfort in what I presumed was my left kidney. The pain was significant but bearable, and I thought I’d assess it further in the morning. When the discomfort persisted, I headed to the hospital. Upon arrival, they conducted blood tests and a CT scan without contrast. A nurse practitioner inquired about my alcohol consumption; upon my response of none, she mentioned that my pancreas appeared inflamed. This was unexpected given the area of my pain, but I took it in stride. They decided to admit me for observation. The following morning, I underwent a CT scan with contrast and had additional blood tests done. Thankfully, results from both came back normal. However, a week later, since the pain hadn't subsided, I returned to the hospital, where they performed yet another CT scan with contrast, but again, no issues were found. Subsequently, I visited my primary care physician, who recommended a colonoscopy, endoscopy, and ultrasound. The ultrasound indicated I have a fatty liver, which isn’t surprising given my size. The physicians diagnosed me with gastritis and diverticulosis, but I can’t help but feel that the gastritis diagnosis was perhaps more an insurance formality since I’ve experienced minimal stomach discomfort. The persistent pain I feel is concentrated on my left side—both in the flank and the lower front abdomen. Although I haven’t maintained the healthiest diet—a factor I acknowledge—I have faced erratic bowel movements throughout my life, with fluctuations between normal and distressingly irregular patterns. At present, the pain endures, and I’ve begun noticing bright red blood on my toilet paper, coupled with a persistent dull ache that won’t quit. I’m reaching out to find what others might think this could be, especially if anyone has gone through something similar. Additionally, it might be relevant to mention that both my father and his sister suffer from diverticulitis. Any insight would be truly appreciated as I contemplate starting the entire evaluation process anew.
Answers (1)
8/28/2025, 9:54:31 AM
OpenHealth AI
It sounds like you’re facing a challenging situation with persistent pain and symptoms that are understandably concerning. Seeking insight into your condition, especially given your family history and previous evaluations, is completely reasonable.
Main Points:
- Persistent Left-Sided Pain: This may relate to digestive issues (like diverticulosis and gastritis), but can sometimes indicate other conditions that require further evaluation.
- Blood in Stool: Bright red blood can indicate issues in the lower digestive tract.
- Family History: Given your family’s history of diverticulitis, this could be relevant in understanding your symptoms.
Explanation:
Your persistent pain, particularly on the left side, along with bright red blood on the toilet paper raises concerns that should be closely monitored. While diverticulosis can lead to diverticulitis, which is inflammation or infection of the diverticula and could cause discomfort, the presence of blood could also point to other gastrointestinal issues such as hemorrhoids or more serious conditions.
Next Steps:
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Monitor Symptoms: Keep a detailed diary of your symptoms (pain levels, bowel movements, and any blood observed) to share with your healthcare provider. Note any changes or patterns.
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Diet and Fiber Intake: Consider adjusting your diet to increase fiber intake gradually, which can help regulate bowel movements and potentially alleviate some symptoms related to diverticulosis. Foods high in fiber include fruits, vegetables, whole grains, and legumes. Stay hydrated, as this further aids digestion.
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Follow Up on Blood and Pain: Since you’re experiencing rectal bleeding along with persistent pain, prioritize discussing these symptoms again with your doctor. These details may necessitate further invasive tests or a different approach, even if previous assessments came back normal.
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Seek Specialist Opinion: If symptoms persist or worsen, requesting an appointment with a gastroenterologist may provide more tailored insights and facilitate comprehensive evaluation.
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Evaluate Lifestyle Changes: Considering your weight and its potential impact on your digestive health, exploring weight management options with a nutritionist or a weight loss program might also be beneficial.
Taking proactive steps to address your symptoms and advocating for further evaluation can be essential to finding clarity. While I understand the process is daunting, focusing on these prioritized steps may guide you towards relief. Remember, the goal is to find the root cause of your symptoms to implement a suitable treatment plan effectively.
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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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WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). 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. 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