OpenHealth Q&A

Seeking Answers for Severe Abdominal Discomfort (Doctors Are at a Loss)

I would like to share some essential details about my situation: I am a transgender man currently undergoing hormone replacement therapy with testosterone (administered as a 0.25 ml shot, which is not related to my pain issues). For context, I still have a vagina. Additionally, I take medications like Adderall and trazodone. I've struggled with an eating disorder, which made it challenging for me to eat before my emergency visit to the hospital. I was unable to keep any food down and was even vomiting due to excessive stress, not because I was intentionally inducing it. By Monday morning, I experienced intense abdominal pain, prompting me to see my primary care doctor the following day. After some tests, I was diagnosed with a urinary tract infection (UTI) and prescribed antibiotics. Yet, after taking three doses over a day without any improvement, I ended up in the emergency room. While at the hospital, further examination revealed that I was on the verge of kidney failure, with my kidney levels at 4.4. I generally have a high pain threshold and often delay seeking medical help, which explains my hesitation before heading to the ER. Financial concerns also played a role in my delay. It appears that my kidney issues stemmed from the overconsumption of ibuprofen, so I’ve been advised to avoid it moving forward. The medical staff took all possible measures, and I was hospitalized for six days, being discharged this morning. Thankfully, my kidney levels have significantly improved to 1.6, although there is some ongoing damage. After receiving multiple rounds of intravenous antibiotics, my infection is nearly resolved. However, a perplexing issue remains: despite being administered various pain relief medications—ranging from Tylenol to morphine—I experienced relentless agony that left me screaming. During the initial days of my hospital stay, I endured intense pain episodes lasting two to five minutes, which would occasionally ease for about twenty minutes before another surge of pain struck. While the pain medication seemed to extend the intervals between these episodes, it did little to alleviate the pain itself. Over time, the intensity of these pain spikes diminished, and the intervals between them lengthened. Initially, I was put on a liquid diet for several days before gradually reintroducing solid foods. Some foods seemed to alleviate my discomfort, while others exacerbated it. Despite the extensive testing—CT scans, ultrasounds, and pelvic examinations—doctors could not identify any source of my severe pain. A lot of my memories from this experience are blurry, as I spent most of my waking hours in distress. One doctor mentioned that it could possibly be irritable bowel syndrome (IBS), but I wonder if such a diagnosis could truly justify pain so severe that even morphine was ineffective. I'm making every effort to identify and avoid foods that may trigger this pain, yet I still experience discomfort after meals—though it's much less severe than what I felt in the hospital. The pain predominantly occurs when food moves through my intestines and slightly before a bowel movement, not in my stomach. I'm reaching out in hopes of advice or suggestions on how to approach this ongoing issue with my healthcare provider, as not only am I confused, but my family and doctors are as well. I've been given Tylenol and some medication for stomach cramps (though I rarely experience them) and have been cleared to continue my current medication regimen. Ultimately, my goal is to avoid pain after each meal. Any insights would be greatly appreciated; thank you for taking the time to read my post.

Answers (1)

9/15/2025, 4:30:59 AM

OpenHealth AI

It sounds like you have been through an incredibly challenging time with severe abdominal discomfort and related health crises. Your persistent pain and the complexity of your medical history understandably leave you feeling confused and concerned, especially after such intense experiences in the hospital. It’s crucial to take a structured approach to address your ongoing symptoms and ensure you find relief and clarity about your health.

Summary of Key Points

1. Unable to Identify Pain Source: After extensive testing, doctors have not found a definitive source for your severe abdominal pain, which could be linked to conditions like Irritable Bowel Syndrome (IBS).
2. Current Pain Management: Despite various pain medications, including opioids, you've experienced significant and persistent discomfort.
3. Dietary Influences: Certain foods seem to impact your pain levels, and you’re interested in dietary management to avoid pain after meals.

Understanding Your Symptoms

Given the nature of your pain, especially its timing related to meals and bowel movements, potential causes include:

• Irritable Bowel Syndrome (IBS): A possibility, especially if stress, diet, and gut function interplay.
• Gastrointestinal Motility Disorders: These may cause pain with movement through the intestines.
• Post-Infectious or Chronic Pain Sensitization: Following your recent severe health crisis, your body might be experiencing heightened sensitivity.

Actionable Next Steps

1. Keep a Detailed Symptom Diary:

   • Track your meals, pain levels, and any other symptoms (like changes in bowel habits). This can help identify specific triggers and patterns.
   • Include the time of day, the intensity of pain (on a scale of 1-10), and any accompanying symptoms.

2. Consider a Low-FODMAP Diet:

   • Start by consulting reliable resources about the Low-FODMAP diet, which has been shown to help individuals with IBS manage symptoms. This diet involves temporarily eliminating certain carbohydrates to see if symptoms improve, then gradually reintroducing them.
   • Pay attention to how your body responds to different foods during this trial.

3. Consult with a Gastroenterologist:

   • If you haven’t done so already, seek a follow-up with a gastroenterologist to explore IBS or other gastrointestinal conditions that align with your symptoms. They may suggest tests like a hydrogen breath test for lactose intolerance or other functional GI assessments.
   • Discuss the possibility of different classes of medications that may target your symptoms more effectively if IBS is the diagnosis.

4. Explore Relaxation Techniques:

   • High stress levels can exacerbate gastrointestinal symptoms. Consider mindfulness practices, yoga, or deep-breathing exercises to help manage stress.

5. Medication Review:

   • Continually discuss with your healthcare provider about the effectiveness of your current pain management regimen. If the medications are not providing relief, exploring alternatives, such as medications targeting nerve pain or those specifically for managing IBS (e.g., antispasmodics) may be helpful.

Final Thoughts

It's essential to be patient with yourself as you navigate your recovery and symptom management. Communicating openly with your healthcare team and voicing your concerns and experiences, especially in response to pain management, can lead to more tailored and effective care. Remember, you’re not alone in this, and finding the right balance in treatment may take time. If your symptoms intensify or new symptoms arise, make sure to address those promptly. Please feel free to reach out if you require additional support or resources.