Right-Sided Pelvic Discomfort
Greetings, I am a 24-year-old female, standing at 176 cm and weighing 72 kg. I am diagnosed with Hashimoto’s thyroiditis, for which I take levothyroxine, and I have a potential case of endometrial hyperplasia along with a history of ovarian cysts. For the past several months, I've also been experiencing intermittent insomnia attributed to stress. Recently, for the past three weeks, I have been contending with discomfort in my lower right pelvic area. Initially, it manifested as a dull ache accompanied by soreness in my lower back and hip for a few days. The pain can best be described as a piercing pressure in my pelvis that intensifies when I stand, sit, or move my pelvis at certain angles while walking. Interestingly, I do not experience discomfort when I am seated or lying still. I visited urgent care for an evaluation, where they performed multiple appendicitis tests, all returning negative; the only significant pain occurred when the doctor applied substantial pressure to my pelvis—which usually causes discomfort anyway. A CT scan was conducted without contrast, which showed no issues and ruled out appendicitis. For the next two weeks, I tried to ignore this peculiar sensation, thinking it might be related to gas or digestive issues. However, the discomfort lingers, albeit slightly diminished during my menstrual cycle. Unfortunately, on the day following my last period, the pain intensified. Now, I feel heightened discomfort when contracting my pelvic muscles, such as during bathroom visits, and I experience sharp pressure during intercourse. This sensation is reminiscent of prior ovarian cysts, which typically burst and resolve quickly. I consulted my general practitioner and had an ultrasound three days ago, receiving the results just yesterday: my ovaries and uterus appear normal. When I expressed my ongoing pain to the GP, their response was dismissive, stating the ultrasound results were clear. They simply prescribed ibuprofen and codeine, neither of which I’ve taken since I prefer to manage this discomfort without medication, especially as ibuprofen hasn’t provided relief in the past. Additionally, while I haven’t experienced nausea or vomiting, I have noted changes in my bowel habits—having loose stools once in the morning followed by constipation for the remainder of the day. I must admit, I feel utterly disheartened. This ongoing pain has significantly disrupted my sleep, as I am consumed with worry that something serious may be happening, yet I remain without answers.
Answers (1)
12/13/2025, 8:10:43 PM
OpenHealth AI
I'm sorry to hear about the discomfort you're experiencing; it sounds quite distressing and challenging. Based on your symptoms and medical history, there are several possible reasons for the pelvic discomfort, particularly considering your conditions related to Hashimoto’s thyroiditis and ovarian cysts.
Main Points:
- Possible Causes: Your pelvic discomfort could stem from pelvic floor muscle tension, hormonal changes, or even referred pain from nearby structures since your ultrasound showed normal findings for the ovaries and uterus.
- Self-Care Tips: There are practical steps you can take to manage the discomfort and possibly identify triggers or relieve tension.
- Monitoring Symptoms: Keeping track of your symptoms may provide insights into their patterns and triggers, helping in management.
Explanation:
Given your diagnosis of endometrial hyperplasia and a history of ovarian cysts, it’s understandable to be concerned about ongoing pelvic pain. Since your ultrasound has ruled out structural issues, the discomfort may involve muscle tension (especially in the pelvic floor) or hormonal factors. Stress can also exacerbate pain perception and lead to changes in bowel habits. The fact that the pain intensifies during certain activities may indicate a connection to muscle tension or pelvic floor dysfunction.
Next Steps:
- Gentle Stretching and Relaxation: Engage in gentle pelvic floor exercises or stretches that promote relaxation. Physical therapy focused on the pelvic floor might be beneficial in learning how to relax those muscles.
- Heat Therapy: Applying a warm compress or heating pad to your lower abdomen for short periods may provide relief from discomfort.
- Dietary Adjustments: Monitor your diet for any foods that might be triggering digestive issues. Consider keeping a food diary to observe how it correlates with your bowel habits and pelvic pain.
- Stress Management Techniques: Practice stress-reduction methods such as mindfulness, yoga, or meditation to help with insomnia and anxiety, which can compound physical symptoms.
- Pain Management Alternatives: If ibuprofen hasn’t helped and you prefer to avoid medications, consider options like magnesium supplements, which can sometimes assist with muscle tension, or herbal teas like chamomile, which may promote relaxation.
Follow-Up Monitoring:
- Keep a daily log of your pain intensity, bowel habits, and any activities that seem to worsen or relieve symptoms. This may help you identify patterns and provide valuable information should you revisit a healthcare professional.
- If symptoms persist or worsen, especially with concerning changes like new or worsening pain, it may be beneficial to seek a second opinion or ask for a referral to a specialist in women's health or pain management.
It's understandable to feel frustrated and worried, but you're taking positive steps by seeking help and being proactive about your health. Remember, managing stress and physical discomfort is very much a process, and seeking support from healthcare professionals can lead to better approaches.
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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. Seeking expert advice on optimal treatment strategy and timing.