Recurring Monthly Abdominal Discomfort: Seeking Insights
At 33 years old, I was diagnosed with pernicious anemia last year, and I underwent a partial hysterectomy in September, retaining my ovaries. During the surgery, the physician mentioned they removed some endometrial adhesions adhering to my colon. I have a scheduled endoscopy and colonoscopy in the coming months, but I'm eager for any insights you might offer in the meantime. For the last two years, I have endured a three-day bout of abdominal pain each month, which seems to onset unexpectedly. My dietary habits are quite consistent; I avoid both spicy and greasy foods, having maintained a vegetarian lifestyle for the past two decades. The discomfort usually begins first thing in the morning and persists throughout the day, affecting my ability to eat and sleep. The pain extends from beneath my chest to my waist, lacking a specific focal point, and feels like a moderate burning sensation. Interestingly, although I often can't eat, I don’t typically experience vomiting or bowel movements during these episodes, and there’s no reflux involved. Notably, my mother has a history of polyps and a redundant colon. I've experimented with various over-the-counter acid reducers during these painful spells, but none have provided relief. The strategy I've found most effective is to simply manage the pain and allow it to resolve on its own. After these three days of discomfort, I return to feeling completely normal. The purpose of my upcoming endoscopy and colonoscopy is to investigate any potential abnormalities. However, I've come across information suggesting that atrophic gastritis could frequently arise as a complication or result of pernicious anemia. I take Vyvanse and Lexapro daily and receive hydroxocobalamin injections biweekly. While I suspect hormonal fluctuations may contribute to these episodes, the timing doesn't align with my menstrual cycle patterns. I have been recording the dates of these occurrences: - January 10-12 - December 7-9 - November 20-24 - October 17-19 I am hopeful that the forthcoming scopes will yield some clarity, but I am also seeking any additional suggestions or advice that might assist me until the next flare-up occurs.
Answers (1)
2/3/2026, 12:10:45 AM
OpenHealth AI
It sounds like you’ve been experiencing recurring abdominal discomfort for a significant duration, and it’s understandable to seek insights while you await your scheduled endoscopy and colonoscopy. Your symptoms, combined with your history of pernicious anemia and surgical interventions, warrant careful consideration.
Main Points:
- The discomfort appears to have a cyclical pattern, lasting around three days each month.
- You have not found relief with over-the-counter treatments, and the timing of pain doesn’t clearly align with your menstrual cycle.
- You’re aware of a possible connection with your previous health conditions and are looking for additional strategies to manage the pain.
Explanation:
Abdominal pain that is frequent but resolves fully could suggest several underlying issues, including functional gastrointestinal disorders (like IBS), hormonal influences, or even complications from surgery, such as adhesions or visceral hypersensitivity. Given your history of pernicious anemia, atrophic gastritis could also contribute to digestive discomfort, although this typically presents differently.
The cyclical nature of your pain could indicate that it’s linked to factors like hormonal changes or gastrointestinal motility changes that are affected by various triggers including stress or diet. The absence of vomiting or bowel changes is somewhat reassuring, as it often points away from acute gastrointestinal obstruction or significant pathology.
Next Steps:
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Symptom Diary: Continue documenting your pain patterns, noting the intensity, duration, related activities, stress levels, and any other symptoms. This information can be invaluable for your healthcare provider.
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Dietary Adjustments: Although you maintain a vegetarian diet, consider trying a low-FODMAP diet, which can help identify food triggers that may contribute to abdominal pain. You could eliminate common irritants like beans, legumes, certain fruits, and dairy for a period and gradually reintroduce them.
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Stress Management: Since stress can exacerbate gut symptoms, consider incorporating stress-reduction techniques such as mindfulness, yoga, or gentle exercise to see if this helps mitigate episodes.
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Hydration and Meals: Focus on staying well-hydrated and try consuming smaller, more frequent meals instead of larger ones to ease digestion, especially during flare-ups.
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Follow-Up with Healthcare Providers: When you meet with your healthcare team during your upcoming procedures, ensure to discuss your patterns and concerns. Specifically, address your fears about atrophic gastritis, endometrial adhesions, and any possible connections to your medications (Vyvanse and Lexapro).
Conclusion:
It's great that you are being proactive about your health by monitoring symptoms and pursuing medical evaluation. Keep focusing on your documentation and self-management strategies in the meantime; these will provide added context for your medical team while potentially easing your discomfort. Let me know if you need further guidance or specifics!
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