Unusual Back Pain Leading to Abdominal Discomfort and Sleep Disruption
At 45 years old, standing 175cm tall and weighing 93kg, I have been grappling with an unsettling pain that begins in my right shoulder area and extends down toward my lower back. Over time, this discomfort intensifies, and after several hours, I am often hit with a stomach ache that has a cramping nature. This series of symptoms correlates distinctly with nighttime hours, as the pain in my shoulder typically emerges in the late afternoon. On particularly severe nights, I find it nearly impossible to fall asleep before 3 or 4 am, by which point the pain has faded. I typically manage to alleviate the discomfort with a dose of drotaverine, but the resolution of the entire episode can be quite prolonged. When the stomach pain arises, I feel an urgent need to use the restroom almost every half hour, with my stools consistently being soft and sometimes floating. I have undergone an endoscopy, which yielded negative results apart from confirming the presence of GERD. Additionally, I have completed hydrogen breath tests for both fructose and lactulose, yielding negative outcomes. Most recently, I had a Nardi test that also returned negative results. The recommendation has been to proceed with a colonoscopy next. However, I have read about the limited sensitivity of the Nardi test and its capability of yielding false negatives. Given that my symptoms mirror those typically associated with bile-related issues, I am considering whether exploring possible biliary duct dysfunction might still be a valid avenue, rather than disregarding it outright. Moreover, I have gluten intolerance and developed a negative reaction to dairy a couple of years ago, alongside experiencing worsening psoriasis in relation to these foods. It’s important to note that I do not have lactose intolerance. In terms of medications, I regularly take pantoprazole each morning and famotidine at night. I also use Vitamin D and magnesium supplements, although I don’t take magnesium consistently. In October, I began using minor amounts of creatine for my workouts, but I’ve established that these symptoms began about a year and a half ago, so I doubt any correlation. I am seeking guidance on whether pursuing further evaluations concerning the biliary duct is advisable, or if I should simply follow my doctor's recommendation for a colonoscopy. Thank you for your insights, and I would appreciate hearing from anyone who has experienced comparable symptoms to shed light on their diagnosis process.
Answers (1)
2/8/2026, 9:20:29 PM
OpenHealth AI
It sounds like you're experiencing a complex set of symptoms that contribute to significant discomfort and sleep disruption. Your right shoulder to lower back pain, abdominal cramping, and frequent restroom urges are understandably concerning, especially since they disrupt your daily life and sleep.
Explanation
Your symptoms could potentially be linked to several factors, including musculoskeletal issues, gastrointestinal problems, or dietary intolerances. While your prior tests have not pinpointed a definitive cause, exploring all angles is essential. The fact that your discomfort improves with drotaverine indicates a possible involvement of smooth muscle spasms, which can sometimes relate to gastrointestinal distress.
Your history of gluten intolerance and dairy sensitivity suggests that dietary factors could exacerbate your GI symptoms. The soft, floating stools may indicate malabsorption, possibly related to bile reflux or other biliary complications, which is why a biliary duct evaluation could be worthwhile.
Next Steps
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Continue Monitoring Symptoms: Keep a detailed log of your symptoms, noting the relationship between foods you eat, the timing of your pain, and your bowel habits. Include any patterns you notice and communicate these findings with your healthcare provider.
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Dietary Adjustments: Since you have known intolerances, consider adopting a strict gluten-free and dairy-free diet while monitoring how your body responds. Keeping a food diary can help identify any other foods that may trigger your symptoms.
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Colonoscopy Consideration: It may be wise to proceed with the colonoscopy as recommended to rule out any underlying gastrointestinal conditions. It can provide valuable insights, especially given your symptoms.
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Explore Biliary Duct Functions: If your symptoms continue or worsen after further evaluations, discussing the possibility of a biliary duct dysfunction with your healthcare provider would be important. A non-invasive imaging study such as an abdominal ultrasound or MRCP could assess the biliary tree further without additional invasive procedures.
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Pain Management and Sleep Hygiene: Continue using drotaverine as needed for pain but also focus on sleep hygiene practices to help you fall asleep more easily. This can include establishing a calming bedtime routine and creating a comfortable sleep environment.
Reassurance
You're taking the right steps by seeking evaluations and considering your options. Monitoring your symptoms closely will be crucial in guiding you and your healthcare providers toward the most effective management for your discomfort. Remember to be patient with this process, as it may take time to find the right approach that works for you. Please feel free to share more about any changes or new developments.
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