Struggles with Unexplained LUP Discomfort: Seeking Guidance
I'm reaching out for help due to mounting frustration with my health situation. I’m a 31-year-old Caucasian woman with a complicated medical history. Here are some potentially relevant details: - At 16, I was diagnosed with polycystic ovary syndrome (PCOS) and have been taking Diane 35 ever since. - I received a lupus diagnosis (systemic lupus erythematosus, SLE) at 18. For a decade, I was treated with plaquenil, but due to the inactivity of my lupus, I was taken off the medication, and I haven’t experienced any major issues since. - My mother had a sizeable fibroid, weighing 5 kg, that was only discovered during unrelated surgery. - There’s a family history of endometriosis. - I have a history of a noticeably enlarged spleen tracked over several years. Currently, I’m dealing with a sense of fullness and discomfort specifically in my left upper quadrant (LUP). It feels tender to the touch and causes pain when I cough or bear down, with some of the discomfort radiating to my left shoulder. Lying on my right side makes my abdomen feel particularly tight, whereas I sense tenderness when on my left. I'm quite active, especially in leg presses, which reveal a peculiar sensation – a firm object on the left side of my abdomen that isn’t mirrored on the right when I add weight. This sensation has recurred multiple times, often intensifying to the point of needing emergency care. Alongside this, I frequently experience nausea and bouts of severe vomiting. I've had regular blood tests, and generally, my levels remain stable; however, my C-reactive protein (CRP) is consistently elevated between 14 mg/L and 25 mg/L. My antinuclear antibody (ANA) tests have shown positivity in the past, but my current readings are negative. Over the years, I’ve undergone various abdominal ultrasounds in search of answers. My spleen was measured at 110 ml six years ago and 114 ml this week, showing no signs of enlargement. No abnormalities were detected in these ultrasounds, and there were no indications of any hernias. I have yet to undergo an MRI focused on my abdomen, and it has been a while since I’ve had imaging of my reproductive organs. Frustration is setting in as I seek a proper diagnosis so I can explore treatment options. Whenever my symptoms flare, it impacts my ability to stay active, hampers my athletic aspirations, and even disrupts my sleep. Yet my primary care physician seems uncertain of how to proceed. I’m seeking advice on potential next steps or suggestions for specialists to consult. I’ve noticed that whenever my blood tests and ultrasounds yield normal results, I hit a dead end with my healthcare providers, receiving either general referrals that are costly and lengthy or an unclear sense of being abandoned in pursuing my health concerns.
Answers (1)
2/17/2026, 7:40:48 AM
OpenHealth AI
I understand your frustration and concern regarding your unexplained discomfort, particularly in your left upper quadrant (LUP). Given your complex medical history, including lupus, PCOS, and family history of fibroids and endometriosis, it's crucial to approach this systematically.
Summary of Main Points:
- Your symptoms are concerning but may have various explanations related to your existing conditions or new issues.
- Further investigation through imaging and specialist consultations may be necessary to gain clarity.
- Immediate self-care and monitoring can help manage symptoms while pursuing answers.
Explanation:
The left upper quadrant discomfort you're experiencing could be due to several factors, including visceral issues (related to organs), musculoskeletal pain, or even complications from past diagnoses. The fact that you feel tenderness, especially when lying on your right side, may suggest something related to your abdominal organs (like the spleen or surrounding structures). The persistent nausea and vomiting you mention could also be contributing factors that warrant attention.
Your elevated CRP levels indicate some degree of inflammation in your body, which could relate to lupus activity or other underlying issues. The fact that your recent imaging has not revealed any abnormalities is frustrating, but it doesn't eliminate the need for further investigation.
Next Steps:
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Consult a Gastroenterologist: Given your abdominal symptoms, a specialist who focuses on digestive system disorders could help identify any gastrointestinal causes and recommend appropriate imaging studies, such as an MRI or CT scan of the abdomen.
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Consider a Rheumatologist Review: Since you have a history of systemic lupus erythematosus, a follow-up with a rheumatologist could be beneficial. They may assess if your lupus is contributing to your symptoms, even with normal blood tests.
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Explore Imaging Options: Talk to your healthcare provider about scheduling an MRI focused on your abdomen and possibly repeat imaging for your reproductive organs. These can help explore any hidden structural issues.
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Symptom Journal: Keep a detailed log of your symptoms, including timing, severity, and any associated activities (like exercise efforts), which may help your doctors understand what triggers your discomfort.
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Self-Care Measures: While pursuing these steps, focus on rest and avoid heavy lifting or activities that exacerbate your symptoms. Experiment with gentle stretching or relaxation techniques to alleviate any musculoskeletal discomfort.
Your journey toward understanding and managing your health can be complex, but continuing to advocate for yourself and seeking out the right specialists is key. Please don’t hesitate to reach out for further support or questions along the way.
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