Have abdominal pain radiating to groin area and aggravating sciatic pain. All tests are normal. What to do?
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I have been having serious abdominal pain for over almost 4 years ... My pain has been getting worse as time progresses. In 2009 I developed toxic mega colon from C diff infection within hours of a endoscopy. From 2009 to 2012 I had re-concurrent c difficile at least once every month with Vancomyacin. Pain persisted even when cdiff not present.last infection was after several months without antibiotics ( 11 ) and was 3 weeks ago , treatment with vanco cleared it. I have had 2 negative tests since then. Pain starts in low abdomen behind the navel then radiates out to lower left and right abdomen and into lower groin behind the sacrum. If I push on the perineum it hurts more and worsens in the abdominal area. It also aggravates the sciatic nerve ... Pain is sharp at the spot in the abdomen. It feels like its just in front of the sacrum and deep behind the Navel . its deep and pulsates ,the area surrounding it pulsates with a burn and throbbing sensation. This pain generally never stops and is constant. The severity of pain changes but never seems to go lower than a 4 of 10 . I have had several ct scans with no unusual results, An Endoscopy in 2009 with 2 biopsy's that were clean. Urinalysis clean blood-work and vitals are all text book normal. Eating aggravates it and elimination is normal when c diff is gone. Pain is constant and doesn't leave after deification. It hurts more when defecating. No Crones disease has been found, everything comes back normal. The frequency of these attacks and emergency visits have increased as has the pain severity and duration. Pain seems to move around the abdomen now after the initial stabbing in the area mentioned above. I already minor IBS and this isnt related that pain is entirely a different sensation and goes away with diarrhea after elimination. My Ibs flares are rare ( 2 in the last 4 years) but they aggravate this condition. These pain attacks can last days and or weeks and the throbbing is there even with 62 micro patch time release fentanyl and 20 mg morphine oral. Tonight its sharpest in the area above the perenium and behind and just below my navel and it feels like a jab that shoots into the rectum and the base of the penis ... its also radiating from there into both hips. The hips are sore and worsen with weight or walking. I almost collapse when getting out of a car. I live in Calgary AB Canada and the theory is there is invisable damage to the colon / visceral nerve system that is causing this pain and each time the c diff gets in there it makes it worse ... I have profuse sweats that seem random in nature , and when I exercise I sweat unbvelivably compared to everyone else in my yoga class ... Hot yoga is worse... Light Jogging for 2-5 mins makes me sweat like I ran a mile. I have bouts of neasea from pain and I take Ondanstran for it , I have Depression so bad that I am monitored by a psychologist and a psychiatrist and am on several anti depressants to both alieveiate pain and the suicidal tendancies ... Living like this isnt living its just surviving and I hate it. I was an active healthy person before this all began. I don't know what to do or where to go ... The Gastro specialists here are not good ones and have 5 times now give a diagnosis of IBS, When I got a second opinion from Emerge and testing it turned out to be Reccurent C Diff again. Now the Cdiff is gone and I am in unbearable pain . THe Gastro here are also notorious for sayingeverything is IBS and there are literaly hundreds of people going to BC XXXXXXX Washington and Edmonton for tratment because they have such a terrible reputation. I am at my wits end , I finally have a useful good GP but we don't know what to do next ... Plkease help . DJ ( James) Rouse I provided these details to one Homeopath here. You may take it if it helps to give me a helpful answer. CASE TAKING / RECEIVING FORMAT I PRELIMINARY DATA 1. Name DJ Rouse 2. Age 37 3. Sex m 4. Occupation : Government investigator fo Canada Revenue 5. Financial Status : On med Leave 6. Social status 7. Religion : Agnostic 8. Address : Calgary Alberta Canada 9. Contact no 403 508 9964 10. Email address YYYY@YYYY 11. Mother tongue : English II PRESENTING /CHIEF COMPLAINTS 1. Since when the complaints started Late 2009 2. Onset sudden or gradual: Sudden after C Difficile 3. Pain – Lasting sometimes days and weeks , Never below a 2 / 10 And in constant throbbing pulsating senstation , then about every 10 days an excruciating severe sharp pain in the abdomen 4. Side of affection - Left or Right, from left to right or from right to left, upper left and lower right or upper right and lower left ( Lower abdomon both left and right Mostly in the center. 5. Aggravating or ameliorating factors or conditions : Stress and strain aggrivates it and can trigger "attacks" but most of the time the pain just starts from waking and escalates throughout the day. On "Bad Days" my pain escalates exponentialy untill I have to go to emergency and have them use IV Morphene and Hydromorph to calm it. 6. Supportive investigations and reports, diagnosis, findings… I have had 10 CT scans ( Nothing seen) Blood Tsts ( All normal ) Colonoscopy in 2009 with Biopsy (NORMAL) Enterography ( Normal) 7. Speed of development of disease - slow or fast : Its getting worse by the year. But the level of pain for the last few months has been gradualy getting worse. 8. Probable or final diagnosis : The Diagnosis I have currently is Post C Difficile Neuralgia ( Nerve Damage to the colon) III ASSOCIATED COMPLAINTS / OTHER DISEASES None : Only Depression and severe anxiety brought on by this pain IV PAST HISTORY ( MAJOR ILLNESSES / SURGERIES / ACCIDENTS) IN THE PAST 1. Meningitis at age 6 and 14 . Right leg ran over by a car at age 6 C Difficile at age 34 ( Developed toxic Mega colon then after antibiotics for years the c diff left ... Now the pain is constant.) 2. Any suppressive treatment like ointments for skin, laser therapy for stones, corrective surgery for eye etc. 3. Emotions that precipitate the disease every time: None that I know 4. Emotional conflict happened just prior to the onset of disease that remain unresolved : none 5. How from lower layers of tissues the disease shifted to more important and higher layers of tissues : I dont understand this question. 6. Chronological journey of disease- how you started with first sickness, next what happened , then what etc. till you developed the present state of illness. In 2009 I had a cancer screening by colonosopy. My mother wasx diagnosed with colon caqncer at age 44 and I was 34 so I was immediately High risk. I was on antibiotics at the time. The GI specialist tried to say it was just IBS untill 3 days later I developed severe and Antibiotic resistant C Diff. From 2009 - 2012 it was constant , Positive c diff test , antibiotics, then fine for a few weeks then c diff again ... in Feb 2012 I beat it , Pain this entire time was constaqnt burning and throbbing with neaswea, Sweats and always feeling cold. Severe bouts of insomnia and depression started because I dont feel like I am living life but surviving it. The pain is throbbing and escalates about every 8 - 14 days to an un controllable point. After seeing an Anesthesiologist and pain specialist its their opinion that its nerve damage from the c diff. We have been treating it with Fentanal Patches and Morphiene. I tested positive for C diff again a month ago and it made everything worse and they had to raise my dosages. V FAMILY HISTORY / HEREDITARY DISEASE TENDENCIES/GENETIC DISEASES ETC. IN THE FAMILY 1. Father - Not Much Known he was violently abusive and beat me from birth to age 16 when I ran away from home and was emancipated after he threatened to kill the social worker when I went to live with my grandparents. 2. Mother - Cysts in her spinal column, Diabetes, Osteo Arthrightis, TMJ, Ceiliac Disease, Hystorectomy at my birth due to hemmoraging, ( I have been screened for all of this but the cycts in spinal cord as they say its not likely) 3. Paternal Grand Father - quaduple bypas in 1988 hypertention and arythmia death from prostate cancer in 2002. 4. Paternal Grand Mother - alcoholic , had to have 3/4 of stomach removed from alcoholism causing large ulcers. Smoker untill 68 death by Embolysm at age 72 5. Siblings, in order NONE 6. Paternal uncles and aunts : Maternal aunt has Chrones ( i was tested, they say I dont have it) Another aunt has Parkinsons, Paternal Unkle Died of stroke at 47 he was an alcoholic ( I am not) VII DRUG / TREATMENT HISTORY 1. Any medication, Allopathic, Ayurvedic or Homoeopatic 2. Allergic sensitivity to any drug : penicillin allergy ( anaphalactic) sweat and temperature reactions to perkoset, Severe panic attacks from immovane. 3. Over use or abuse of drugs: none 4. Any affection / side effects of taking drugs VIII INVESTIGATION REPORTS / RESULTS (ATTACH RELEVANT REPORTS) 1. General health 2. Presenting complaints IX PATIENT AS A PERSON / PHYSICAL / GENERAL 1. Appearance: built average , structure168 Lbs and 5ft 8inches, height, weight, Clear complexion, small moles on back , Light pigmentation blue eyes, dark blond hair etc. 2. Speed: talking walking etc normal , Eating has slowed and often affects pain levels bad. 3. Thermals: Sensitivity to cold AND heat, Hot baths help the abdominal pain , feet constantly cold and always needing heating pad, Sensitive to temp change need ac in anything over 25 C and heat must be at or above 17 C or im cold 4. Appetite: decreased, cravings and aversions to milk and breads, Sensitive to heavy creams and homoginized milk over 2%, Preffer food hot. 5. Thirst: Always Dehydrated , drinking 10 - 15 cups of water / day, thirsty during night, by feeling thirsty, drinks in between meals, throat and mouth getting dry, cold or room temperature, fruit juices, some Diet cola and water, 6. Stool: habits, : Normal and pain is the same before and after movement , Pain durring movement increases. 7. Urine: no Difficulty ( Dark) Tested its normal. 8. Sleep: disturbed, catnap- alert, easily waking, restless, tossing about in bed, position in sleep: On Left side, salivation occaisionaly. 9. Dreams: good/ bad repetitive,Have PTSD related to family and rtelationship trauma. PTSD comes and goes usually involving incidents of violence I relive that I have blocked in early childhood or teen years. 11. Sensitivities: to sun, noise, light, tight clothing, touch, At times severe but for the most part just an irritation. When I have a pain attack light touching and even constrictive undergarment band bothers abdomen. 12. Senses: all senses normal 13. Habits: Quit smoking in 2005 smoked for 4 years. X PATIENT AS A PERSON/ MIND/ LIFE SITUATION 1. staying together - in long term stable XXXXXXX relationship of 11 years , I have suspiscions of partner cheating but its very unlikely , he inisists he doesnt. 2. High Stress job , but currently stress due to bills from money issues as Im on Diasability. 3. Education, diligence for gathering or updating knowledge qualified for the job very Diligent , College education , but didnt finish as I started to get headaches and familly issues ( my grandparents raised me and died when I was in college and I cant afford to go back) 4. Expressive, extrovert, vivacious eloquacious , sweet talker, open hearted, 5. VERY Communicative, easily starting conversation, easily mixing with strangers, sharing feelings with others, prefers to be in company. 6. Intellect: studied by self intellectually sharp , concentration WAS easy before the drugs and antidepressants now its not. comprehension easy, read a book about 3 times a year . good and quick in making decisions,independant thinker and decisive. 7. Diligent regular or not able to work because of pain frequencey and durration. Before this set in I was dependaqble and loved my work. I miss work , office friends etc. 8. Morals: respecting rules and morality, sensitive to values and mores. 9. Will: good and confident in handling responsibilities alone and in critical situations, confident courageous, optimistic, persevering and a bit of a pessimist 10. Memory: good , recollecting events of the past, remembering numbers and names not so good. 11. Nature or disposition: mild, sarcastic, contemptuous, fearful , contented. 12. Emotions: when getting angry anger expressed keep thinking about the issue for long times. sentimental or sensitive, sympathetic to the point of forgetting one’s own needs, involved in XXXXXXX and social service,affectionate, lead by my passions and a bit of a sensualist. 13. Sensitivity: to behaviour of others criticism, success or failure, money, injustice, to the surroundings, Loves nature, animals, music, Hates religion. 14. Anxiety about conscience, health, future, for others, apprehension, anticipation, punctual, 15. Attachment: attached to career, worked hard to get the position im in , family, friends, mean alot to me. 17. Fears: death , petrified I will have cancer and leave my partner alone with bills. Im frustrated with being sick all the time and its wearing on my attitude . Asked by Me , 1 day ago I hope this is sufficient. Today was particularly a bad day with pain growing from the moment I woke till late evening and then I got controll with my breaqktherough medication ( Morphiene)
Posted Mon, 2 Dec 2013 in Digestion and Bowels
Answered by Dr. Klerida Shehu 15 days later
Brief Answer: Please follow the suggestions below Detailed Answer: hi Thank you for asking XXXXXXX I read carefully your history. You have done all exams and tests. it is good that your gastroenterologist has ruled out inflamatory bowel disease and C-difficcile infection is negative ,this means that you have not to do with such infastidible diseases In our medical term, we call it more a "functional" problem rather than somatic (related to any organ). All people have their own level of pain, yours is quite lower than other, so you become more sensitive to pain than others. This is not to be worried about, it is normal. What I see not normal is related to your perception of pain. Please do not let pain limit your daily activities. Try to work with yourself and make realize day by day that you can be as normal as the other people, defeating the pain. If you cannot succeed yourself, ask for help: your family or close friends can give a help. If not still satisfied, can ask consultation with psychologist until you are definetely defeating pain. I am sure you can succeed. Hope you all the best. P.s. If you still have some other concerns, please write back to me.