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What Causes Abnormal Abdominal Pain After A C-section?
Question: i had a ceserean delivery in nov14, since then abdominal pain is troubling me, usg says its possible tb
Brief Answer:
Get a blood test done to confirm this.
Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
Persistent pain in the abdomen more than 3 months after the cesarean section is less likely to be due to the surgery. If the ultrasound examination is suggestive of a mild fluid collection and the findings are suggestive of tuberculosis then you can get a blood test done to confirm this.
Starting the proper antibiotics for tuberculosis will cause a pain relief as well as symptomatic improvement. It would be better to start antitubercular drugs early, if this is indeed tuberculosis. Therefore do consult your gynecologist to confirm diagnosis and for proper prescriptions.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal
Get a blood test done to confirm this.
Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
Persistent pain in the abdomen more than 3 months after the cesarean section is less likely to be due to the surgery. If the ultrasound examination is suggestive of a mild fluid collection and the findings are suggestive of tuberculosis then you can get a blood test done to confirm this.
Starting the proper antibiotics for tuberculosis will cause a pain relief as well as symptomatic improvement. It would be better to start antitubercular drugs early, if this is indeed tuberculosis. Therefore do consult your gynecologist to confirm diagnosis and for proper prescriptions.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal
Above answer was peer-reviewed by :
Dr. Prasad
its a tract which was of 27 mm in length 15 days back, with treatment of zinase d for 10 days its has come down to 14mm length , but radiologist is confirm that its tuberculosis, my tb gold test is negative, esr value is 37
Brief Answer:
Presumptive antibiotic treatment can be started to see the response.
Detailed Answer:
Hello.
Thanks for writing again.
A negative TB gold test with a raised ESR is suggestive of a chronic infection or inflammation. If the radiologist is sure that the findings are suggestive of TB then there is no harm in starting a presumptive treatment for TB. In case your symptoms improve then continue with the treatment. A trial for 15 days will be sufficient.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Presumptive antibiotic treatment can be started to see the response.
Detailed Answer:
Hello.
Thanks for writing again.
A negative TB gold test with a raised ESR is suggestive of a chronic infection or inflammation. If the radiologist is sure that the findings are suggestive of TB then there is no harm in starting a presumptive treatment for TB. In case your symptoms improve then continue with the treatment. A trial for 15 days will be sufficient.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
how is tb or endiometeriosis of abdominal wall identified?and if it is the case whose the doctor that wil deal with this issue a general surgeon ,physician or a gynae ,infectious diaease specialist i m taking zinase d for 12 days for howmany days can it be taken.will ct scan help me in identifying my problem.. can this be coverted into cancer if i wait.can this be cellulitis ..as per my radilogist it is cellulitis tuberculosis .will it be safe for me to go on for a trial of ATT without any conformation fot TB.it it really that simple treatment because i read somewhere it is equivalent to chwmotherapy.what if i dont have that os there a possibilty that i have devloped this tb track post my iv treatment since my firt usg didnt reveal this.pls guide soc
Brief Answer:
Details below.
Detailed Answer:
I have read the detailed history and seen the attached reports. Ultrasound is suggestive of abdominal TB. MRI scan suggests adhesions in the small bowel with ovaries- this is also suggestive of TB and can cause the pain like you are having.
Endometriosis is usually associated with pain during periods. The confirmation of diagnosis needs a diagnostic laparoscopy and biopsy.
Your gynecologist can guide you regarding the correct treatment.
Taking Zynase D will only give a temporary relief. It will not decrease the infection. You can take it for 3-4 weeks if needed.
This is not related to cancer or cannot cause cancer.
Trial of ATT is a safe and routine method. It is less problematic than going for a laparoscopy.
Chemotherapy means giving medicines. It does not mean it will be harmful for you. You need not worry. The adhesions are formed late in TB. It is not likely to have developed after the i.v. treatment.
Your internal stitches are alright. TB infection happens due to a bacterial growth only.
Taking insufficient antibiotics will cause the infection and bacteria to flourish again. You need to continue antibiotics for TB.
The other symptoms are due to infection.
For problem in passing stools you can take a laxative. It can also happen due to the adhesions in the abdomen.
Regards.
Details below.
Detailed Answer:
I have read the detailed history and seen the attached reports. Ultrasound is suggestive of abdominal TB. MRI scan suggests adhesions in the small bowel with ovaries- this is also suggestive of TB and can cause the pain like you are having.
Endometriosis is usually associated with pain during periods. The confirmation of diagnosis needs a diagnostic laparoscopy and biopsy.
Your gynecologist can guide you regarding the correct treatment.
Taking Zynase D will only give a temporary relief. It will not decrease the infection. You can take it for 3-4 weeks if needed.
This is not related to cancer or cannot cause cancer.
Trial of ATT is a safe and routine method. It is less problematic than going for a laparoscopy.
Chemotherapy means giving medicines. It does not mean it will be harmful for you. You need not worry. The adhesions are formed late in TB. It is not likely to have developed after the i.v. treatment.
Your internal stitches are alright. TB infection happens due to a bacterial growth only.
Taking insufficient antibiotics will cause the infection and bacteria to flourish again. You need to continue antibiotics for TB.
The other symptoms are due to infection.
For problem in passing stools you can take a laxative. It can also happen due to the adhesions in the abdomen.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks doc.i went to my gynae today and she has now reffered me to physician.my physiacian is in the opinion of getting a ct scan of abdomen done and usg guided fnac.pls guide me of both in terms of safety and radiations involvement as per my health
for how long trial of att is given .my concern is that if i dont have that tb prob,i will still need to take so many med for at least 6 months,how to confirm whether i really reuired this as i have already been on so many amtibiotics for so long..will this att treatment will not make seroius side effects on my body.
i have got some blood work done tday.attaching all my reports.also i was on antibiotic for last 5 days,will these affect my blood work andESR.
IS There ny other test that i can get done to know about actual bactetial growth
PLS GUIDE
for how long trial of att is given .my concern is that if i dont have that tb prob,i will still need to take so many med for at least 6 months,how to confirm whether i really reuired this as i have already been on so many amtibiotics for so long..will this att treatment will not make seroius side effects on my body.
i have got some blood work done tday.attaching all my reports.also i was on antibiotic for last 5 days,will these affect my blood work andESR.
IS There ny other test that i can get done to know about actual bactetial growth
PLS GUIDE
Brief Answer:
Allergic cause indicated.
Detailed Answer:
In CT scan the radiation is more than that in X-rays but it is within normal limits. FNAC will help in confirmation of diagnosis. Both the procedures are safe and will help in the diagnosis.
Usually a trial is given for 4 weeks and is continued if there is a symptomatic improvement. The side effects are there but these are well tolerated. There can be a mild effect on the liver. It is best to get the investigations done to know if ATT is actually required or not.
Taking antibiotics will not affect your blood work. The attached reports suggest an allergic cause- raised IgE and vitamin D3 deficiency. Proper supplements will help you. ESR is just mildly raised.
Laproscopic biopsy can help.
Regards.
Allergic cause indicated.
Detailed Answer:
In CT scan the radiation is more than that in X-rays but it is within normal limits. FNAC will help in confirmation of diagnosis. Both the procedures are safe and will help in the diagnosis.
Usually a trial is given for 4 weeks and is continued if there is a symptomatic improvement. The side effects are there but these are well tolerated. There can be a mild effect on the liver. It is best to get the investigations done to know if ATT is actually required or not.
Taking antibiotics will not affect your blood work. The attached reports suggest an allergic cause- raised IgE and vitamin D3 deficiency. Proper supplements will help you. ESR is just mildly raised.
Laproscopic biopsy can help.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for the detailed reply doctor.
The pain in abdomen is tolerable,but yes i feel it is now extending to left side too as i feel heaviness over there,more till the time i dont get fresh.i do feel very tired ,with blurred vision and feeling of not well being.i dont know it is the side effects if taking so many antibiotics for so long or not taking them gives me this
I have srarted devloping low back pain and swelling in my left nose and behind the left ears,with numbness in my head left side also.wen i recently started the treatment of cefi xl d five days back ,all symptoms were settled,but now i left so again its resurfacing,though doctor has asked me for a course of 10 days,but i could not take antibiotics since they trouble me..
i m hsving pain in right side of rib cage also for so many days..was my lft normal what does the higher value indicates
Mam,isnt there any test to confirm as u said severe cellulitis or soft tissue infection..any blood test that can help me to identify the proper bacteria so thst proper antibiotic for that particular infection be given.till now i feel hit and trial is going on.pls help
I m attaching my the ist usg ,mri report and then iind usg in chronologicall order..had it been tb would the track have reduced to this almost half extent,.is it becoz of serratopeptidase or zinase d.what should i do..15 days back i have had urine culture ,stool culture done with expert plusvtest for tb also,i m attaching that report too..pls guide
The pain in abdomen is tolerable,but yes i feel it is now extending to left side too as i feel heaviness over there,more till the time i dont get fresh.i do feel very tired ,with blurred vision and feeling of not well being.i dont know it is the side effects if taking so many antibiotics for so long or not taking them gives me this
I have srarted devloping low back pain and swelling in my left nose and behind the left ears,with numbness in my head left side also.wen i recently started the treatment of cefi xl d five days back ,all symptoms were settled,but now i left so again its resurfacing,though doctor has asked me for a course of 10 days,but i could not take antibiotics since they trouble me..
i m hsving pain in right side of rib cage also for so many days..was my lft normal what does the higher value indicates
Mam,isnt there any test to confirm as u said severe cellulitis or soft tissue infection..any blood test that can help me to identify the proper bacteria so thst proper antibiotic for that particular infection be given.till now i feel hit and trial is going on.pls help
I m attaching my the ist usg ,mri report and then iind usg in chronologicall order..had it been tb would the track have reduced to this almost half extent,.is it becoz of serratopeptidase or zinase d.what should i do..15 days back i have had urine culture ,stool culture done with expert plusvtest for tb also,i m attaching that report too..pls guide
Brief Answer:
LFT are almost normal.
Detailed Answer:
Your LFT shows only a marginal variation. Such mild rise can be due to the side effects of medicines you are taking. It is not suggestive of anything serious. It will settle on its own.
The specific tests are CRP and ESR. All these are almost normal in the recent tests. You can get a blood culture done and see if there is any infection in the blood.
The track of TB does not reduce on its own. The reduction of size can be due to reduced inflammation caused by serratiopeptidase.
I have seen all the attached reports. The cause cannot be detected from these.
Regards.
LFT are almost normal.
Detailed Answer:
Your LFT shows only a marginal variation. Such mild rise can be due to the side effects of medicines you are taking. It is not suggestive of anything serious. It will settle on its own.
The specific tests are CRP and ESR. All these are almost normal in the recent tests. You can get a blood culture done and see if there is any infection in the blood.
The track of TB does not reduce on its own. The reduction of size can be due to reduced inflammation caused by serratiopeptidase.
I have seen all the attached reports. The cause cannot be detected from these.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doc
Pls give me all the minute details regarding att treatment.
Can elisa and ,mantoux test be helpful for diagnosing tb
And if i have allergic problem ,is mantoux safe my serum ige level is 444.5
I also camt to know about abdominal wall scar endometriosis ..can this have happened in my case
What is the relwvamc of rifamipin resistance expert plus test for diagnosing tb
Pls give me all the minute details regarding att treatment.
Can elisa and ,mantoux test be helpful for diagnosing tb
And if i have allergic problem ,is mantoux safe my serum ige level is 444.5
I also camt to know about abdominal wall scar endometriosis ..can this have happened in my case
What is the relwvamc of rifamipin resistance expert plus test for diagnosing tb
Brief Answer:
Details below.
Detailed Answer:
ATT treatment involves giving 4 or 5 antibiotics for first 2 or 3 months and then 2 antibiotics are continued for next 4-6 months depending on the response to the medicines. It helps in treating the chronic infections. The medicines are given orally and are to be taken at the same time daily.
Elisa and Mantoux tests can be false negative but are rarely false positive. If both the tests are negative even then TB can be there.
Mantoux can be positive due to an allergic reaction also.
Scar endometriosis is a possibility but it is mostly a vascular tissue.
Rifampicin resistant TB can only be diagnosed after a biopsy. Expert plus test will not help.
Regards.
Details below.
Detailed Answer:
ATT treatment involves giving 4 or 5 antibiotics for first 2 or 3 months and then 2 antibiotics are continued for next 4-6 months depending on the response to the medicines. It helps in treating the chronic infections. The medicines are given orally and are to be taken at the same time daily.
Elisa and Mantoux tests can be false negative but are rarely false positive. If both the tests are negative even then TB can be there.
Mantoux can be positive due to an allergic reaction also.
Scar endometriosis is a possibility but it is mostly a vascular tissue.
Rifampicin resistant TB can only be diagnosed after a biopsy. Expert plus test will not help.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi mam.
Thanks for the detailed reply.
I consulted a general surgeon and a infectious disease specialist yesterday
In surgeon opinion after seeing my mri nd ultrasound reports has prescribed me again some medications.
Flucort ointment chymoral forte tds tayo 60k once weekly and tab nurokind and folic acid with one test oc cect abdomen and barium meal through follow
As per infectious disease specialist he suggested for fnac and montoux test to start att or not
Now keeping in view of my health condition and allergic problem is montox test and ce ct safe for me as i m already in healing phase and last year before pregnany i also got cect done..aftr getting that done i had allergy and severe shivering for a day.is it safe in teems of radiation during my healing process
Is ct plain helpful in detection of bowel obstruction or tb..or should i go for 3rd mri
How is fnac done and what are the chances of side effects of this procedure
Can an allergic asthmatic can get mantoux done ,
And what if all these test came negative and still i need to go for empirical att.my gynae said that they follow an empirical att approach to women of i fertility too.is that true mam . I dnt want go fora laproscopy as i m scared ofany further surgeries and their complications post op becaz of these xonsequences
And despitetakingso many medicinesas llist attached ,should i gollow a surgeon prescribed medicine for a week and see if that works,becaz wen i was on zinase d last 15 daysback my track was reduced from 27mm to 14 mm.,had it been tubecular shuld it have been reduced like this
Should i really go for empirical att directlyfor a trial of 2 to 4 weeks..will it be safe for long period of lifetime.in terms of its resitance and reoccurence
I was given amikacin pipzo and orni wen i was admitted .are these also drugs of tb.i read it on net and found them as a second line of treatment.why i was not given ist line
.Pls guide in a detailed manner
Thanks for the detailed reply.
I consulted a general surgeon and a infectious disease specialist yesterday
In surgeon opinion after seeing my mri nd ultrasound reports has prescribed me again some medications.
Flucort ointment chymoral forte tds tayo 60k once weekly and tab nurokind and folic acid with one test oc cect abdomen and barium meal through follow
As per infectious disease specialist he suggested for fnac and montoux test to start att or not
Now keeping in view of my health condition and allergic problem is montox test and ce ct safe for me as i m already in healing phase and last year before pregnany i also got cect done..aftr getting that done i had allergy and severe shivering for a day.is it safe in teems of radiation during my healing process
Is ct plain helpful in detection of bowel obstruction or tb..or should i go for 3rd mri
How is fnac done and what are the chances of side effects of this procedure
Can an allergic asthmatic can get mantoux done ,
And what if all these test came negative and still i need to go for empirical att.my gynae said that they follow an empirical att approach to women of i fertility too.is that true mam . I dnt want go fora laproscopy as i m scared ofany further surgeries and their complications post op becaz of these xonsequences
And despitetakingso many medicinesas llist attached ,should i gollow a surgeon prescribed medicine for a week and see if that works,becaz wen i was on zinase d last 15 daysback my track was reduced from 27mm to 14 mm.,had it been tubecular shuld it have been reduced like this
Should i really go for empirical att directlyfor a trial of 2 to 4 weeks..will it be safe for long period of lifetime.in terms of its resitance and reoccurence
I was given amikacin pipzo and orni wen i was admitted .are these also drugs of tb.i read it on net and found them as a second line of treatment.why i was not given ist line
.Pls guide in a detailed manner
Brief Answer:
Details below.
Detailed Answer:
CECT needs more exposure to radiations but it is within the safe limits for our body to tolerate it. You can intimate the radiologist about the previous reaction that you had after CECT so that adequate precautions can be taken and excessive exposure can be avoided. A CECT is not likely to reveal any more information than MRI scan.
I would recommend MRI scan better than CT scan
FNAC is done with the help if a needle. The intra abdominal fluid is collected. It can be USG guided to reduce the chances of failure. Mild side effects like pain and local infection can be there.
Yes. Mantoux can be done in allergic persons also.
Empirical treatment with ATT is not harmful. If all the tests are negative and the pain continues then ATT might be needed. It is given in infertility patients.
Taking Zynase will reduce the inflammation and it will reduce the track length even if it is due to TB.
Taking it again will not do any harm. The chances of further improvement are there.
Empirical ATT will be the only choice left after all the tests are negative. It is best if your treating doctor decides about this as she has examined you physically right from the beginning.
The choice of antibiotics depends on the symptoms and the treating doctor. Your treating doctor can tell you the reason for choosing amikacin and ornidazole. These are given in mixed infections of the gut. May be she was not treating you for TB at that time.
Hope this helps.
Regards.
Details below.
Detailed Answer:
CECT needs more exposure to radiations but it is within the safe limits for our body to tolerate it. You can intimate the radiologist about the previous reaction that you had after CECT so that adequate precautions can be taken and excessive exposure can be avoided. A CECT is not likely to reveal any more information than MRI scan.
I would recommend MRI scan better than CT scan
FNAC is done with the help if a needle. The intra abdominal fluid is collected. It can be USG guided to reduce the chances of failure. Mild side effects like pain and local infection can be there.
Yes. Mantoux can be done in allergic persons also.
Empirical treatment with ATT is not harmful. If all the tests are negative and the pain continues then ATT might be needed. It is given in infertility patients.
Taking Zynase will reduce the inflammation and it will reduce the track length even if it is due to TB.
Taking it again will not do any harm. The chances of further improvement are there.
Empirical ATT will be the only choice left after all the tests are negative. It is best if your treating doctor decides about this as she has examined you physically right from the beginning.
The choice of antibiotics depends on the symptoms and the treating doctor. Your treating doctor can tell you the reason for choosing amikacin and ornidazole. These are given in mixed infections of the gut. May be she was not treating you for TB at that time.
Hope this helps.
Regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
thanks mam
my crp is coming as 7 now from.4.why is it evated dwpite taking zinase is that significant in terms of soft tissue inflammation.
again lft and kft done..attaching the files ..pls detail the abbrations as i m having pain in my right side also below rib cage
also i have taken zinase d for almost 25 days..so will it be fine now to switch to chymoral forte,.what is the difference between action of zinase and chymoral ..as per my coition which would be beneficial.can i take surgeon prescribed medicine for a aweek and see if it works
is overodose of thses enzymes or probiotics not to be done..i have had darolac for almost one and half month during XXXXXXX and noe0w zinase and then chymoral
is it safe yo use flucort ointment locallythough my scar looks healthy feom outside..is that a steorid
can i take tayo 60 k once a week for a month..mine level was 30.
i have also consulted an ayurvedic doc,,can i take those medicines with thos treatment
mam e ven if it is tb,wil it be safe on my part to drag it like this since its alredy been 2.5 or 3 months or may be four five (as i dont know wen it coneverted to cellulitis or tb),do i have enough time to wxperiment with difference doctors opinion as one of the physician said it can convert into cancerous form.pls guide
my crp is coming as 7 now from.4.why is it evated dwpite taking zinase is that significant in terms of soft tissue inflammation.
again lft and kft done..attaching the files ..pls detail the abbrations as i m having pain in my right side also below rib cage
also i have taken zinase d for almost 25 days..so will it be fine now to switch to chymoral forte,.what is the difference between action of zinase and chymoral ..as per my coition which would be beneficial.can i take surgeon prescribed medicine for a aweek and see if it works
is overodose of thses enzymes or probiotics not to be done..i have had darolac for almost one and half month during XXXXXXX and noe0w zinase and then chymoral
is it safe yo use flucort ointment locallythough my scar looks healthy feom outside..is that a steorid
can i take tayo 60 k once a week for a month..mine level was 30.
i have also consulted an ayurvedic doc,,can i take those medicines with thos treatment
mam e ven if it is tb,wil it be safe on my part to drag it like this since its alredy been 2.5 or 3 months or may be four five (as i dont know wen it coneverted to cellulitis or tb),do i have enough time to wxperiment with difference doctors opinion as one of the physician said it can convert into cancerous form.pls guide
Brief Answer:
Details below.
Detailed Answer:
The increase in CRP is suggestive of an increase in inflammation. The LFT and RFTs are almost within normal range.
You can change to chymoral and see if it helps you more. It will only help in reducing the fibrosis but will not affect the actual infection or allergy that you are having.
These enzymes are safe and given in clinical doses these do not cause any toxicity. These are safe medicines.
Yes. Flucort is a steroid. Using the ointment externally on a healed scar will not help you.
Yes. You can take Tayo 60K once a week.
You will have to ask your ayurveda specialist if you can combine the treatments.
If it is TB then you should not delay the treatment as the infection can spread and cause more fibrosis. It never turns into a cancer.
Regards.
Details below.
Detailed Answer:
The increase in CRP is suggestive of an increase in inflammation. The LFT and RFTs are almost within normal range.
You can change to chymoral and see if it helps you more. It will only help in reducing the fibrosis but will not affect the actual infection or allergy that you are having.
These enzymes are safe and given in clinical doses these do not cause any toxicity. These are safe medicines.
Yes. Flucort is a steroid. Using the ointment externally on a healed scar will not help you.
Yes. You can take Tayo 60K once a week.
You will have to ask your ayurveda specialist if you can combine the treatments.
If it is TB then you should not delay the treatment as the infection can spread and cause more fibrosis. It never turns into a cancer.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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