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What Causes Persistent Pain In Lower Abdomen After Doing Rigorous Physical Activity?
Question: I have had lower abdominal pain for 6 weeks. Before the pain started I had done heavy cleaning and moved furniture. Started low and had urinary symptoms dx UTI but tests came back negative. Pain increased and ended up in ER where CT scan showed bilateral hydronephrosis. Referred for Gyno workup. Gyno workup clear referred to urologist. 4 weeks in had a cystoscopy that showed all clear. Follow up CT scan showed hydronephrosis had cleared. Pain on right side has been getting worse not better. They thought it was a kidney stone but ruled out after cystoscopy and CT scans. Another internal ultrasound showed ovaries, uterus fine however during ultrasound I experienced the right side pain when the wand was put into that area. Pain is worse the more I move around or sit. Cannot sleep on that side. My dr has referred me for GI workup and I am having a renal ultrasound today because urologist wants to be sure he has covered everything. Any ideas?
Brief Answer:
As discussed in details below.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Noted all the points you have mentioned.
My thoughts:
It is very difficult to understand the appearance of bilateral hydronephrosis on CT on first scan and cleared on follow-up CT.
Pain on internal ultrasound on the right side.
Pain is worse on moving around or sitting.
Can not sleep on that side.
Laying down in recliner helps to alleviate pain.
UTI tests negative but had urinary symptoms.
Pain in abdomen for 6 weeks after heavy work
Gyno cleared .
Urologist - cystoscopy normal- ordered Ultrasound today- please give feedback.
Since so much work up has been done and the exact cause still not found in a Female patient of 51, I can think of the following reasons.
- PID, pelvic inflammatory disease but in a mild form that could not be picked up by the tests done (limitations of CT and Ultrasound)
- Hernia: inguinal or femoral should be searched for as it may be small but symptomatic.
- Typhlitis, inflammation of cecum, usually picked up by CT scan.
- Appendicitis in catarrhal or such form that appears normal and fits in the normalcy of investigations.
- Adhesion can not be picked by CT or ultrasound.
- Rare chance of endometriosis or such things.
Please discuss all these possible diagnosis with your concerned Doctor and you may come up with a possible diagnosis.
In some cases a diagnostic Laparoscopy can be helpful for getting a correct diagnosis and many a times therapeutic too.
I hope this answer helps you to get an early and proper diagnosis and proper treatment. Please feel free to ask for further relevant queries if you feel that there is a gap of communication.
As discussed in details below.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Noted all the points you have mentioned.
My thoughts:
It is very difficult to understand the appearance of bilateral hydronephrosis on CT on first scan and cleared on follow-up CT.
Pain on internal ultrasound on the right side.
Pain is worse on moving around or sitting.
Can not sleep on that side.
Laying down in recliner helps to alleviate pain.
UTI tests negative but had urinary symptoms.
Pain in abdomen for 6 weeks after heavy work
Gyno cleared .
Urologist - cystoscopy normal- ordered Ultrasound today- please give feedback.
Since so much work up has been done and the exact cause still not found in a Female patient of 51, I can think of the following reasons.
- PID, pelvic inflammatory disease but in a mild form that could not be picked up by the tests done (limitations of CT and Ultrasound)
- Hernia: inguinal or femoral should be searched for as it may be small but symptomatic.
- Typhlitis, inflammation of cecum, usually picked up by CT scan.
- Appendicitis in catarrhal or such form that appears normal and fits in the normalcy of investigations.
- Adhesion can not be picked by CT or ultrasound.
- Rare chance of endometriosis or such things.
Please discuss all these possible diagnosis with your concerned Doctor and you may come up with a possible diagnosis.
In some cases a diagnostic Laparoscopy can be helpful for getting a correct diagnosis and many a times therapeutic too.
I hope this answer helps you to get an early and proper diagnosis and proper treatment. Please feel free to ask for further relevant queries if you feel that there is a gap of communication.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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