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Have bloating in stomach. Ultrasound showed fluid in cu-de-sac behind uterus. Have fibroids on uterus. Suggest?

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Hello, I had an ultrasound done on my abdomen because I was complaining of extreme bloating in my stomach area that would not go away. They found fluid in the cu-de-sac behind my uterus, and said that this was causing my bloating, and that it would go away on it's own in about 1-2 months. Is there any way to make the bloating go away any quicker? My clothes are snugger, and it's just uncomfortable. I also have a couple of fibroids that are 1.2 cm and 1.6 cm on my uterus. My blood work came back normal and my TSH was 1.64 Thank you! XXXXX
Posted Sat, 13 Jul 2013 in General Health
Answered by Dr. Grzegorz Stanko 1 hour later

Thank you for the query.

That is really strange what have you been told by doctors. Fluid behind the uterus usually does not appear there without the reason. It can be caused by an inflammation of the uterine, ovaries, ovarian cyst. Fluid in the abdominal cavity also appear due to cancer. It can be ovarian cancer, colon cancer, stomach cancer or even pancreas cancer. That is why such finding in the ultrasound should not be ignored.
It is recommended to remove uterine fibroids.

I suggest you to do not leave it as it is, and force diagnostics. You should start with blood work, CRP, liver tests, amylase, bilirubin, Ca-125 level (ovarian cancer marker), CEA (colon cancer marker), CA 19-9 (stomach cancer marker), FOBT (fecal occult blood test). As you are almost 50, colonoscopy should be done as well. It is because over the age of 50, colon cancer risk significantly rises.
Depending of the results, abdominal CT might be also necessary.

Hope this will help. Feel free to ask further questions.
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Follow-up: Have bloating in stomach. Ultrasound showed fluid in cu-de-sac behind uterus. Have fibroids on uterus. Suggest? 8 hours later
Thank you for your reply Dr. Stanko. I did forget to mention that the fluid was from a cyst that burst. (sorry about that) I asked about taking the fibroids out, and was told that they were too small to worry about. A complete blood count was done and all of my results for that were normal. My POC Bili, UA was negative. I am scheduled for a colonoscopy at the end of the year when I turn 50.
I was told that nothing else showed up on the ultrasound except the fribroids and the fluid in the cul-de-sac. I am taking 3 Advil every 6 hours for the discomfort/pain, which today was going into my lower back. The bloat is unbelievable for me to look at. Given that I was told that this is from a cyst bursting, do you still feel that I should pursue further diagnostics? Thank you!
Answered by Dr. Grzegorz Stanko 9 hours later
Well, it is really hard to diagnose ovarian cyst with an abdominal ultrasound. So maybe it was trans vaginal ultrasound? This test can visualize uterine and ovaries. Regular abdominal ultrasound rather can not.

That is why the fluid source can not be determined with abdominal ultrasound. And fluid presence does not give bloating, pain and discomfort. The source of the fluid does. Moreover, we do not know what kind of fluid it is. And if it is a blood, serious infection and abscess can appear.

So for your safety (maybe its nothing), you should pursue further diagnostics. And if its possible, reschedule colonoscopy a little bit earlier.

Hope this will help.
Above answer was peer-reviewed by
Follow-up: Have bloating in stomach. Ultrasound showed fluid in cu-de-sac behind uterus. Have fibroids on uterus. Suggest? 1 hour later
Thank you Dr. Stanko. I looked at my copy of the ultrasound and it was transvaginal, with my uterus in the Retroflexed position. My Endometrium had a Normal appearance and a thickness of 7.8. Under "cul-de-sac" it stated "a small amount of fluid was noted". The final Impression was: Three intramural uterine fibroids, measuring up to 1.6 cm, with impingement on the endometrial cavity.

I appreciate your advice and I am going to give my primary doctor a call tomorrow morning to be seen. The pain radiating into my back has me concerned, and I have felt that the fluid alone would not cause such uncomfortable and constant bloating. Aside from the suggested tests above, if there is anything specific you feel that I need to be asking my doctor, I would greatly appreciate your suggestions. Thank you again! This has been a stressful weekend of not knowing where to turn to for answers.

Answered by Dr. Grzegorz Stanko 2 hours later
So it is not even a lot of fluid, just a small amount. This is definitely not a reason of bloating and abdominal pain. However it does not seem to be caused by mentioned before cancers (small amount of fluid - that is a good news).

Your doctor should know what to do and what questions to ask (that is what we are trained for). As you have mentioned back pain, urinary tract infection should be also considered. But this does not give bloating either.
Just visit your doctor and start with mentioned tests.

Hope this will help.
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