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Having Stomach Pain With Frequent Vomiting. Pregnancy Test Came Negative. Should I Go For The Test Again?
Question: This is on behalf of my wife. She recently had stomach pain, followed by frequent vomiting and hence she consulted a gynecologist last week. The doctor asked for a urine test just to check if she was pregnant. The result was negative. Two days back she noticed that there is a slight liquid leaking from her breast. We are not sure on the reason for this. Does she have to take the pregnancy test once again?
Hello XXXXXXX
Let me put down the information you have given me:
1. Pain abdomen with vomiting. No vaginal bleeding.
2. Urine Pregnancy Test (UPT) negative.
3. Breast/Nipple discharge.
If you have reason to believe that your wife could be pregnant, you will need to repeat the UPT- 1st morning sample. Reasons to consider pregnancy would be - trying for a pregnancy, no contraceptive e.g. Condom used, missed period.
Now if there is reasonable doubt that this could be a pregnancy then the pain abdomen and vomiting may be due to pregnancy in the tube, or a pregnancy threatening to abort.
On the other hand, the pain and vomiting may be due to an episode of food poisoning, unconnected to pregnancy, or intestinal infections.
If your wife's period is delayed then either it's a simple late period or a pregnancy. Delayed period, not because of pregnancy occurs with hormonal imbalance which is often associated with nipple discharge. In fact this may be a very important clue to the cause of your wife's delayed period - a high level of the hormone Prolactin which cause nipple discharge.
Having given you this background information, which I encourage patients to know to intelligently understand how and why the doctor advises you, let me give you the practical guidelines:
I would recommend repeat UPT. If negative, consider testing and investigation for delayed period if that is so.
If UPT is positive, even weakly so, one should get an ultrasound done to rule out tubal pregnancy and please be in touch with your local doctor for this as tubal pregnancy is an emergency.
The pain abdomen and vomiting should be correlated with the results of the pregnancy test and treatment taken for stomach infections in case not pregnant.
I hope this answers your queries. Take care.
Dr Nirja Chawla
Let me put down the information you have given me:
1. Pain abdomen with vomiting. No vaginal bleeding.
2. Urine Pregnancy Test (UPT) negative.
3. Breast/Nipple discharge.
If you have reason to believe that your wife could be pregnant, you will need to repeat the UPT- 1st morning sample. Reasons to consider pregnancy would be - trying for a pregnancy, no contraceptive e.g. Condom used, missed period.
Now if there is reasonable doubt that this could be a pregnancy then the pain abdomen and vomiting may be due to pregnancy in the tube, or a pregnancy threatening to abort.
On the other hand, the pain and vomiting may be due to an episode of food poisoning, unconnected to pregnancy, or intestinal infections.
If your wife's period is delayed then either it's a simple late period or a pregnancy. Delayed period, not because of pregnancy occurs with hormonal imbalance which is often associated with nipple discharge. In fact this may be a very important clue to the cause of your wife's delayed period - a high level of the hormone Prolactin which cause nipple discharge.
Having given you this background information, which I encourage patients to know to intelligently understand how and why the doctor advises you, let me give you the practical guidelines:
I would recommend repeat UPT. If negative, consider testing and investigation for delayed period if that is so.
If UPT is positive, even weakly so, one should get an ultrasound done to rule out tubal pregnancy and please be in touch with your local doctor for this as tubal pregnancy is an emergency.
The pain abdomen and vomiting should be correlated with the results of the pregnancy test and treatment taken for stomach infections in case not pregnant.
I hope this answers your queries. Take care.
Dr Nirja Chawla
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for the detailed information. It was very helpful. One thing I forgot to mention is that, she dint miss her periods. She had it during her regular time which got over on last to last Saturday i.e. 9th. Only thing that made me skeptical was the nipple discharge along with the frequent vomiting. There was no vaginal bleeding so far. I guess you are referring to the bleeding that occurs on its own and not during sex.
For you information, we just got married last year on 30th of December.
We are not planning for a baby now due to which we did not have any intense Sex. I had some questions in this regard too. I need to know the ways in which one can be pregnant. I am not sure if you are the right person to ask. If not you, could you please point me to the right person.
Thanks,
XXXXXXX
For you information, we just got married last year on 30th of December.
We are not planning for a baby now due to which we did not have any intense Sex. I had some questions in this regard too. I need to know the ways in which one can be pregnant. I am not sure if you are the right person to ask. If not you, could you please point me to the right person.
Thanks,
XXXXXXX
Hello XXXXXXX,
Yes I know, you didn't give me the menstrual dates and history of your wife. That's why I covered the possibility of delayed periods. I presumed your doctor would have got the UPT done if there was a delayed period. :)
For the nipple discharge, I would suggest that your doctor make a smear on a slide and send it for testing. In most likelihood there could be a Prolactin hormone problem, as I mentioned earlier, which can be tested by a blood test; best done on 2nd or 3rd day of period.
However, its important to mention here that high Prolactin levels may be associated with a Pituitary tumour, which may cause this intense vomiting. This tumour usually responds to medicines. Your doctor will be the best guide further to this information.
Give your wife some antacids like Gelucil or other anti -acid preparations as advised by your doctor. They may help. She may need antibiotics for her intestinal infection too, if that is the cause if her pain abdomen and vomiting.
The only way to get pregnant is by sexual activity. Even contact of semen with the genital parts of the female partner can get her pregnant, without actual penetration. So the Withdrawal Technique to prevent a pregnancy is not really effective in preventing a pregnancy.
If you do not desire a pregnancy please use effective contraceptive methods of which Oral Contraceptive Pills work well with a failure rate of 0.2-2%. If the cause if nipple discharge is found to be high Prolactin levels, these pills will also help decrease it although another medication may also be required.
I hope this covers all possibilities.
Dr Nirja Chawla
Yes I know, you didn't give me the menstrual dates and history of your wife. That's why I covered the possibility of delayed periods. I presumed your doctor would have got the UPT done if there was a delayed period. :)
For the nipple discharge, I would suggest that your doctor make a smear on a slide and send it for testing. In most likelihood there could be a Prolactin hormone problem, as I mentioned earlier, which can be tested by a blood test; best done on 2nd or 3rd day of period.
However, its important to mention here that high Prolactin levels may be associated with a Pituitary tumour, which may cause this intense vomiting. This tumour usually responds to medicines. Your doctor will be the best guide further to this information.
Give your wife some antacids like Gelucil or other anti -acid preparations as advised by your doctor. They may help. She may need antibiotics for her intestinal infection too, if that is the cause if her pain abdomen and vomiting.
The only way to get pregnant is by sexual activity. Even contact of semen with the genital parts of the female partner can get her pregnant, without actual penetration. So the Withdrawal Technique to prevent a pregnancy is not really effective in preventing a pregnancy.
If you do not desire a pregnancy please use effective contraceptive methods of which Oral Contraceptive Pills work well with a failure rate of 0.2-2%. If the cause if nipple discharge is found to be high Prolactin levels, these pills will also help decrease it although another medication may also be required.
I hope this covers all possibilities.
Dr Nirja Chawla
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks once again for educating me on all this. I have asked my wife to take note of the things that you have mentioned and discuss the same with her doctor. She was admitted yesterday. She went through a blood test and an abdominal scan. No issues were found so far.
Today she mentioned about the nipple discharge to her doctor. Doctor has asked for some additional test to check for any thyroid and if required she might have to take an MRI of her head. One of the doctor felt that the nipple discharge is the side effect of the medicine that was prescribed to her last week.
One more thing i wanted to mention to you is that she has a hard substance inside her right breast. While pressed it keeps moving around. It seems she had consulted the same doctor 2 years back regarding this. The doctor told it is some kind of thyroid and its a normal thing which can be ignored. Neither was she asked for any test nor was she given any medicine. I am not sure if that is the reason for anything that she is going through now. In any case i guess she will have to go through numerous tests before we can diagnose the disease.
Let me know in case you have any additional information on all this.
Thanks,
XXXXXXX
Today she mentioned about the nipple discharge to her doctor. Doctor has asked for some additional test to check for any thyroid and if required she might have to take an MRI of her head. One of the doctor felt that the nipple discharge is the side effect of the medicine that was prescribed to her last week.
One more thing i wanted to mention to you is that she has a hard substance inside her right breast. While pressed it keeps moving around. It seems she had consulted the same doctor 2 years back regarding this. The doctor told it is some kind of thyroid and its a normal thing which can be ignored. Neither was she asked for any test nor was she given any medicine. I am not sure if that is the reason for anything that she is going through now. In any case i guess she will have to go through numerous tests before we can diagnose the disease.
Let me know in case you have any additional information on all this.
Thanks,
XXXXXXX
Yes XXXXXXX,
As pregnancy is ruled out, your wife will need blood tests for the hormones - Prolactin (done on 2nd or 3rd day of period), Thyroid (can be done any day of the cycle). If Prolactin levels are high she may need further work up by MRI head to rule out Pituitary tumour.
The hard, moving nodule in the breast is commonly called 'breast mouse' and is a fibroadenoma, which is generally benign. In some cases, depending upon how it feels to the doctor, a Fine Needle Aspiration Cytology (FNAC) test may be required.
All in all, my inner feel is that there is nothing really seriously wrong with your wife. Fibroadenomas of breast are common and high Prolactin levels causing nipple discharge are also very common, without a Pituitary tumour.
Relax. Sometimes, one begins to get alarmed by these abnormal symptoms. But i'm happy you are intelligently attempting to understand the science of medicine. As you go on, you will learn to differentiate between the serious from the non-serious problems and pass this 'wisdom' to your children, whenever you plan to have them.
All the best...
Dr Nirja Chawla
As pregnancy is ruled out, your wife will need blood tests for the hormones - Prolactin (done on 2nd or 3rd day of period), Thyroid (can be done any day of the cycle). If Prolactin levels are high she may need further work up by MRI head to rule out Pituitary tumour.
The hard, moving nodule in the breast is commonly called 'breast mouse' and is a fibroadenoma, which is generally benign. In some cases, depending upon how it feels to the doctor, a Fine Needle Aspiration Cytology (FNAC) test may be required.
All in all, my inner feel is that there is nothing really seriously wrong with your wife. Fibroadenomas of breast are common and high Prolactin levels causing nipple discharge are also very common, without a Pituitary tumour.
Relax. Sometimes, one begins to get alarmed by these abnormal symptoms. But i'm happy you are intelligently attempting to understand the science of medicine. As you go on, you will learn to differentiate between the serious from the non-serious problems and pass this 'wisdom' to your children, whenever you plan to have them.
All the best...
Dr Nirja Chawla
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Most welcome.....
Wishing you and your wife all the best.
Regards,
Dr Nirja Chawla
Wishing you and your wife all the best.
Regards,
Dr Nirja Chawla
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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