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I Have Been Suffering From Pain In My Lower Right

Posted on Fri, 31 Jul 2020

Question: I have been suffering from pain in my lower right quadrant for 11 years. It started as my gallbladder, which was removed, but pain would come and go in waves sometimes with constipation. I’ve had several CT, MRI, colonoscopies, and various scans in the last 4 years as my pain was getting worse with each episode. All of this led to a hospitalization in early 2018, where they discovered that my abdomen was inflamed with no apparent reason. It was noted that my cecum was mildly redundant in the lower anterior central pelvis. After more testing and radiology my GI told me they just didn’t know and dropped me as a patient. I am still experiencing bouts of pain regularly but have no where else to turn. I was tested for Crohn’s disease, Meckel’s Diverticulum, Ulcerative colitis, and appendicitis. There were a few others on the super rare scale but I’ve forgotten their names. Each episode is accompanied by high white cell count and occasionally low lipase levels along with enlarged lymph nodes.

Follow up: Dr. Ramesh Kumar (0 minute later)

I have been suffering from pain in my lower right quadrant for 11 years. It started as my gallbladder, which was removed, but pain would come and go in waves sometimes with constipation. I’ve had several CT, MRI, colonoscopies, and various scans in the last 4 years as my pain was getting worse with each episode. All of this led to a hospitalization in early 2018, where they discovered that my abdomen was inflamed with no apparent reason. It was noted that my cecum was mildly redundant in the lower anterior central pelvis. After more testing and radiology my GI told me they just didn’t know and dropped me as a patient. I am still experiencing bouts of pain regularly but have no where else to turn. I was tested for Crohn’s disease, Meckel’s Diverticulum, Ulcerative colitis, and appendicitis. There were a few others on the super rare scale but I’ve forgotten their names. Each episode is accompanied by high white cell count and occasionally low lipase levels along with enlarged lymph nodes.

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Need a few details.

Detailed Answer:
Hi and thank you for choosing "Ask a Doctor" service for your query,
I've been through your details and I am very sorry for the agony you are going through.

Now before I answer the query(As you must already be knowing that it's not a simple case otherwise Drs won't take those many years and that too in vain).

1)Is the pain spasmodic in nature?
2)Pain is constant or Off and on?
3)One episode of pain lasts for the duration?
4)Any factor which eases the pain?
5)Does the point where pain occurs feel tender to touch also.
6)Why are you taking Humira and from how long?
7)Medications tried to date?
8)Stools quality? Normal or mucoid/loose or constipated?

Please revert with these details.
Awaiting...

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Answered by Dr. Ramesh Kumar (0 minute later)

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ramesh Kumar (4 hours later)

1)Is the pain spasmodic in nature? No
2)Pain is constant or Off and on? The pain is constant, when I eat the pain gets worse within 20 minutes.
3)One episode of pain lasts for the duration? The pain has gotten manageable but never goes away completely. When I mentioned episodes I am referring to the pain worsening to the point of distraction. Those episodes can last anywhere between a few hours to a couple weeks.
4)Any factor which eases the pain? A liquid diet is easier, in that the pain is less intense.
5)Does the point where pain occurs feel tender to touch also. Just to the right of my pelvis.
6)Why are you taking Humira and from how long? I was on humira for 3 months because my first GI diagnosed me with Crohn’s disease while I was hospitalized.
7)Medications tried to date? I have tried several antispasmodic medications 2 of which gave me insomnia.
8)Stools quality? Normal or mucoid/loose or constipated?If I avoid foods high in fat I become constipated, if I add some fats in I get diarrhea.

Follow up: Dr. Ramesh Kumar (0 minute later)

Answered by Dr. Ramesh Kumar (24 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi,
Thank you for following up,

The symptoms you are having are specific for inflammatory bowel disease however you can ask your doctor considering increasing dose of Humira.

Secondly, for the pain increasing after food intake an endoscopy should be done to rule of Duodenal ulcers.

Thank you!

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Answered by Dr. Ramesh Kumar (0 minute later)

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ramesh Kumar (2 hours later)

They have ruled out IBD as a possibility, there is no evidence in colonoscopy, I have had 6, I had a pill cam endoscopy that was also negative. Also several barium CT scans and xray. I was taken off humira as it wasn’t helping.

Follow up: Dr. Ramesh Kumar (0 minute later)

Answered by Dr. Ramesh Kumar (24 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi again,
I can very well understand the level of frustration you must be feeling because of lack of a proper diagnosis despite of all possible tests.
Now I would suggest you to go a bit out of the box now.You have tried modern medicine and this treatment XXXXXXX for a very long time but with no results.
As I am also a Gastroenterologist and the doctors treating you were also the same so more or less we would recommend the same thing(I never give false assurance to my patients).
I would suggest you to to try Ayurveda or Homeopathic or Acupuncture therapy. See as all reports are normal so it's nothing serious but is causing trouble in your life so why not to give a try to other pathies available.
I would suggest you to give it a try once.
Regards!

Above answer was peer-reviewed by : Dr. Nagamani Ng