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Stabbing pain in the lower right abdomen and bloating. Having hyperthyroid, follicular cysts and bowel movements. Treatment?

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General & Family Physician
Practicing since : 2009
Answered : 3094 Questions
Looking for another opinion on a long list of symptoms I've been having. I'll go in chronological order.
For 5 or more years, I've had bouts of sharp, stabbing pain in the lower right abdomen around what I assumed was my right ovary. I've always mentioned this to my doctor and she never seemed concerned. These episodes have lessened over the years, but I can somewhat attribute that to an increased sedentary lifestyle -- the pain usually occurred when I was up and about. The pain was enough to make me double over until it passed within a few minutes.
Three goes ago, after my mother died (of colon cancer at 68), I experienced extreme bloating for several months. I looked very pregnant for most of the day, most days, for many months. My doctor said it was likely food related. Even before this, I had episodes of very bad bloating overnight, usually related to my menstrual cycle. Very painful bloating that I had to walk off before I could go back to sleep. The bloating eventually lessened, although I still bloat easier than I did before, or at least I notice it more.
Two years ago, the same general area was tender when she palpated it during a physical. Again, she didn't seem concerned. I have a cat who likes to step on my lower abdomen, so I noticed this tenderness myself as well. This pain continues to this day and I can feel a dull pain without palpating it now. It just comes and goes, on and off all day, every day. I have no idea how long this has been going on, since I got so used to pain in that area. A similar pain is also apparent on the left side now, and there is a general dull pain on both sides that can go as high as my belly button and as low as the top of my legs. It's not severe, but it's noticeable. Doesn't stop me from doing anything. Around this same time two years ago, I also noticed a very dull pain on the middle right side of my back. It's not there all the time, but I have noticed lately that it is sometimes more noticeable after eating.
Things started to get more weird 5 months ago, when I started having very loose stools / diarrhea and nausea every morning for a few weeks. The nausea eventually subsided, but the loose stools persisted. My doctor ran a bunch of blood tests, and it was found that I have subclinical hyperthyroid -- ruled out Graves and struma ovarii, so right now it's suspected to be thyroiditis, which should have come out of the hyperthyroid phase by now, so I'm not convinced that it is causing the loose stools. Around the time the stools became loose, I started noticing little red and sometimes black flecks in my stools the size of pepper grains -- they seem solid and not like liquid blood, so I'm not sure if it's food particles or not. I have also, for a while, had swelling around the anus during the occasional bowel movement -- I assumed hemorrhoids. The swelling always goes back in when I wipe -- the swelling is typically 1-2 cm big. I haven't noticed this happen since I've been panicking about my symptoms, probably because the stools are loose. When my thyroid came back abnormal, I was sent for a transvaginal ultrasound that discovered a possible polyp. This is on the same side as the long-term abdominal pain, but I've read that polyps shouldn't cause pain.
My concerns are that I have either colon cancer or advanced endometrial cancer if the polyp is not a polyp. I won't find that out for another month. I did get a clean endometrial biopsy though (though it didn't show evidence of a polyp either). So my main concern is colon cancer, given so many long-term symptoms and recent change in symptoms.
My doctor still just wants me to try adjusting my diet and nothing else. I'm concerned that no imaging has ever been done to check out the abdominal pain other than a transvaginal ultrasound. Although it wasn't mentioned to me, I saw on the report that I also have follicular cysts.
Other possibly unrelated symptoms are swelling in the lower back for a couple of years and weird nerve sensations in various places on my body. And right now, severe anxiety. I just began medication for GAD. I do find that, sometimes, if I can remain calm in the morning, I won't necessarily have a loose bowel movement. They were almost always happening in the morning. However, if I don't have one in the morning, I am typically still having one at night. Before all of this, I would only have bowel movements every 3-4 days.
Thoughts on the odds of this being cancerous? I'm 32 years old.
Posted Mon, 2 Sep 2013 in Abdominal Pain
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Brief Answer:
For now the problem is functional and not a cance

Detailed Answer:
Hi and thanks for the query,

I went through your description very keenly and I strongly do not think its colon cancer nor endometrial cancer. I really do not think so.

However, The long lasting abdominal symptoms you present are compatible with a functional and not an organic problem. I think stress and psychological unrest could affect your intestinal movements either directly or indirectly. Indirectly by affecting your diet choices and life style. Less exercise on its own could predispose to constipation.

I first of all would think in the same direction as your doctor. It is possible that this should be a functional disorder of Irritable Bowel Syndrome (IBS) must be considered. Exercise, social support, enough water, vegetable and fruit XXXXXXX diet are essential. these would also be essential in ameliorating the crises experienced with hemorroids. Management of hemorroids depend on the stage. There are drugs that do exist that could be sufficient added top nutrition in alleviating these symptoms.

My strong suggestion is consulting a gastroenterologist for a proper clinical review. Assessing the stage of the hemorroids, a clinical examination of the abdomen and an ultrasound if necessary could be initial first steps in the management process. I think for now the problem is functional and not a cancer.

Thanks and kind regards.

Bain LE, MD.
Above answer was peer-reviewed by
Follow-up: Stabbing pain in the lower right abdomen and bloating. Having hyperthyroid, follicular cysts and bowel movements. Treatment? 3 hours later
Thank you. Of course, tonight my bowel movement ended up having much larger chunks of red in them! I ate a sandwich for lunch today that contained chopped up veggies. I recognized a solid piece of black olive in my stool, which was definitely from the sandwich, as well as a piece of what appeared to be onion, along with several chunks of something red. Unlike the other bits, the red bits were difficult to separate from the rest of the stool and smeared easily on the toilet paper. It was like it had some red/pink liquid that dissolved into the paper, and then the rest smeared like either bright red stool, or I guess, a food particle. Does this still sound like it was probably red pepper? It was a very bright red. I'm not entirely sure what all was in the sandwich, but I'm pretty sure there were red chunks of something. The last time I noticed something like this was a week or so ago after I ate chilli. Another doctor suggested it could be a red kidney bean, but all the red showing up is scaring me. I also had random irritation and itching in the area before the bowel movement, but not really with it.

Thank you for your response. I'm not currently experiencing constipation -- rather the opposite -- and am still having abdominal pains. The swelling that might be hemorrhoids can occur with a bowel movement that I'm not even necessarily straining for, but I don't think it's ever occurred with the loose stools I'm experiencing now.
Answered by Dr. Luchuo Engelbert Bain 1 hour later
Brief Answer:
Detailed clinical review by gastroenterologist imp

Detailed Answer:
Hi and thanks for the query,

I am afraid it might be real difficult for this to actually be red pepper. Secondly, with respect to the possibility of kidney stones presenting as such, its almost very impossible for them to have this clinical, predominantly digestive tract scenario. Kidney stones could present with abdominal pain, nausea, vomiting. It s unlikely that this scenario be kidney stones.

IBS (irritable bowel syndrome) or other functional disorders could also present with lose stools. I strongly recommend the opinion of a gastroenterologist. However, I do not think it should be very serious. Changes in diet recently should properly be examined too.

Kind regards,

Bain LE, MD.
Above answer was peer-reviewed by
Follow-up: Stabbing pain in the lower right abdomen and bloating. Having hyperthyroid, follicular cysts and bowel movements. Treatment? 10 hours later
You may have misunderstood me. I meant red pepper as in red bell pepper, not red pepper the spice. I've read the red bell pepper can show up in stools?

Also, kidney beans the food is what the other doctor said could possibly have shown up in the stool. He didn't say anything about kidney stones.
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Brief Answer:
You are right.

Detailed Answer:
Hi and thanks for the clarification,

I totally agree with you its very possible. In case of IBS and other functional disorders its a possibility. Other pathologies or food intolerance syndromes could as well explain this fact.

This further enforces the fact you might absolutely need a gastroenterologist to orient the investigation and management process. Thanks again for the thoughtful and clear clarification.
Kind regards.

Bain LE, MD.
Above answer was peer-reviewed by
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