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Suffering from low back pain, thigh pain and discomfort in anal region. Abdomion sonography showed mild fatty liver. Suggest

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General & Family Physician
Practicing since : 2005
Answered : 2572 Questions
i am mail 41 , i am suffering with law back pain n hips pain , thigh pain , pain doesnt rediat down to leg , i also feel discomfrt in anal region , not feeling normally in ansu part , i had a history of 2 times fistulla surgery at 12 o'clock . my hips pain is so long , and al;so law back , not tenderness , at tail bone not good feeling come , whn we touch no pain , abdomion pain many time there , specially right upper side . i can walk properly , no fever no weight loss , no weakness , orthopedic doesnt find anything , anorectal surgen did dre , he found piles nothing else , he did check by proctoscop , but i cant understand with un explaint mild pain and discomfirt.

my varius report done as bellow

blood report

cbc = normal
esr = 13 in 1 hour
crp = 2.5
s creatin= normal
vitmin 25 oh d = 29
sgpt = 44
sgot = normal
calsium = normal
r a factor = normal
uric acid = normal
suger = normal
cea = 5.5
psa = normal

abdomion sonography= mild fatty (non alcohol) liver , mild inflammed appendix

tran sonography = anal canal and rectum , prostate normal
mri hips = normal , normal rectum
c t of tail bone = dislocate may be due to trauma
i would like also ask you

my 10 to 12 abdomion sonography had done so no harmfull???? how reliable this test ???
my 10 to 12 transonography done so no harmfulll?? how reliable this test , this test can proper information anal region n rectum n tissues????

i had done mri 3 times so any harmfull ????? and hips mri is reliable for information?????

i had done one c t abdomion and 1 c t of tail bone??? so harmfulllll ??/

kindly plz help me if any test requied i will go for it , i want to come out from this

my endoscopy result says hital hernia
my colonoscopy is nagative... colonoscopy harmfull??????
i have non alco fatty liver so what i have to do???

kindly pl reply in detail with allll my questions...

my law back pain and hips pain any relation with abdomoion or gas????

if dre , proctoscopy , colonoscpy , transonography result nagative so no need to worryyyy???/

my hips pain and law pain is any sign of upcoming discease??/

i am waiting your reply with detail
Posted Sat, 22 Jun 2013 in General Health
Answered by Dr. Prasad 9 hours later

Thanks for this query.

I understand you are suffering with multiple painful symptoms at 41 years of age; hence you posted a lot of questions. I shall try my best to answer each of it.

Well, at my clinic when I see patients with multiple site pains, most often I find that there is an element of stress, anxiety and psychological fact contributing. However I do see other organic pathologies found on tests contributing to the disturbing symptoms. You have undergone some tests which suggest the following:
- CT scan revealed dislocated tail bone
- Non alcoholic fatty liver and mildly inflamed appendix
- Hiatus hernia on endoscopy

Accordingly, my comments are as follows:

1. Dislocated tail bone usually cause pain at the tail bone. However I would not be surprised if the hip and anal region pain may be related to this. You need to consider discussing with your orthopedician and plan treatment for it. The treatment could be conservative in the form of occasional pain killers, warm compresses and physiotherapy. Surgical treatment can be planned otherwise if conservative management isn't helpful.
You did not mention any issues with bowel movements. If stools are frequently hard and painful, recurring fistula need to be considered.

2. Appendix inflammation is concerning when the features represent acute or chronic inflammation. As the report does not reveal any such features, this could be benign self limiting condition.

3. Non alcoholic fatty liver is often related to overweight and high cholesterol levels. Re asses your cholesterol and weight and plan its treatment if needed. Besides the weight and cholesterol infective viral causes need to be excluded by your doctors.

4. Right abdominal pain, bloating and gas are unrelated to hip pain. These could be features of dyspepsia (indigestion) associated with hiatus hernia. Liver and bile disturbances and gastric issues need to be assessed with specific tests.

5. Abdominal ultrasound, transrectal ultrasound, endoscopy, colonoscopy, CT and MRI scans are sensitive and specific tests. The test is accurate. That being said, as the results are interpreted by individual radiologist/specialist wrong results are entirely based on subjective biases. You may always consider a repeat test from a different specialist / radiology institute if you strongly suspect the results to be wrong.
The test in all means is not harmful.

In brief, all your test reports except for fatty liver and dislocated tail bone seem normal. Both fatty liver and dislocated tail bone may be causing most of your symptoms. Stress and pschological issues (if any) may also have a role to play. You will need work together with a competent gastroenterologist and orthopaedic surgeon to plan the right treatment.

Hope this answers all your questions. Will be glad to add further comments if you need clarifications.

Good luck!!
Above answer was peer-reviewed by
Follow-up: Suffering from low back pain, thigh pain and discomfort in anal region. Abdomion sonography showed mild fatty liver. Suggest 31 minutes later
no constipation , usealy i go for potty 2 time in morning , not feeling abdomion fullness , piles is there (significient) i feel like something is wrong in anal region and tail bone, above tail bone is also mild pain , i dont think muscluer pain , even hips pain , my weight is only 72 to 73 kg height is 5'5" , not tender touch pain, i feel inside law back pain something is wrong , hips region something wrong , my thigh also mild pain , i want to go for proper dignoses , which test do you suggest for my complaint , i am very much scared for cancer.
scitica nerve can cause for this?????
should i go for trans sonography???
should i go for abdomion mri???? ( bcoz there is no rediation)
should i go for spinal mri with hips region
with all nerve and soft tissu and bony structer.
mri gives result in bony structer???
if colonoscopy is nagative so any issuse can be with anal region and rectum??
i dont have any anxity or unnecessary stress , what i suffer or feel i explain this , generally dr do not go in depth and ask the patient you feel anxity.
other wise i never copmlaint so many years.
can any cause in side of spinal cord , i mean spine and abdomion bitween, means depth of spinal cord. mri hips detect abnormaity of hip structer and thigh????

mri, sonography 3 to 4 x XXXXXXX harmfull you didnt guide me , i request you dr may be i am irritting you , but i am so nervus

Answered by Dr. Prasad 1 hour later
Specific answers to your questions are as follows:

1. Colonoscopy is a very useful tool to diagnose colon cancers. Since it was normal, I am very much sure that you do not suffer from anal / bowel cancers. Moreover you are able to pass stool normally. In the presence of colon and bowel cancer, you invariably would find difficulties to pass stools; you also would have significant bloody stools. So stay reassured; you do not have cancers.

2. Sciatic nerve radiculopathy is not uncommon condition. Here the pain is more at the back and spread behind your hip - thigh - leg and feet. What you described is not classical representation. Therefore it is less likely to be sciatica.

3. Transrectal ultrasound needs to be repeated if we strongly suspect a prostate problem which you do not have. Therefore I do not feel you need to repeat it.

4. Based on your description and the fact that you have normal bowel movement, the anal and hip pain may be related to tail bone dislocation or coccydynia. You might consider re-evaluation from an orthopedic surgeon in these lines. Repeating radiological tests (X-rays and spine MRI scan) is an option after the initial work up. And yes, radiological tests look at bony structure and spinal nerve pathology.

5. Dyspepsia combined with hiatus hernia can explain the right abdominal pain. Proton pump inhibitors drugs may be used briefly to take care of it. I do not feel abdominal MRI will add any value here.

6. MRI and ultrasound scans are completely harmless even if repeated "n" number of times.

In brief, there may be a strong relation between coccydyna and anal / hip pain if tail bone dislocation is proved to be stable and not causing this pain. Careful clinical examination by an orthopedic and if needed repeat radiological test can be useful. Besides that, abdominal pain seems to be related to digestive issues. MRI scan may not help in this case.

I hope I have answered all your questions to your satisfaction this time. Let me know if I have missed any.

Above answer was peer-reviewed by
Follow-up: Suffering from low back pain, thigh pain and discomfort in anal region. Abdomion sonography showed mild fatty liver. Suggest 13 minutes later
Thank you so much , i jus came from ortho Dr , he said clinicly ther eis no issue , i refuse MRI , finally i am so satisfied with you Dr sir .

i am leave on nature n God , i hope my pain at hips n law back pain remove .

I will work with excersise

Regards sir
Answered by Dr. Prasad 55 minutes later
Dear Sir,

I am glad to know that you met an orthopedic surgeon and bony/structural problems are excluded. That leaves us with only function problem such as coccydnyia problem to ponder. Positive intent, exercise and physiotherapy are good options. Please continue; it will help you.

Though I will be more than happy to assist you further if needed in future, I pray to thee that you are blessed with good health and you have no more problems to write.

Good luck.... Please close this discussion and rate your experience.
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