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What causes intermittent right-sided chronic progressive pain?

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Posted on Tue, 12 May 2015
Question: My daughter has been having pain on her right side for over 6 months now. Two trips to the ER, the endocrinologist, a GI doctor, colonoscopy, endonoscopy (?), two CT scans, ultrasound on the gall bladder, laproscopy (to check for endometriosis) which found adhesions and were lasered out (Feb of 2015)...exercise and caffeine seem to make the pain worse. The pain comes and goes, but is very often...sometimes feels like someone is squeezing her in that area, sometimes the pain is stabbing like a knife, sometimes it feels like someone punched her in that area. All the tests are coming up with nothing, although two bloodworks showed an elevated DHEA level (498 & 598), she is low on Vitamin D, but that's all that is coming up. She found an old Rx of dycicline, which is helping a little with the pain. She sees a fibromyalgia doctor and a psychiatrist (depression, anxiety) . She is only 20 years old and we are at a loss as to what to do next. Someone suggested seeing a surgeon so this may be our next step, but other than that we don't know what to do.

Medications she is now taking:
lamotrigine
naratriptan
Cymbalta (duloxetine)
Klonopin (clonazepam)
Nexplanon (etonogestrel)
Xanax (alprazolam) - as needed
Relpax - as needed for Migraines
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Answered by Dr. Shailja Puri (34 minutes later)
Brief Answer:
Connective tissue disorder or psychological disorder suspected

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

Pain on the right side of abdomen with no organic lesion detected on various investigations leaves with possibilities of connective tissue disorder or a psychological pain.
Fibromyalgia is one of the connective tissue disorders which causes chronic progressive pain.
You are rightly seeing a fibromyalgia doctor. In addition, you need to get a panel of investigations for connective tissue disorders called ENA (extractable nuclear antigen) panel.
you can consult your doctor regarding this panel and get it done if required.
The other possibility that I talked about is psychological pain.
If no underlying cause for the pain is found, then probably there is a psychological basis for the pain.
In that case, medication and behavioral therapy will help.
At the same time, it is important to correct vitamin D deficiency by taking vitamin D supplements.
Vitamin D deficiency is associated with severe pain but that is mainly concentrated around joints.
You can continue with your consultation with fibromyalgia doctor and psychiatrist.
Role of surgeon is doubtful since there is not structural or organic lesion detectable on various investigations.

If you have more queries, I will be glad to answer.
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Answered by
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Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 8715 Questions

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What causes intermittent right-sided chronic progressive pain?

Brief Answer: Connective tissue disorder or psychological disorder suspected Detailed Answer: Hello, Thanks for posting your query on HealthcareMagic. Pain on the right side of abdomen with no organic lesion detected on various investigations leaves with possibilities of connective tissue disorder or a psychological pain. Fibromyalgia is one of the connective tissue disorders which causes chronic progressive pain. You are rightly seeing a fibromyalgia doctor. In addition, you need to get a panel of investigations for connective tissue disorders called ENA (extractable nuclear antigen) panel. you can consult your doctor regarding this panel and get it done if required. The other possibility that I talked about is psychological pain. If no underlying cause for the pain is found, then probably there is a psychological basis for the pain. In that case, medication and behavioral therapy will help. At the same time, it is important to correct vitamin D deficiency by taking vitamin D supplements. Vitamin D deficiency is associated with severe pain but that is mainly concentrated around joints. You can continue with your consultation with fibromyalgia doctor and psychiatrist. Role of surgeon is doubtful since there is not structural or organic lesion detectable on various investigations. If you have more queries, I will be glad to answer. Dr Shailja Puri