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What causes steady growth of abdomen while pregnancy tests are negative?

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Posted on Wed, 17 Dec 2014
Question: My abdomen is steadily growing with an even round appearance.I look 7-8 months pregnant and my belly now extends further than my breasts. I began to feel movement the last week of August although they have always seemed unusually high and until 6 weeks ago i usually only felt them on the left side of my upper abdominal quadrant. Now it is all over both upper abdominal quadrants. When i bend over i feel like theres a large mass that keeps me from normal ability to bend my body over. Multiple friends and family have also seen and felt the movement. I have gained 25 lbs in the last 3 1/2 months, breasts are 2 cup sizes bigger with sensitive and tender nipples, i feel XXXXXXX hocks contractions some that i have to breathe through now. I have only missed 2 periods since April and all others were shorter in duration. I have had 4 home pregnancy tests negative, 2 more positive, then 2 more negative. Blood tests come back negative. I have 3 children already ages 20, 11, and 8 years old. I have had 2 transvaginal ultrasounds results of negative. No one will give me an abdominal ultrasound because i had a tubal ligation 8 years ago and pregnancy tests return negative. My fear is that i have an advanced abdominal pregnancy and because many doctors seem to be forgetful that medicine is a practice thus calling it an Art vs a Science. I have been told by one ER doctor i am feeling peristalsis, which i KNOW what that is and that motion would be rhythmic and this motion twists, kicks, turns, pushes and seems to turn somersaults. I am far from uneducated and have an AS Degree in Respiratory Therapy and went to school for MRI. From my calculations i would be right around 30-32 weeks gestation. My fear is that no one believes me so no further tests are ordered. Why is it so freaking hard to do an abdominal ultrasound, a CT or an MRI to figure this out? Right now I'd settle for an xray. I'm open to other explanations including fibroids, tumors and cancer. But if i end up losing a child due to medical negligence because I verbally have made it clear what I think is going on i am going to XXXXXXX the socks off of the doctors and hospitals involved. All i need is visual confirmation that there is NO CHILD in my abdomen. What advice can you offer? I dont care at this point if i have to make up some ailments or symptoms to get results....the stress is unbearable now along with the feeling of urgency .....please advise. ...
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Answered by Dr. Timothy Raichle (2 hours later)
Brief Answer:
A consult visit with an OB/GYN is the answer...

Detailed Answer:
You are not the first person to feel convinced of a pregnancy based on what you are feeling and observing. I have encountered this question many times and I understand where you are coming from. I have also taken care of patients who think they are pregnant and who have even come in to the hospital in "labor" but there is no baby. But here are the facts:
1. You have had a tubal ligation
2. A negative blood pregnancy test (more accurate than urine)
3. A transvaginal ultrasound that showed a uterus that did not have a pregnancy
4. Abdominal pregnancies are EXCEEDINGLY RARE and you would probably be dead by this point if this were the case
5. You have missed ONLY two periods which is not uncommon, so you are implying that you have continued to get 'periods' or bleeding during the time that you think you are pregnant

So, I truly believe that you are NOT pregnant, but it seems your concerns are not really being addressed. They have only answered the question "are you pregnant or not", but they have not really addressed the cause of abdominal distention. This could be related to excess bowel gas related to a partial small bowel obstruction, for example. This could easily be sorted out with an XRAY, the cheapest of the tests that you mentioned. Finally, I want to say that the worst way to an answer is to seek care in an ER. I would recommend against EVER going to an ER for non-urgent care. It is not appropriate and you are never going to get an answer. Here is what I would recommend:

1. You need to schedule a visit with an OB/GYN
2. You need to stop "self diagnosing" and just go in with a description of your symptoms - just tell the story and try to stop telling them what you think is going on.
3. Ask for a repeat blood pregnancy test, but also ask about labs related to thyroid disease
4. Additional imaging is indicated - either an abdominal XRAY or CT scan to evaluate the swelling of the abdomen. An abdominal ultrasound is useless in this case.

I hope that this helps. Please let me know.

Dr. Tim
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Timothy Raichle (42 hours later)
I scheduled another OBGYN appt for today and a regular doctors appt for Wednesday. Maybe I'll finally get some answers. My previous GI problems felt nothing like this. Have you ever had a patient with distension like this, no pain except after eating on deep inspiration, with feelings of movement? If so and even if not, what was possible or actual diagnosis? What would you assume as first suspicion if I had come to you first as far as next tests or thoughts of initial diagnosis? My stomach was flat end of August so this has grown this much in 3 months...
doctor
Answered by Dr. Timothy Raichle (10 hours later)
Brief Answer:
You will get an answer

Detailed Answer:
I hope that you made a step towards an answer today. Yes, I have had patients very similar to you. This is clearly a GI issue as the symptoms are more pronounced after eating! I am not going to continue to guess at a diagnosis as I am unable to examine you in person. I am curious what they thought is going on today. If I were to make a guess, you have problems related to stomach emptying, increased reflux related problems, and excess bowel gas.

Good luck!!

Dr. Tim
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Timothy Raichle

OBGYN

Practicing since :1999

Answered : 1687 Questions

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What causes steady growth of abdomen while pregnancy tests are negative?

Brief Answer: A consult visit with an OB/GYN is the answer... Detailed Answer: You are not the first person to feel convinced of a pregnancy based on what you are feeling and observing. I have encountered this question many times and I understand where you are coming from. I have also taken care of patients who think they are pregnant and who have even come in to the hospital in "labor" but there is no baby. But here are the facts: 1. You have had a tubal ligation 2. A negative blood pregnancy test (more accurate than urine) 3. A transvaginal ultrasound that showed a uterus that did not have a pregnancy 4. Abdominal pregnancies are EXCEEDINGLY RARE and you would probably be dead by this point if this were the case 5. You have missed ONLY two periods which is not uncommon, so you are implying that you have continued to get 'periods' or bleeding during the time that you think you are pregnant So, I truly believe that you are NOT pregnant, but it seems your concerns are not really being addressed. They have only answered the question "are you pregnant or not", but they have not really addressed the cause of abdominal distention. This could be related to excess bowel gas related to a partial small bowel obstruction, for example. This could easily be sorted out with an XRAY, the cheapest of the tests that you mentioned. Finally, I want to say that the worst way to an answer is to seek care in an ER. I would recommend against EVER going to an ER for non-urgent care. It is not appropriate and you are never going to get an answer. Here is what I would recommend: 1. You need to schedule a visit with an OB/GYN 2. You need to stop "self diagnosing" and just go in with a description of your symptoms - just tell the story and try to stop telling them what you think is going on. 3. Ask for a repeat blood pregnancy test, but also ask about labs related to thyroid disease 4. Additional imaging is indicated - either an abdominal XRAY or CT scan to evaluate the swelling of the abdomen. An abdominal ultrasound is useless in this case. I hope that this helps. Please let me know. Dr. Tim