Brief Answer:
Ruptured ectopic pregnancy, intestinal obstruction

Detailed Answer:
Hello Ms. XXXX,

Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Am very sorry that you are going through this.

Would you please clarify a few things for me?
1)were you sexually active during the last six months? Did you use any contraceptive?
2)do you usually have pain related to IBS?
3)are you able to pass gas through your rectum?
4)is the pain continuous or does it increase Intermittently? Is it in the lower abdomen or upper abdomen?
5) do you have any nausea or vomiting?
6)have you checked your temperature? Any fever?
7)what were the vegetables included in the salad and was there any dressing, cheese, nuts, fish, meat?

If you were sexually active these past six months I would primarily like to rule out a ruptured ectopic pregnancy.
If not, an obstruction of the bowels and a severe flare up of IBS needs to ruled out.

I recommend monitoring your pain on a scale of 1-10 (1 being the lowest and 10 being excruciating pain) and passing of gas/stools.
If pain is more than a 5 and you haven't passed gas OR you pass blood /mucus, I recommend you visit the ER.
If less than 5 and you pass gas /stools wait till you see your OBGYN.
Try to have warm fluids (stick to clear liquids like water or clear soup) to help with passing stools. If this aggravates the pain and distention, stop and see a doctor right away.
Avoid carbonated, sugary drinks
I would :
-clinically examine you for signs of acute abdomen
- do a general exam including rectal and vaginal exam
-do a basic blood work (complete blood count, pregnancy test, renal function tests, electrolytes and more if indicated)
- get an Ultrasound scan or a CT scan of the abdomen.

Based on these I would decide on a treatment plan.
high blood pressure can be associated with severe pain.


Hope I've answered your queries.
Please let me know if I can help you further.

If not please close this discussion and rate my answer.
Wish you good health and hope you feel better soon
Regards,
Dr. Shuba Hariprasad

---

Brief Answer:
Polycystic ovaries

Detailed Answer:
Hello,
Thank you for the follow up.

Is your pain better?

A large mass with multiple cysts with your medical history is most probably a Polycystic ovary.

Did they mention if they were simple cysts or complex cysts in the ultrasound scan?

In case of Polycystic ovaries, treatment would be aimed at reducing the size and development of follicles and pain management.
Rarely, if the cysts are too many or large, it may need to manually reduced laparoscopically.

If the cysts are complex or suggestive of tumors, a biopsy or removal of a cyst would be required. I believe this is unlikely give your history of PCOD and that you were off Medications for 6 months.

Ask you OBGYN:
- how to prevent this from recurring?
-what are the possible complications?
- what are the treatment options and associated risks?
- what further tests would be needed to confirm diagnosis if it isn't Polycystic ovaries?

Hope this helps. Please let me know if I can help you with anything else?

Hope you feel better

Regards,
Dr. Shuba Hariprasad

---

Brief Answer:
Can be scary, don't worry. Most likely pcod

Detailed Answer:
Hello,
Thank you for the follow up.

OK. Please don't panic. Let us deal with it when we have to. Confirmation of the diagnosis first.
I haven't seen the scans but from what you have told me, my instincts say that it is not cancer.

I wish you well. Please let me know if there is anything else I can help you with.

Regards,
Dr. Shuba Hariprasad

---

Brief Answer:
Welcome

Detailed Answer:
Hello,
You are most welcome. I'd be help you should you need any clarification.
If not, please close this discussion & rate my answer.
Am glad to have been of help.
Wish you a speedy recovery.
Regards,
Dr. Shuba Hariprasad

---