hi i wondered how you both were? If I can ask the CT scan of the abdomen was it with or without intravenous contrast? ive ended up in A&E due to the pain where they conducted a chest x-ray, ECG, blood tests for liver and kidney and Pancreas all which were clear and in normal levels. Unfortunately, I still have some very chronic aching on my right side (where . at most patients whom have undignosed their diseases. This is a classic example of older patients with abdominal catastrophes presenting with pain in the wrong location. Have had hida scan, CT scan, ultra sound. Always speak to your doctor before acting and in cases of emergency seek https://patient.info/forums/discuss/normal-tests-but-still-have-upper-abdominal-pain--454405. Diagnosis of viral gastroenteritis. During this test, a trained physician checks the large intestine for sources of pain or bleeding. yes i have had three rounds of bloods, mri of abdomen, ultra sound and endoscopy - all clear. Chronic pain often stems from an ongoing problem that can't be cured, such as cirrhosis of the liver. ), my suggestion to vist histolic ordietition doctor if. An acute illness is one that starts suddenly. I have had so many tests think ive had 4 blood tests in a month, X-rays, endoscopy CT scan all clear. I think anxiety hasnt helped my symptoms either i was constantly googling my symptoms and it was coming back with the worst results possible, but thankfully all my scans have been clear. What tests are used to diagnose appendicitis? If you have, you may". Sue. It is also very useful when the CT of the abdomen is normal because serious disease needing treatment is often excluded. In general these days there are a lot of gluten sensitivity. Now i've been on Omeprazole for 4 days and my symtpoms havent gotten better. Admitted to the burn center, where medication is accidentally re-started, and she dies. Upgrade to Patient Pro Medical Professional? She has experience in primary care and hospital medicine. If blood is there but you can't see it, you may have a problem in your upper digestive tract. They are good for diagnosis, but the scopes cannot cover the entire intestinal track. In some cases, a healthcare provider may take a small stool sample is often during the rectal exam. However, 2 of the GP's that I have seen have both told me that all the tests can come back clear but my gallbladder will still be chronic and will propbably need to get it removed. Subscribe today to get a new case every week. An infection in the appendix makes it swell and become more and more painful. 5 users are following. An approach to narrowing the differential diagnosis based on history, physical examination, and laboratory testing, in addition to imaging, is outlined in our previous article on this topic.2 If a likely diagnosis is apparent based on the clinical presentation, imaging may or may not be indicated (Table 1312 ). Sometimes I may be constipated and sometimes i have diarrhea. . I am going to look up that disorder and definitely start keeping a food journal. If so could be nerve entrapment or damage. they should at minimal add a CT scan. Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below. A radiologist can "read" the picture. Results did not show any emergency findings. ive had issues with acid reflux for nearly 2 years but it hasnt caused abdominal pain. Beta human chorionic gonadotropin testing should be considered before performing diagnostic imaging in all women of reproductive age presenting with acute abdominal pain. There are many different types of imaging tests used to . This article explains some of the most common tests used to find the source of abdominal pain. I am stuck now i dont know what more to do? Abdominal pain is a common presentation in the ambulatory setting, accounting for 1.5% of all office-based visits and 8% of all emergency department visits in the United States in 2010.1 Acute abdominal pain has many potential underlying causes, ranging from benign, self-limited conditions to life-threatening surgical emergencies. I make an outline of my journal before my doctor visits and questions for the doctor. This may mean drawing blood, taking a stool sample, or collecting a sample of saliva, among other options. Our mission is to help you understand your radiology reports by explaining complex medical terms in plain English. I just discovered if I push intensely between my back ribs, that I have somewhat relief from the pain. The American College of Obstetricians and Gynecologists. No diagnosis apart from GERD but i am now following a low acidic diet and eating less and often and taking Lansoprazole daily had helped the stomach pain. Abdominal pain is a common symptom that brings patients to the emergency department (ED) for evaluation. An acute illness may come one quickly, but it can go on for weeks or even months. I have had acute abdominal pain since April 2011 and it has escalated over the months.. x-rays are used to create a cross-sectional . If a patients symptoms are suggestive of inflammatory bowel disease, for example, we may provide a referral to a gastroenterologist, who can perform a colonoscopy for evaluation. Additionally, it would have been wise to check a salicylate level. CT and Xray shows nothing. A computed tomography (CT) scan is a type of CT scan. The appendix is a finger like pouch that comes off the large intestine in the right lower abdomen. Have had stomach pain for over a year with swelling. Oct 2, 2019 Explaining Unexplained Abdominal Pain by Katie E. Golden, MD Abdominal pain is a common symptom that brings patients to the emergency department (ED) for evaluation. Once you catch up write it down everyday.. what you ate, bowel habits.. is the pain traveling or in one spot.. do you have a fever. Data Sources: We reviewed the American College of Radiology Appropriateness Criteria at https://acsearch.acr.org/list. So there is a latest, test of sensitivity or allergy for all types of foods your dietition doctor know it. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. and Privacy Policy and steps will be taken to remove posts identified Acute sigmoid diverticulitis is the most common cause of left lower quadrant pain in adults and is the focus of imaging recommendations for this quadrant. Thank you, {{form.email}}, for signing up. Cause of a fever. Have pain in right side. 2015;38(2):49-54. doi:10.18773%2Faustprescr.2015.019, Mendelson R. Imaging for chronic abdominal pain in adults. There are many types of pathology that can be seen on a CT scan of the abdomen with contrast. I have been having severe abdominal pain and nausea for 6 months, about a 7 constant and a 8 when pushed. Everything comes back normal, gallbladder seems - Answered by a verified Endocrinologist . Initially, Bland was concerned she had appendicitis, Boodman writes. If the left upper quadrant hurts after a serious car accident, the cause of pain could be the spleen. Osteoporosis And Broken Bones: What Can You Expect From Spine Fractures. Egton Medical Information Systems Limited. It also explains when to seek medical care. An inflamed appendix revealed on a CT scan is larger than 6 mm in diameter, and has appendiceal wall thickening and wall enhancement after contrast media infusion. 11. I had a ct scan done yesterday and the results are back already that show absolutely nothing except a slightly enlarged liver (which I have been told before) Since the episode and honestly a few days prior, I have been having stomach cramping/back pain. If the patient has a bad outcome, it is preferable to have a vague but not incorrect diagnosis, rather than a specific and wrong diagnosis. In some cases, doctors may do stool tests to rule out other gastrointestinal diseases, such as ulcerative colitis. Clin Biochem. wondering if anyone has had any similar symptoms and has had a diagnosis? Connect with thousands of patients and caregivers for support and answers. An MRI isn't safe for people with certain types of metal in their body. It's good your doctor is still recommending a colonoscopy to find the cause of the problem. Read our editorial policy. Imaging tests used may include a CT scan or an ultrasound. Treated for H Pylori and then told that was not the issue. Its severity ranges from annoying to life-threatening. CT scan of the abdomen for abdominal pain is one of the most common reasons for ordering a CT scan. Sometimes these scans involve the use of special dyes called contrasts. This includes life-threatening infections, bowel obstructions, abnormal fluid or bleeding, kidney stones, masses or tumors, abnormalities of the blood vessels that run through the abdomen, the list goes on. For the past year now I have been having really bad pains in the upper middle and right hand side of my abdomin like someone is stabbing me. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Hernia. . . Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. However it is promising nothing glaring has shown up. Charlotte, NC 28260-1504, Post-Graduate Certificate Program for PAs & NPs, Website Designed & Developed by Company 119. Because so many health conditions can cause abdominal pain, you may need tests to identify the problem. CT also provides more consistent results than ultrasonography,5 because ultrasonography is a highly operator-dependent technique that varies based on the skill and experience level of the technologist and radiologist. ive had this pain on my left side under my ribs and my back which comes and goes it seems to be more painful when sitting. Joanna. The risk of a negative outcome for a developing embryo or fetus exposed to a single CT of the abdomen and pelvis is very low.26 The ACR practice parameter regarding the use of imaging with ionizing radiation in pregnant patients outlines the specific risks based on gestational age, and emphasizes the importance of obtaining informed consent from the patient before imaging is performed.26. CT showed free air, from a duodenal ulcer perforation. The CT suggested "abnormal densities in the pancreatic head". The digital rectal exam (DRE) is a test where a healthcare professional inserts a gloved and lubricated finger in the rectum. Does anyone else have any ideas? lymphoma. Preliminary data on the use of MRI for the evaluation of diverticulitis suggest that it may be useful, with sensitivity of 86% to 94% and specificity of 88% to 92%.8, Although certain disease processes such as cholecystitis, appendicitis, and diverticulitis commonly present with pain localized to a specific quadrant of the abdomen, diffuse abdominal pain is also a common clinical presentation. Any associated symptoms like vomiting, fever, or lab abnormalities such as an elevated white blood cell count. This article includes one clinical variant for each pain location; tables for all clinical variants are available at https://acsearch.acr.org/list. I would try and get ultra sound done of pelvic area. The cramping is kind of all over. A urinary tract infection (UTI) can cause pain in any of these body parts: These blood tests look at enzyme levels produced by the pancreas. My own tumour was missed on a CT scan. A CT scan of the abdomen is one component of the workup of abdominal pain. If your test is ordered stat, then it will be read quickly, usually in under an hour. Read our editorial policy. We might be in the same boat. People with kidney conditions may not do well with contrasts. Please read the disclaimer Acute appendicitis is an inflammation of the appendix. If you cannot get answers from your doctors if possible seek better doctors in another nearby city. The differential diagnosis of acute nonlocalized abdominal pain is broad. It is also common that our ED workup does not find an identifiable cause, and patients are discharged home without a clear diagnosis. This scan uses many x-ray type images to create a picture of the inside of the body. Higher levels may be a sign of an infection or inflammation in the pancreas called pancreatitis. Notes on Help? Will be contacting my GP next week regarding the aches in my back but i assume she wont be interested. This has been happening for 3 days and I have lost 4 lbs from it. It is tendor to touch (no pain on the left) and cant sleep properly on my right hand side as it is too sore to lean on, feel nauseous most of the time, have the pain when I eat and when I dont eat (feel likeI cant win). Join 7000+ doctors and attorneys on the email list. If the patient has a bad outcome, it is preferable to have a vague but not incorrect diagnosis, rather than a specific and wrong diagnosis. CT of abdomen and pelvis with contrast media, Consider CT if ultrasonography is nondiagnostic, presentation is atypical, or patient is critically ill, Cholescintigraphy or CT may be considered if ultrasonography is equivocal, Choice of examination depends on institutional preferences and resources, Patients with typical symptoms and no suspected complications may not require imaging, Ultrasonography of pelvis (transvaginal and transabdominal), CT angiography of abdomen with contrast media, Conventional angiography is invasive but may be considered to diagnose and treat with a single procedure, CT of abdomen and pelvis without contrast media, Ultrasonography may be considered if CT is unavailable; ultrasonography may help detect obstruction but has poor sensitivity for visualizing stones, Conventional radiography may be appropriate for initial evaluation, MRI of abdomen without and with contrast media, See statement regarding contrast media under anticipated exceptions, Based on ultrasound findings, this generally should follow ultrasonography of the right upper quadrant, CT of abdomen without and with contrast media, Oral or rectal contrast media may not be needed depending on institutional preference, Use of oral or rectal contrast media depends on institutional preference, Perform this procedure with graded compression, This procedure is appropriate in women with pelvic pain, MRI of abdomen and pelvis without and with contrast media, See statement regarding contrast media under anticipated exceptions (, This procedure may be useful when there is concern for perforation and free air, CT of abdomen and pelvis without and with contrast media, MRI of abdomen and pelvis without contrast media, Technetium 99m white blood cell scan of abdomen and pelvis, For the procedure, oral and/or colonic contrast may be helpful for bowel luminal visualization, Ultrasonography of abdomen, transabdominal graded compression, Radiography of upper gastrointestinal series with small bowel follow-through, May be helpful in select cases but should be used with caution because of increased radiation dose, Indium 111 white blood cell scan of abdomen and pelvis, Only after other studies without ionizing radiation have been used, Because it is unclear how gadolinium-based contrast agents will affect the fetus, these agents should be administered with extreme caution, Gadolinium-based contrast agents are recommended for use during pregnancy only when there are no alternatives and benefit outweighs risk. Before ordering diagnostic imaging in premenopausal women, it is important to consider obtaining a beta human chorionic gonadotropin (-hCG) measurement to narrow the differential diagnosis and to limit the possibility of exposing an embryo or fetus to ionizing radiation. Author disclosure: No relevant financial affiliations. If so, the stool will feel small or hard. EM physicians are often ridiculed for ordering too many CT scans. Egton Medical Information Systems Limited. All Rights Reserved. pheochromocytoma. Stomach pain and swelling is worse when I eat, and after I eat. remar If having a CT scan would put your mind at ease then you probably should have it done. This is abnormal because the only air seen should be within, Read More Free Air on CT (Pneumoperitoneum)Continue, Please read the disclaimer Abdominal MRI is a test used to evaluate the abdomen in detail. Acute abdominal pain is a common presentation in the outpatient setting and can represent conditions ranging from benign to life-threatening. Pain over the upper back, Radiating pain to the jaw, Radiating pain over the neck region Upper part the stomach (epigastric region)-In this condition usually women are mis diagnosed as they are suffering from gastritis and treated with antacids. This may mean drawing blood, taking a stool sample, or collecting a sample of saliva, among other options. Gastrointestinal Stromal Tumors: Warning Signs, Diagnosis And Treatment, Abdominal Pain And Testicular Soreness Likely To Be A Hernia, Early Pregnancy Signs: Cramping And Lower Abdominal Pain, Causes of abdominal pain during pregnancy, What Can Cause That Abdominal Pain Spreads To The Back, Stomach Gurgling and Lower Abdominal Pain Has Numerous Causes, Ovarian Cancer: Know Your Body, Know Your Risk, Several Disorders Can Cause Pain In The Left Abdominal Region. It is also worth mentioning that it is common for psychological stress to manifest in real, severe, and debilitating abdominal pain. i have similar symptoms too. I wake up with the pain and it can last all day. In pain but tests are clear. When I went to the ER it was just for the EXTREME abdominal pain. A CT scan can only show if something looks abnormal, not if it functions abnormally. Oral contrast media is used for bowel visualization, and intravenous contrast media allows for enhanced visualization of vascular structures and solid organs.25 The ACR Appropriateness Criteria outline whether contrast is recommended for various indications (Tables 1 through 5312 and eTable A), and note that protocols on the use of contrast media vary among institutions. A repeat CT scan may be required to make the diagnosis. Undiagnosed Abdominal Pain EXTREME abdominal pain. This test allows a physician to inspect the inside of the colon (large intestine) with an instrument that has both a light and a camera. The pressure in my abdomen is sometimes too much and no one seems to be able to tell me anything. What tests should be done if CT scans and blood work are not showing anything except white blood cell count going up? This test looks at the urine to see if there is blood or infection in the urinary tract. Some of the more common causes of abdominal pain I see are bowel obstructions, appendicitis, diverticulitis, and kidney stones. Mostly you have allergy or sensivity for one or some. (note:sensetivity of any food not found by biopsy when you made endoscopy or colonscopy) . The test uses no radiation unlike CT scans. Every ED clinician hopes to be able to diagnose and treat the cause of a patients pain, providing immediate relief and a resolution to the patients discomfort. The standard physical exam is done in the following order: For example, if the pain is mostly in your right lower abdomen, also known as the right lower quadrant, the appendix might be the cause of the pain. Ultrasonography is the initial imaging study of choice for evaluating patients with acute right upper quadrant pain. Search dates: May 2014 through January 2015. Some of the questions may seem personal. Your clinician may speak to you about the possibility of early appendicitis. Normal labs and CT scan, but continuing abdominal pain. Try our Symptom Checker Got any other symptoms? Nothing picked up on the CT or PET. I am new here and hoping you guys can help. A CT scan will be done by a technologist who operates the CT scanner and makes sure the test is done well and safely. What was the outcome? 5 days ago 51 Replies. Why do I still have abdominal pain if the CT scan is normal? Has anyone been through this and got anywhere futher thanI have? Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. The hospital ordered a CT scan for the next day which again showed nothing and everything was fine. Complete your request online or contact us by phone. The CT suggested abnormal densities in the pancreatic head. I have also read that you can get bone spurs in your pelvis. Finding out the history of the illness, as well as your medical history, helps narrow down the potential causes. The location of pain is often a helpful starting point. leave nothing to chance. Are those the only test you have had? Notes on Normal tests but still have upper abdominal pain? For example, a broken leg is an acute problem, but the leg may hurt for a long time. respect of any healthcare matters. I have actually had 4 surgeries for endometriosis, a surgery for an ovarian torsion and recently a hysterectomy. 2nd specialist refuses to do more tests. Both imaging and non imaging tests may be needed. Also see if having a non or low fat diet helps, good luck, Ive had a scan done/ blood work done and also a brath test and it all cam back clear. sorry to hear you are going through similar symptoms. Unfortunately, this doctor was sued for the exact opposite issue. 2 years ago, No emails. Through this time you can make a test for your self : Aviod any. This site requires JavaScript to run correctly. My daughter had symptoms similar to yours (stomach pain so bad we ended up at emerg a few times). I have had 2 abdominal CT scans, endoscopy, Colonoscopy, 2 hyda scans, and countless bloodwork tests all have come back negative. could it possibly be IBS along with acid reflux? Guest Everything looks fine they said, not even stones. Although some studies have shown similar sensitivity of ultrasonography compared with CT for detecting diverticulitis, others have shown significantly lower sensitivity with ultrasonography.19 Variation in ultrasonography results may be due to the highly operator-dependent technique and the limitations of patient body habitus, compared with other imaging modalities. been in the ER 3 times. Abdominal complaints may be as simple as an upset tummy from overeating or as complex as needing emergency surgery to remove an oxygen-starved part of the intestine. One of the most useful diagnostic tools that we do not have at our disposal in the emergency room, however, is time. Ectopic Pregnancy. A positive pregnancy test can explain many symptoms. Pelvic exams involve checking reproductive organs, including: A healthcare professional will check for signs of infection, irritation, cysts, or other growths that could be causing pain. CT scans aren't the most reliable way to diagnosing colon cancer. I've have an ultrasound and 3 CT scans in 7 years. Most people are familiar with how ultrasounds are used in pregnancy. In the interest of decreasing radiation exposure, efforts have been made to use CT more judiciously. Yes, a CT scan can show peritonitis. The test can also be used to find the source of abdominal pain. Imaging tests use magnetic fields, x-rays, or sound waves to create detailed pictures of the inside of your abdomen. Routine use of CT for evaluation of appendicitis has reduced the negative-finding appendectomy rate from 24% to 3%,16 and it has been shown to decrease overall costs by $447 per patient by preventing unnecessary appendectomies and hospital admissions.17. 2023 A. Mendelson, MD Star Direct, Inc. | About The Author | Imaging Categories | Disclaimer | Privacy Policy | Contact. CT scans utilize X-rays to form images of organs and tissues inside the body (for example, abdominal organs, brain, chest, lungs, heart) while colonoscopy is a procedure that can visualize only the inside surface of the colon. All rights reserved. Just wanted to give couple options of what it could be. Although studies have shown improved sensitivity and specificity for diagnosing acute abdominal pain with the use of contrast enhancement, the accuracy of CT or MRI remains high regardless of the use of contrast media.5, In females of reproductive age, gynecologic and obstetric causes of abdominal pain (e.g., ectopic pregnancy, ovarian cyst, ovarian torsion, pelvic inflammatory disease) are important considerations in addition to the diagnoses commonly made in the general population. Testing in the ED typically begins with lab work: we check blood counts, electrolytes, kidney function, liver function, and perform an analysis of the urine. Ultrasonography has also been studied for evaluation of suspected diverticulitis. Abdominal persistent pain. The hospital and my GP said it was just Acid. A 57-year-old woman presented to the ED on January 6 with lower abdominal pain. Cause of abnormal blood test results such as liver or kidney problems. The ACR Appropriateness Criteria recommend CT as the initial imaging test of choice for patients presenting with right lower quadrant pain (Table 3).5 A meta-analysis of six studies from 1994 to 2005 found that CT has better sensitivity and specificity (91% and 90%, respectively) than ultrasonography (78% and 83%, respectively) for detecting acute appendicitis15 (Figure 2). In many cases, an abdominal CT is done with a pelvis CT. Unfortunately, I have the latter and haven't worked in 14 years. We will also sometimes obtain an ultrasound instead of a CT scan, which is particularly useful at evaluating the gallbladder, ovaries and uterus, and testicles. This test checks for signs of acid reflux or stomach ulcers. A Practical Guide to Clinical Medicine. He reviewed the prior CT and did not feel that a repeat was necessary. -Doctors Lounge (TM) Medical Specialty >> Gastroenterology Doctors Lounge - Gastroenterology Answers Back to Gastroenterology Answers List If you think you may have a medical emergency, call your doctor or 911 immediately. sometimes its in my pelvis area and sometimes its a . This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. It is taking over my life and getting me really down! Hey Sue, I feel your pain!! i started getting abdominal pain upper right side and lower left side beginning of December i assumed it was IBS as did my GP. If you are of childbearing years and you have abdominal pain, a pregnancy test might be a good starting place. The decision to use oral or intravenous contrast media with abdominal imaging depends on the suspected diagnosis as well as specific patient characteristics. They made me drink some nasty tasting stuff and did a CT scan and Xrays. I also get pain on both sides in my lower abdomen but not as frequently as the upper abdomen(which is pretty much constant). I hope you find some relief from your symptoms. Is it possible this is an entrapped nerve? I hadn't thought of the few things you suggested but I think I am going to see if I can get an ultrasound of my pelvis- that may give some good insight. Right now with covid still ongoing it may be difficult to get an appointment. Still the same really, upper left abdominal pain has gone from being constant to just appearing sometimes throughout the day for a few minutes, still having mid/upper back pain, its a strange feeling its not painful just uncomfortable especially when in certain positions and the feeling moves around my back. Interested in more discussions like this? The camera allows a trained physician to view the inside of the esophagus, stomach, and duodenum (the first part of the small intestine). It is also common that our ED workup does not find an identifiable cause, and patients are discharged home without a clear diagnosis. Well I am now in hospital on a drip getting strong antibiotics for a perforated bowel.My Dr finally got blood tests done and was very alarmed by my results .Then when the ct scan was done the radiology Dr rang and said get to the hospital emergency immediately . When you have an infection, your body increases certain types of blood cells. SARAH L. CARTWRIGHT, MD, AND MARK P. KNUDSON, MD, MSPH. I am bloated and nauseas most of the time. If the pain advances to the point that standard, over the counter medications, are ineffective, we hope the patient will seek urgent re-evaluation at their nearest ED. Good luck ! Copyright 2015 by the American Academy of Family Physicians. I have noticed the pain in the left side stops after a bowel movement but flares up again within an hour or so. Gall bladder stones which can be seen on ultrasound cause pain in right-upper abdomen which is worse after you eat and can be worse at night as well. Magnetic Resonance Imaging (MRI) Radionuclide Scanning. Hi everyone. Its more painful to sit and im dealing with constipation as well. After about a year of this she was finally diagnosed with something called Functional Gastrointestinal Disorder. The pain begins early morning, remains unrelenting and escalates throughout the day.
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