Severe abdominal pain

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I've had severe abdominal pain both RIF and LIF and lower back pain for a few months now.

Several sets of varying blood tests have returned as normal

2 hospital admissions 

consisting of several sets of bloods - all normal

2 ultrasound scans - 1 unclear, 1normal

Abdominal and pelvic CT scan - Normal, however I had this scan on a sunday and was told that the radiologist's report said it was all clear after 55 mins despite being told it would take a few hours by the technicians.

Tried different painkillers, buscopan, laxido - no relief

Additional symtomps

Significant loss of apetite and nausea, vomitting 

Tried to persuade the hospital consultant to keep me admitted and investigate further and that the lack of answers was causing anxiety to which he replied: "you don't have cancer, you have no life threatning condition, you don't need to be here. The CT as I expected was all clear"

Any ideas on further investigations, or possible conditions that a CT would not pick up would be extremely appreciated. The lack of appetite is leaving me extremely weak, my life is starting to suffer as a result.

Please someone out there help...

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  • Posted

    You could ask for a colonoscopy, endoscopy and MRI.   However, CT scans are very reliable and do generally pick things up.  Ask for an H.pylori test which can be done with blood tests, breath test, stool sample or stomach biopsy.  Ask about celiac and IBS.  Do you have changes in bowel habit such as constipation or diarrhoea?  Have you had any recent stress?  Keep a food diary to check for any intolerances. Ask to see a dietician and enquire about the Fodmap diet. If necessary, change your doctor or go private if you can.  

    If all tests are negative, IBS can be diagnosed. Everyone with IBS has different symotoms and will not react in the same way to treatment.  You could try probiotics, peppermint tea or capsules.  My IBS was only diagnosed after eight visits to the doctor over three and a half months.

    My IBS symptoms are mainly mild stomach pain that moves around and occasional back pain.  I have had constipation and loose stools along with nausea.  Sometimes I have a bad flare up which I treat with Buscopan and Nurofen.

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    • Posted

      Thanks for the advice, I will raise the H.pylori issue however, my WBC is within normal range. I'm quite sure it's not IBS as it is constant and not flaring. Also,have tried buscopan which had no effect. Bowel habbits have been normal,once instance of constipation. 
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    • Posted

      IBS pain can be constant; mine is.  I didn't believe I had IBS either because there was no let up in pain.  However, I later read that sometimes the pain comes and goes in flares and other times people have it all the time.  By the way what is WBC?
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    • Posted

      I would imagine it's the white blood cell count being in the normal range. Guess I need to wait for his reply though instead of me guessing !
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    • Posted

      Yeah I meant white blood cell count. Okay portacrean that's viable cause then! Will raise it with my GP, have a longer appointment in 2 weeks with the managing Doctor at my surgery. Have had to wait ages for it!!
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    • Posted

      Great ! Be sure and get back to us. Let us know what they find ( if anything ) took me a year and a half just to find this. Good luck
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    • Posted

      I will do. Might sound strange  but I was hoping the CT scan showed something because well the devil you know  is better than the devil you don't.. 

      I really sincerely hope that the diagnosis of abdominal pain improves one day.There's absolutely no consitency, I was fortunately given some investigation because of a second admission in a short space of time

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    • Posted

      White Blood Cell Count, high count usually is found when inflammation is present, any inflammation, very general test like measuring 'fever'. Also the distribution of the different white blood cells is usually counted (lymphocytes, neutrophiles...etc). Even IBD (yes, not to be confused with IBS) often enough has normal WBC. It is one routine parameter that has to be viewed in connection with other parameters.
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    • Posted

      I don't understand how I had a normal WBC and then a week later tell me my stomach sample tested positive for H Plori. But that's what happenrd. And my blood test didn't test positive for H Plori. So I'm taking all these antibiotics for H Pylori

      What to do and what to believe ?

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    • Posted

      Hi Portacrean,

      No, nothing to be wondering about blood test results being negative for H.pylori, biopsie H.pylori positive, WBC normal.

      There is hardly anything in lab tests, that is 100% to be taken black and white, it always is just a helping tool in the big picture, and it highly depends which test we are looking at,

      and so is also the fact of when and where a sample is taken (be it biopsie location, depths, or for blood the timing  e.g. diagnostic window)

      and your very own individual response to something anyway, which can be very different from individual to individual.

      I just got to know a patient, who had pneumonia (finally diagnosed in xray) but had no fever, which is one of the prime symptoms, hence the delay.

      It is possible though.

      Regarding lab tests:

      it's called 'SPECIFITY' and 'SENSITIVITY' of a test method, that a test can be false positive or false negative (despite the fact, that the sample itself can actually represent wrongly and the test be correct) 

      Always the best compromise is used, also depends if a screening should rather pick up with high sensitivity rate (hence risk of false positive results) anything possible or be specific already (risk of false negative results); lab tests are constantly replaced if a better one comes up regarding specifity and sensitivity depending what is needed,  this is a big field and I don't go in further details.

      Regarding H.pylori

      there are histology, culture, rapid urease, PCR, serological blood, Carbon urea breath test, stool as diagnose tools.

      ALL those are luckily high in sensitivity and specifity!!

      So they dedect small amounts and if positive is H.pylori and not something else. But 'small amounts' can still be too little.

      Regarding YOUR BLOOD TEST, I don't know which blood test it was, there are some different ones, but they all look for your immune response, a protein, that your immune system produces after contact with H.pylori. Now, your production can be too small or at the time of sampling having been too little because of being too early (and would be detectable now?).

      Also the blood antibody IgG ELISA test itself e.g. has a sensitivity of 95%, which is really good, other tests like latex agglutination are 93% sensitivity, specifity 95%.

      But see, not 100%.

      HENCE you can have a false negative H.pylori blood antibody test and still actually be infected with H.pylori. Unlikely, but possible.

      That's why we don't give up right there if symptoms persist.

      You got a BIOPSIE tested for it! If cultured, rapid urease, whatever the test was, it was positive and you can due to the specifity trust this result.

      the blood test was for whichever possible reason (and it is possible) false neg at it's time of sample taking or will always be neg.

      Out of a scientific interest it would be interesting if your antibodies showed up now, too, or still neg (then this would be no test for you ever for follow ups), if a breath test would show up positive.

      This 'blood neg, biopsie pos' is hence plausible. Same happens with celiac, hence biopsies are so needed. Hence we never rely on one test if symptoms say different.

      The carbon urea breath test is btw - if done correctly and not after an antiacid or antibiotic treatment, wait 4 weeks- very accurate!!

      So is the stool test.

      I am not sure why a blood test was the first choice for your doc. But he persisted (or you), so all good.

      Now to the WBC:

      H.pylori causes a chronic infection of your stomach lining.

      Infection fighting white blood cells move to the stomach, they go there (not the H.pylori into blood), see it as an intrudor = produce antibodies, that you can find in the blood (usually in measurable levels)....duhduh,

      so yes, the WBC should be higher.

      Yes, and it often is,

      BUT IT OFTEN IS NOT,

      since the other theory is, that the H.pylori do not enter the blood stream itself. There are studies that show, that WBC do rise and correlate with what is found in the biopsie (distribution of white blood cells), other studies show, that some are 100% (breath test, biopsie stain, culture) H.pylori infected and have a normal WBC.

      Another study shows a coexistence of elevated WBC and H.pylori infection increased the risk for gastric cancer.

      Happy now to have normal WBC? ;-)

      All these constellations are very possible and plausible.

      The WBC is just one piece in a puzzle, the WHOLE picture with your history and other test results gives the answer, not a single out one, especially if it sounds a bit contradictory, which is still plausible.

      WBC is very helpful, but not the gold standart to tell you, if you have H.pylori or not.

      I am very happy for you that you have a stomach sample positive and treatment could start, the specifity is very high to be correctly diagnosed with H.pylori from the biopsie sample.

      After the treatment you see, you experience, if it helped or not.

      Don't forget: sometimes we have a combination of things happening, good to tackle one but might not be everything done and dusted then.

      (also one can get re-infected....)

      All the best!!!!

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    • Posted

      Thank you. So that , pretty much answers all the questions I had concerning H Pylori and blood work. And it is comforting to find out something abut the WBC being normal and still getting a positive result for H Pylori from the stomach sample. Very informative . And it was me who wanted and went for the endoscopy , not my GP. . It seems that in today's world of medicine , the patient has to do most of the digging. So , thank you again for your expertise.
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  • Posted

    You might push to have an endoscopy. Could be H Pylori or a host of other stomach problems. I pretty much had the same symptoms . Excruciating abdominal pain and neausea. No lower back pain though. Had it for 1 1/2 years and just got diagnosed last week. Had all the test you've mentioned and nothing ever showed up. When a test result comes back that auickly. It makes you think , maybe the radiologist has become complacent in hi job. Doesn't it ? I've had that feeling several times. Anyway , try to get the endoscopy done to see if anything shows up. I'm sure other people on here may have different sugestions. This can be a very helpful place to get started looking for things like this. So good luck , and keep us posted on what you find out.
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    • Posted

      Thanks for the advice. Glad to hear that! Exactly, considering that I did some work experience with a radiologist about a 18months ago and he said that a proper report of a CT scan regardless of whether anything is wrong, would take him an hour.  Considering he is highly experienced and has done the job for many years, I was concerned that on an on call possibly locum thought they could do a better job in a shorter time...
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