[18F] With chronic lower right abdominal and pelvic pain

Patient Description

An 18-year-old female presents with lower right abdominal pain, tenderness, and pain in the pelvic and vaginal areas for the past 8 months. The pain is described as sharp, comes and goes, and is rated as a 6 out of 10 in severity. The patient also experiences chills but has not found anything that alleviates the pain. The last bowel movement was healthy and occurred yesterday. There are no associated symptoms of nausea, vomiting, abnormal vaginal discharge, fever, irregular menstrual cycles, or pain during intercourse. The patient has no history of ovarian cysts, endometriosis, or pelvic inflammatory disease (PID). She does not use tobacco, alcohol, or recreational drugs, and there have been no recent changes in diet or specific foods that trigger symptoms. There has been no recent exposure to known infections or travel to areas with known diseases. Current medications include trazodone 100mg and fluvoxamine 15mg, taken daily. No other medications, supplements, or herbal remedies are reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Chronic Pelvic Pain Syndrome (CPPS):

    • Rationale: CPPS can cause persistent pain in the pelvic region, including the lower abdomen, and can be associated with tenderness and pain in the vaginal area. The pain can be sharp and come and go, as you've described.
    • Typical Treatments/Testing: Treatment may include pain management strategies, physical therapy, and sometimes medications to manage pain and inflammation. A healthcare provider may perform a pelvic exam, imaging tests (like an ultrasound or MRI), and possibly refer you to a specialist.
  2. Irritable Bowel Syndrome (IBS):

    • Rationale: IBS can cause abdominal pain and discomfort, which can be sharp and intermittent. While IBS typically affects bowel habits, it can also cause pelvic pain and tenderness.
    • Typical Treatments/Testing: Management often includes dietary changes, stress management, and medications to relieve symptoms. A healthcare provider may recommend a colonoscopy or other tests to rule out other conditions.
  3. Ovarian Cysts:

    • Rationale: Ovarian cysts can cause sharp, intermittent pain in the lower abdomen and pelvic area. While you mentioned no history of ovarian cysts, they can develop at any time.
    • Typical Treatments/Testing: Treatment may include watchful waiting, pain management, or surgical intervention if the cysts are large or causing significant symptoms. An ultrasound is typically used to diagnose ovarian cysts.

What you can do

For Chronic Pelvic Pain Syndrome (CPPS):

  • See a healthcare provider: It's important to get a proper diagnosis and treatment plan. They may refer you to a specialist, such as a gynecologist or a pain management specialist.
  • Pain management: Over-the-counter pain relievers like ibuprofen or acetaminophen may help manage pain. Always follow the recommended dosage.
  • Physical therapy: A physical therapist specializing in pelvic pain can provide exercises and techniques to help alleviate pain.

For Irritable Bowel Syndrome (IBS):

  • Dietary changes: Consider keeping a food diary to identify any foods that may trigger your symptoms. A low-FODMAP diet is often recommended for IBS.
  • Stress management: Techniques such as mindfulness, meditation, and yoga can help manage stress, which can exacerbate IBS symptoms.
  • Consult a healthcare provider: They can provide specific dietary recommendations and possibly prescribe medications to help manage symptoms.

For Ovarian Cysts:

  • Monitor symptoms: Keep track of your pain and any other symptoms. If the pain worsens or you develop new symptoms, seek medical attention.
  • Consult a healthcare provider: They can perform an ultrasound to check for ovarian cysts and recommend appropriate treatment.

What you should look out for

Given the chronic nature of your symptoms and the potential for underlying conditions, you should seek medical care to get a proper diagnosis and treatment plan. Reasons to seek care more urgently include:

  • Severe or worsening pain
  • Fever or signs of infection
  • Unexplained weight loss
  • Changes in bowel habits or urinary symptoms
  • New or unusual vaginal discharge

Remember, while I can provide information and suggestions, it's important to consult with a healthcare provider for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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5 mo ago


People Also Ask


What are the common symptoms of Chronic Pelvic Pain Syndrome (CPPS)?

Common symptoms of CPPS include persistent pain in the pelvic region, lower abdominal pain, tenderness, and sometimes pain in the vaginal area. The pain can be sharp, intermittent, and may be associated with other symptoms like urinary or bowel issues.


How can Irritable Bowel Syndrome (IBS) cause pelvic pain?

IBS can cause pelvic pain due to the close proximity of the intestines to the pelvic region. The pain is often sharp and intermittent, and while IBS primarily affects bowel habits, it can also lead to discomfort and tenderness in the pelvic area.


What are the typical signs of ovarian cysts?

Typical signs of ovarian cysts include sharp, intermittent pain in the lower abdomen and pelvic area, bloating, and sometimes changes in menstrual cycles. However, many cysts are asymptomatic and are found during routine examinations.


What lifestyle changes can help manage chronic pelvic pain?

Lifestyle changes that can help manage chronic pelvic pain include regular physical activity, stress management techniques like yoga or meditation, dietary adjustments to avoid trigger foods, and maintaining a healthy weight. Consulting with a healthcare provider for personalized advice is also recommended.


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Anonymous#8743

5 mo ago

test

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