[23F] Experiencing chronic abdominal and lower spine pain

Patient Description

A 23-year-old female has been suffering from chronic abdominal pain for two years, which intensifies with movement and walking, often reaching a severity of 10/10. The pain is sharp and located in multiple areas of the abdomen, including the groin and sides, and is sometimes connected to a dull pain above the tailbone in the lower spine. The patient has a history of endometriosis, resulting in heavy and painful menstrual cycles, and experiences pain during sexual activity, bowel movements, and when having a full bladder. Nausea occurs a few times a week without vomiting. Past medical history includes hospitalization for low white blood cell count as an infant, kidney stones, and a kidney infection from a UTI. The patient is allergic to IV contrast, droperidol, and Benadryl but is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information provided, possible diagnoses include:

  • Endometriosis: This is a condition where tissue similar to the lining of the uterus is found outside of the uterus, often in the pelvic area. It can cause severe abdominal pain, especially during periods, and can also cause pain during sex, bowel movements, and when the bladder is full. The pain can be exacerbated by physical activity and relieved by rest.

    • Treatment options include pain management, hormonal therapies, and surgery.
  • Musculoskeletal issues: Given the history of heavy lifting and the location of your pain, musculoskeletal issues related to your spine or abdominal muscles could be contributing to your symptoms.

    • Treatment typically involves physical therapy, pain management, and avoiding activities that exacerbate the pain.
  • Kidney Stones: Given your history of kidney stones, it's possible that new stones have formed. These can cause severe abdominal and back pain, especially when moving.

    • Treatment typically involves pain management, drinking plenty of fluids, and in some cases, medical procedures to remove or break up the stones.

What you can do

  1. Continue with yoga or other gentle exercises that don't exacerbate your pain.
  2. Apply a warm compress to your abdomen and lower back to help alleviate pain.
  3. Stay hydrated and maintain a balanced diet.
  4. Over-the-counter pain relievers may help manage your pain, but always follow the package instructions.
  5. Schedule an appointment with your healthcare provider to discuss your symptoms and potential treatment options.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe, sudden, or worsening abdominal or back pain
  • Blood in your urine or stool
  • Fever or chills
  • Unexplained weight loss
  • Persistent nausea or vomiting

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care.

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10 mo ago

People Also Ask


What are the common symptoms of endometriosis?

Common symptoms of endometriosis include severe menstrual cramps, chronic pelvic pain, pain during or after sex, pain with bowel movements or urination, and heavy menstrual bleeding. Some women also experience fatigue, diarrhea, constipation, bloating, and nausea.


How can kidney stones be managed or treated?

Kidney stones can be managed by drinking plenty of fluids to help pass the stones, taking pain relievers, and in some cases, using medications to help pass the stones more quickly. If stones are too large to pass, medical procedures such as shock wave lithotripsy or surgery may be necessary.


What are some non-medication methods to alleviate chronic abdominal pain?

Non-medication methods to alleviate chronic abdominal pain include applying a warm compress to the affected area, engaging in gentle exercises like yoga, maintaining a balanced diet, staying hydrated, and practicing relaxation techniques such as deep breathing or meditation.


When should I seek immediate medical attention for abdominal pain?

You should seek immediate medical attention for abdominal pain if you experience severe, sudden, or worsening pain, blood in your urine or stool, fever or chills, unexplained weight loss, or persistent nausea or vomiting.


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