Other Tests. She has experience in primary care and hospital medicine. foods that you eat. I have had horrible abdominal pain for weeks now, once it was so bad I was on the floor crying. Common Tests Used to Diagnose Abdominal Pain. I'm in discomfort/pain everyday. Over the next 3 weeks her abdomen continued to hurt. As mentioned, some diagnoses cannot be made initially, but the evolution of the underlying condition and the resultant development of new symptoms requires re-evaluation. It ruins my day to day life. Please consider the clinicians recommendations regarding follow-up, whether it be a primary care doctor or a specialist. Copyright 2015 by the American Academy of Family Physicians. I am thinking about trying to go to the Mayo as well. All Rights Reserved. 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. A repeat CT scan may be required to make the diagnosis. Many cases of unexplained abdominal pain will resolve on their own and are likely due to a transient period of maldigestion. A CT scan will be done by a technologist who operates the CT scanner and makes sure the test is done well and safely. 5 users are following. Good luck ! Posted Sue. These CT scans can help identify cancer . A Practical Guide to Clinical Medicine. I've had 3 CT scans done over the past 1 1/2 years with no results. Had an abdomen/pelvis CT scan with contrast and they found, nothing Posts: 3. This can be an understandably frustrating situation for patients. The docs gave me Ranitidine to take 300mg evry night before bed and they said if that doesnt help then ive to get a camera indown my throat :s. At one point the docs asked me if it could all be in my mind???? A CT scan can only show if something looks abnormal, not if it functions abnormally. 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. It is more common in older individuals. What is wrong with me? She had a perforated duodenum with pain in the RLQ, not the epigastrium. Requests for medical attention largely ignored, patient dies. https://patient.info/forums/discuss/normal-tests-but-still-have-upper-abdominal-pain--454405. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, organs, and blood vessels. Do your best to answer them clearly, because your answers may influence which tests you have. She returned to the same ED on January 30 (26 days after her first visit). While these tests are designed to efficiently and accurately identify abdominal and pelvic emergencies, the list of non-life-threatening diagnoses that can cause pain is much longer, and unfortunately requires specialists and testing that we do not have in the ED. I have spoke to my GP who said its still Acid reflux and to follow a low acidic diet and take Lansoprazole. The test uses strong magnets that can harm patients with some implants. For example, a broken leg is an acute problem, but the leg may hurt for a long time. Lab tests give healthcare professionals an idea of how the body is functioning. In some cases, they think its nothing serious but want to make sure with a CT. CT scan for abdominal pain most commonly also covers the pelvis. Good luck Im gonna pray for you and me tonight.. 2nd specialist refuses to check my pancreas. My own tumour was missed on a CT scan. This test requires anesthesia so that you can sleep through it. Evaluation of Acute Abdominal Pain in Adults. All the doctors are trying to blame it all on my IBS, which I have had since I was 18, but I have never had any pains like this in the 10 years that I have had and not had any bad episodes with it in years as I have learned to manage it. 22 users are following. wondering if anyone has had any similar symptoms and has had a diagnosis? Your symptoms and health history will determine what tests you need to find out what's causing your pain. Conventional radiography has limited diagnostic value in the assessment of patients with acute abdominal pain. respect of any healthcare matters. sorry to hear you are going through similar symptoms. Have you had many abdominal surgeries? as being in breach of those terms. A study of low-dose CT compared with standard-dose CT found no significant difference in the negative appendectomy rate between the two groups, and the median radiation dose of the low-dose protocol was 22% of the standard-dose protocol.24 MRI is an emerging modality in the evaluation of suspected appendicitis, showing excellent sensitivity and specificity (97% and 95%, respectively) in a meta-analysis of eight studies.5 MRI avoids radiation exposure altogether, but its high cost and lack of widespread availability continue to limit its use. Because so many health conditions can cause abdominal pain, you may need tests to identify the problem. The plaintiffs expert witness opinion is shown below: The defense attorney deposed the plaintiffs expert witness: The lawsuit was settled for an undisclosed amount. History, physical examination, and laboratory testing are often insufficient for diagnosing acute cholecystitis without further workup.13 The ACR Appropriateness Criteria recommend ultrasonography as the initial imaging test for patients presenting with right upper quadrant pain (Table 2).6 Although a meta-analysis of 57 studies from 1978 to 2010 showed that cholescintigraphy has better sensitivity and specificity (96% and 90%, respectively) than ultrasonography (81% and 83%, respectively) for detecting acute cholecystitis,14 ultrasonography is more readily available, can identify other potential causes of pain (Figure 1A), and does not expose the patient to ionizing radiation. Patient started on new medication and goes to the ED after slowly developing a rash. An ultrasound can often detect problems with the gallbladder and kidneys. The American College of Radiology has developed clinical guidelines, the Appropriateness Criteria, based on the location of abdominal pain to help physicians choose the most appropriate imaging study. Has anyone been through this and got anywhere futher thanI have? Registered in England and Wales. Copyright 2023 American Academy of Family Physicians. Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. CT Scan didn't show cancer? Cancer Survivors Network An infection in the appendix makes it swell and become more and more painful. I had my RNY June 4th, and my gallbladder (open) on June 27th. 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. Can you ask gps to explain about chronic gall bladder and symptoms that can cause. Exam of the Abdomen. The ACR Appropriateness Criteria for abdominal imaging are based primarily on the location of pain. 4. My anxiety is through the roof and I wish the pain would just go away. These studies have shown significant decreases in CT use while maintaining acceptable diagnostic sensitivity and specificity.5 The use of low-dose CT for evaluating suspected appendicitis is another strategy to decrease radiation exposure. I had an endoscopy and a colonoscopy yesterday and both came back fine. I have had so many tests think ive had 4 blood tests in a month, X-rays, endoscopy CT scan all clear. He reviewed the prior CT and did not feel that a repeat was necessary. Stomach /Bowel pain Update: Hi everyone Well I am - PMRGCAuk By looking at samples of your blood, urine, stool, and enzymes, they can identify disorders that may be causing your pain. -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. Diagnosis of appendicitis. Yes, CT scans can detect diverticulosis. however my pain has changed and it on the upper left side just under my ribs, i have started getting mid to upper back pain as well. Having low grade fevers and nausea for over a month now. 7 years ago, Subscribe today to get a new case every week. as well as Vicodin from a prior prescription. Lower abdominal pain during the third trimester of pregnancy. @jojo13 Mostly you have allergy or sensivity for one or some. Feels like lump but nothing shows on any scans. (note:sensetivity of any food not found by biopsy when you made endoscopy or colonscopy) . 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 ). Prescription pain medication, more specifically opioid medications, are rarely advisable for abdominal pain. What fairly common condition could lead to peritonitis if not properly 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. Blood counts, stool samples, and other tests may be needed to find the cause of the pain. Diagnostic Imaging of Acute Abdominal Pain in Adults | AAFP Nothing picked up on the CT or PET. The test uses no radiation unlike CT scans. Strategies to reduce exposure are currently being studied, such as using ultrasonography as an initial study for suspected appendicitis before obtaining CT and using low-dose CT rather than standard-dose CT. They did a bunch of blood work and it came back as high white blood cell count. An acute illness may come one quickly, but it can go on for weeks or even months. A computed tomography (CT) scan is a type of CT scan. Use of the forums is subject to our Terms of Use Lab Tests. Unfortunately, I", "Hey Sue, I feel your pain!! 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. One of the most common conclusions I reach when I see an abdominal CT scan for abdominal pain is a normal study. I also get pain on both sides in my lower abdomen but not as frequently as the upper abdomen(which is pretty much constant). An MRI isn't safe for people with certain types of metal in their body. 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. 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. Computed Tomography (CT Scan) CT Angiography. Hi, I have had chronic abdominal pain for over a year. Everything comes back normal, gallbladder seems - Answered by a verified Endocrinologist . Verywell Health's content is for informational and educational purposes only. In pain but tests are clear. hope you manage to sort your symptoms out as well it is horrible being in pain all the time, ill keep in touch if i get any answers as well! We thus want to take the time to explain precisely the tests we can run in the ED, the potential for conditions that require outpatient follow up for diagnosis, and guidance on when a patient should return to the ED for unexplained abdominal pain. Several small studies of magnetic resonance imaging (MRI) suggest that it may be useful for evaluating acute cholecystitis, with a sensitivity (85%) and specificity (81%) similar to that of ultrasonography.14 MRI can be used in patients with equivocal ultrasonography findings or to visualize hepatic and biliary abnormalities that cannot be characterized on ultrasonography.6, Acute appendicitis is the most common cause of right lower quadrant pain requiring surgery5 and is the focus of imaging considerations in this location.