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Re: abdominal painFrom: D. Ashley Hill, M.D. (anonymous@obgyn.net)Sat, 5 Apr 1997 11:39:58 -0600 (CST)
At Fri, 4 Apr 1997, Mary wrote: > >HELP!! For the last three years I have had (off and on) excruciating abdominal pain four (never more, never less) days before my period. What are the odds I'd have an ovarian cyst rupture on me eight times in the last three years EXACTLY FOUR DAYS BEFORE MY PERIOD? When my period starts, everything is fine again. Mary- If I had a medical student sitting here with me, he or she would be jumping up and down going "it's endometriosis, it's endometriosis!" Actually, it's simply impossible to make a diagnosis over the internet, but your symptoms sound very suspicious for endometriosis, a condition where minute amounts of the lining of the uterus (the endometrium) escape from the tubes during a menstrual period and implant on the various pelvic organs (such as the uterus, ovaries, rectum, etc). These little implants can cause severe pain, often (but certainly not always) right before a period. Often, when the period actually starts the pain diminishes. Others have pain all the time, due to scar tissue, or, probably, due to the endometriosis implants pressing against nerves. The diagnosis is made by looking into the pelvis during laparoscopy, where a small, lighted tube is placed through the belly button under general anesthesia. Any implants can be cut away, lasered, or burned to hopefully get rid of the pain. Since your symptoms include pain with gas or bowel function, I usually advise patients to cleanse their intestines with special medications prior to such surgery, since entry into the rectum is possible if there are implants in this area. Other conditions, such as infection, scar tissue, intestinal problems, PMS, and yes, sometimes, ovarian cysts, can cause such pain. (In my experience the overwhelming majority of ovarian cysts produce no symptoms at all, however). You seem uncomfortable with your current health-care system, so you may want to ask for a referral to a larger city, where an experienced gynecologist or reproductive endocrinologist can help you. Good luck!
-- Ashley Hill D. Ashley Hill, M.D. Assistant Director, Department of Ob/Gyn Florida Hospital Family Practice Residency Orlando, FL dahmd@gate.net
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