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31 Year Old, Non-sexually Active Female (for About 2 Years)

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Posted on Tue, 9 Jul 2019
Question: 31 year old, non-sexually active female (for about 2 years) started experiencing abdominal pain above the belly button a few days ago with low grade fever (100.3) and nausea, then spread to left side of abdomen with nausea and no fever, then went to the right side of abdomen with nausea and no fever. Stools are super soft. Stool samples have been sent to the lab. No sign of cancer via stool results. Not all the results are in yet. Abdominal Cat Scan with contrast came back as normal (except a benign mass on the liver). Went to ER 3 times in the last few days (including today): All 3 Blood Work Labs and 3 Urine Tests came back normal. IV Toradol and IV Tylenol did not help. Compazene & Benadryl Combo. just put patient to sleep. Had allergic reaction to Bentyl. Has allergies to Reglan, Morphine, Albuterol, Prozac, Phenegran, Amoxicillan. Occasional Social Drinker. Vapes on a daily basis. Has had 3 Colonoscopies in the very distant past (2010, 2012 & ?). Pain level started out as a level 8, is now down to a level 5 with nausea. Taking Nauzene for nausea here at home. Not knowingly exposed to anything. Works with Schizophrenic adults. No travel outside of the U.S.A. and not anywhere away from home within the U.S.A. No abdominal surgeries or female reproductive system surgeries.
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Follow up: Dr. T Chandrakant (0 minute later)
31 year old, non-sexually active female (for about 2 years) started experiencing abdominal pain above the belly button a few days ago with low grade fever (100.3) and nausea, then spread to left side of abdomen with nausea and no fever, then went to the right side of abdomen with nausea and no fever. Stools are super soft. Stool samples have been sent to the lab. No sign of cancer via stool results. Not all the results are in yet. Abdominal Cat Scan with contrast came back as normal (except a benign mass on the liver). Went to ER 3 times in the last few days (including today): All 3 Blood Work Labs and 3 Urine Tests came back normal. IV Toradol and IV Tylenol did not help. Compazene & Benadryl Combo. just put patient to sleep. Had allergic reaction to Bentyl. Has allergies to Reglan, Morphine, Albuterol, Prozac, Phenegran, Amoxicillan. Occasional Social Drinker. Vapes on a daily basis. Has had 3 Colonoscopies in the very distant past (2010, 2012 & ?). Pain level started out as a level 8, is now down to a level 5 with nausea. Taking Nauzene for nausea here at home. Not knowingly exposed to anything. Works with Schizophrenic adults. No travel outside of the U.S.A. and not anywhere away from home within the U.S.A. No abdominal surgeries or female reproductive system surgeries.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Please give additional information

Detailed Answer:
Hi.
Thanks for your query.
Noted the history well and understood the concerns.
Please give few more details for me to assist you better:
Is the pain spasmodic?
Level of stress and/or anxiety? Any relation of pain with stress/anxiety.
Any antispasmodic?
Please post remaining reports if possible.
Any bloating?
Frequency of stool per 24 hours?
Any other details please.

Awaiting a detailed feedback as these points may be related to the problems.
Dr T Chandrakant.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
Please give additional information

Detailed Answer:
Hi.
Thanks for your query.
Noted the history well and understood the concerns.
Please give few more details for me to assist you better:
Is the pain spasmodic?
Level of stress and/or anxiety? Any relation of pain with stress/anxiety.
Any antispasmodic?
Please post remaining reports if possible.
Any bloating?
Frequency of stool per 24 hours?
Any other details please.

Awaiting a detailed feedback as these points may be related to the problems.
Dr T Chandrakant.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (2 hours later)
Pain is not spasmodic.
No stress or anxiety.
Pain has no relation to stress/anxiety.
No other reports available. Awaiting stool sample results from samples given to lab today (Saturday).
No bloating.
Not sure about frequency of stool in a 24 hour period. Will ask daughter when she wakes up in the morning (Sunday).
No new foods eaten, no sushi, no
For awhile, she was taking XXXXXXX Health brand chewable Acidophilus & Bifidum 1 Billion organisms -- strawberry flavored wafers. She's been off them for a little while. Will find out when the last dose was taken tomorrow (Sunday) when she wakes up.
Even though she is not sexually active, she is on a low dose Birth Control Pill.
She takes a multi-vitamin, Super B Complex pill, fiber gummies.
What other details do you need?
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Follow up: Dr. T Chandrakant (0 minute later)
Pain is not spasmodic.
No stress or anxiety.
Pain has no relation to stress/anxiety.
No other reports available. Awaiting stool sample results from samples given to lab today (Saturday).
No bloating.
Not sure about frequency of stool in a 24 hour period. Will ask daughter when she wakes up in the morning (Sunday).
No new foods eaten, no sushi, no
For awhile, she was taking XXXXXXX Health brand chewable Acidophilus & Bifidum 1 Billion organisms -- strawberry flavored wafers. She's been off them for a little while. Will find out when the last dose was taken tomorrow (Sunday) when she wakes up.
Even though she is not sexually active, she is on a low dose Birth Control Pill.
She takes a multi-vitamin, Super B Complex pill, fiber gummies.
What other details do you need?
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Antispasmodic, PPI with Domperidone if it suits her

Detailed Answer:
Thanks for your detailed feedback except a few points as you have noted will be known the moment your daughter wakes up.
When all the reports are reported to be normal, particularly the CT scan of abdomen then the probable cause can be IBS that is Irritable bowel syndrome or intolerance to certain foods and beverages, medications or so on.
Once all the reports are available then we can decide for sure.
Till then she can certainly take an antispasmodic to relieve the pain.
Nauzene contains phosphorated carbohydrate may cause some unwanted effects.
Domperidone (if it suits her) can also help for nausea well if Nauzene is causing any side effects like loose stools or so. (noted the medications she is allergic to)
Take a PPI like Omeprazole - helps acid related problems including nausea.

I hope this answer helps further.

Please give feedback and any other information.

Dr T Chandrakant
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
Antispasmodic, PPI with Domperidone if it suits her

Detailed Answer:
Thanks for your detailed feedback except a few points as you have noted will be known the moment your daughter wakes up.
When all the reports are reported to be normal, particularly the CT scan of abdomen then the probable cause can be IBS that is Irritable bowel syndrome or intolerance to certain foods and beverages, medications or so on.
Once all the reports are available then we can decide for sure.
Till then she can certainly take an antispasmodic to relieve the pain.
Nauzene contains phosphorated carbohydrate may cause some unwanted effects.
Domperidone (if it suits her) can also help for nausea well if Nauzene is causing any side effects like loose stools or so. (noted the medications she is allergic to)
Take a PPI like Omeprazole - helps acid related problems including nausea.

I hope this answer helps further.

Please give feedback and any other information.

Dr T Chandrakant
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (7 hours later)
Domperidone is currently not legal here in the U.S.A.
In the past, Compazene, has worked really well for her when she has been nauseated. I'll get her off the Nauzene and put her on the Compazene.
I'll make sure she takes the Omeprazole on a regular basis.
And will make sure she takes something to help with the Spasms. Would Baclofen be a good Antispasmodic?
We'll talk to her doctor about doing allergy testing on her.
What tests need to be run to find out if she has something like IBS or Crohns?
What things is the doctor looking for when asking for and running tests on stool samples?
Still waiting for daughter to wake up. It's only 8:35 a.m. here on Sunday. And she's had a rough few days. Will try and get back to you later today.
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Follow up: Dr. T Chandrakant (0 minute later)
Domperidone is currently not legal here in the U.S.A.
In the past, Compazene, has worked really well for her when she has been nauseated. I'll get her off the Nauzene and put her on the Compazene.
I'll make sure she takes the Omeprazole on a regular basis.
And will make sure she takes something to help with the Spasms. Would Baclofen be a good Antispasmodic?
We'll talk to her doctor about doing allergy testing on her.
What tests need to be run to find out if she has something like IBS or Crohns?
What things is the doctor looking for when asking for and running tests on stool samples?
Still waiting for daughter to wake up. It's only 8:35 a.m. here on Sunday. And she's had a rough few days. Will try and get back to you later today.
doctor
Answered by Dr. T Chandrakant (3 hours later)
Brief Answer:
As detailed below.

Detailed Answer:
Thanks for your feedback and additional queries.
Compazine (Prochlorperazine) is a medicine with great results.
Baclofen is muscle relaxer and antispastic and not antispasmodic, so better to use something else.
When all relevant tests for gastrointestinal system are within normal limits then we say that the patient may have IBS. Colonoscopy was done in past, may need another to see for Crohn's.
The stool tests shows many a things - infection, infestations, occult blood and so on. If there is any positive finding then a specific treatment can be given.

I hope this answers your additional queries.

Dr T Chandrakant.
General Surgeon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
As detailed below.

Detailed Answer:
Thanks for your feedback and additional queries.
Compazine (Prochlorperazine) is a medicine with great results.
Baclofen is muscle relaxer and antispastic and not antispasmodic, so better to use something else.
When all relevant tests for gastrointestinal system are within normal limits then we say that the patient may have IBS. Colonoscopy was done in past, may need another to see for Crohn's.
The stool tests shows many a things - infection, infestations, occult blood and so on. If there is any positive finding then a specific treatment can be given.

I hope this answers your additional queries.

Dr T Chandrakant.
General Surgeon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (33 hours later)
My daughter doesn't remember how many days she took the Acidophilus nor when she stopped taking it.
She's not having a bowel movement very often. Maybe once a day.
We just found out that 1 set of her Lymphocite level and white blood cell differential levels are both high. She had 3 sets of bloodwork done -- one each time I took her to ER.
She's still having pain in her right abdominal side and is still nauseated.
The 3 ER MDs did not tell us that the Lymphocite and White Blood Cell Differential test results would take more time to process.
How many days does it take to get the Lymphocite level results?
How many days does it take to get the White Blood Cell Differential level results?
What are the normal ranges for both?

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Follow up: Dr. T Chandrakant (0 minute later)
My daughter doesn't remember how many days she took the Acidophilus nor when she stopped taking it.
She's not having a bowel movement very often. Maybe once a day.
We just found out that 1 set of her Lymphocite level and white blood cell differential levels are both high. She had 3 sets of bloodwork done -- one each time I took her to ER.
She's still having pain in her right abdominal side and is still nauseated.
The 3 ER MDs did not tell us that the Lymphocite and White Blood Cell Differential test results would take more time to process.
How many days does it take to get the Lymphocite level results?
How many days does it take to get the White Blood Cell Differential level results?
What are the normal ranges for both?

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Follow up: Dr. T Chandrakant (8 minutes later)
Supposedly the CT Scan with contrast supposedly showed her Appendix along with other abdominal areas. Supposedly the appendix looks okay.
What other conditions would cause the symptoms my daughter is having? To recap:
Abdominal pain started above her belly button, spread to her left abdominal area, and now is staying in the right side of her abdomen. Her pain level is about a 5. She's still nauseated. No fever. Bowel movements are loose/diarrhea and don't happen very often.

She's allergic to Amoxicillan. What are other Antibiotics that could be given to her?
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Follow up: Dr. T Chandrakant (0 minute later)
Supposedly the CT Scan with contrast supposedly showed her Appendix along with other abdominal areas. Supposedly the appendix looks okay.
What other conditions would cause the symptoms my daughter is having? To recap:
Abdominal pain started above her belly button, spread to her left abdominal area, and now is staying in the right side of her abdomen. Her pain level is about a 5. She's still nauseated. No fever. Bowel movements are loose/diarrhea and don't happen very often.

She's allergic to Amoxicillan. What are other Antibiotics that could be given to her?
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
As detailed.

Detailed Answer:
Thanks for additional feedback and queries.
Once a day motion is normal for most of the people.
I do not know about such tests of lymphocytes that take long, usually all the reports are available within and hour or a day at the most. Please post the reports for me to understand which tests take so much time.
The normal ranges are written in the reports as they may vary from lab to lab.

Since the CT scan is normal, it rules out appendicitis and other inflammatory diseases in most of the cases.
There may be problem in the colon like colitis, amoebiasis or so that can be confirmed by repeated stool tests as well as colonoscopy. Please get these done to be ascertained about the cause so that an appropriate and definitive management can be given.
Antibiotics are prescription based hence her DOctor can only tell and prescribe about the choice of antibiotics.

I hope this answer helps you further.

With Regards.
Dr T Chandrakant.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
As detailed.

Detailed Answer:
Thanks for additional feedback and queries.
Once a day motion is normal for most of the people.
I do not know about such tests of lymphocytes that take long, usually all the reports are available within and hour or a day at the most. Please post the reports for me to understand which tests take so much time.
The normal ranges are written in the reports as they may vary from lab to lab.

Since the CT scan is normal, it rules out appendicitis and other inflammatory diseases in most of the cases.
There may be problem in the colon like colitis, amoebiasis or so that can be confirmed by repeated stool tests as well as colonoscopy. Please get these done to be ascertained about the cause so that an appropriate and definitive management can be given.
Antibiotics are prescription based hence her DOctor can only tell and prescribe about the choice of antibiotics.

I hope this answer helps you further.

With Regards.
Dr T Chandrakant.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (21 hours later)
My apologies for giving you wrong information about her bowel movements. I confirmed with her just now that she's going 2 or 3 times a day and that she has diarrhea.

Her results from the blood work done on 6/6, which showed up on 6/10 are:
Lymphocite = 4.52 x 1,000/mcL.
The report says normal range is 1.00 - 3.6 x 1,000/mcL.

Her White Blood Cell Count Differential = 11 x 1,000/mcL
The report says normal range is 4 - 11 x 1,000/mcL.

She got the above test results from her online account. It does not say why it took so long to get the results.

Her pain level is still about a 5, she's still nauseous. She had a headache today, took some Tylenol and it got better.

We're still awaiting the results from the 2 different stool samples that she gave the lab at the end of last week.
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Follow up: Dr. T Chandrakant (0 minute later)
My apologies for giving you wrong information about her bowel movements. I confirmed with her just now that she's going 2 or 3 times a day and that she has diarrhea.

Her results from the blood work done on 6/6, which showed up on 6/10 are:
Lymphocite = 4.52 x 1,000/mcL.
The report says normal range is 1.00 - 3.6 x 1,000/mcL.

Her White Blood Cell Count Differential = 11 x 1,000/mcL
The report says normal range is 4 - 11 x 1,000/mcL.

She got the above test results from her online account. It does not say why it took so long to get the results.

Her pain level is still about a 5, she's still nauseous. She had a headache today, took some Tylenol and it got better.

We're still awaiting the results from the 2 different stool samples that she gave the lab at the end of last week.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
As discussed in details below.

Detailed Answer:
Thanks for your feedback.
Yes, the total white cell count is touching the highest normal limit and there is lymphocytosis = Lymphocyte = 4.52 x 1,000/mcL. The report says normal range is 1.00 - 3.6 x 1,000/mcL. It indicate recent infection.
This may be an indication for antibiotic treatment. Antibiotic needs a prescription.
Diarrhea 2-3 times a day, high counts, headache, pain in abdomen can be an indications
for antibiotic cover but surely this will be decided by your Doctor whether to give her antibiotic and which one.
I would advise her to see her Doctor for proper clinical evaluation, examination, correlation with reports and get started on proper definitive treatment. (3 visits to ER do not look to be beneficial.)

I hope this answer helps further.
Please give feedback.

Dr T Chandrakant.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. T Chandrakant (0 minute later)
Brief Answer:
As discussed in details below.

Detailed Answer:
Thanks for your feedback.
Yes, the total white cell count is touching the highest normal limit and there is lymphocytosis = Lymphocyte = 4.52 x 1,000/mcL. The report says normal range is 1.00 - 3.6 x 1,000/mcL. It indicate recent infection.
This may be an indication for antibiotic treatment. Antibiotic needs a prescription.
Diarrhea 2-3 times a day, high counts, headache, pain in abdomen can be an indications
for antibiotic cover but surely this will be decided by your Doctor whether to give her antibiotic and which one.
I would advise her to see her Doctor for proper clinical evaluation, examination, correlation with reports and get started on proper definitive treatment. (3 visits to ER do not look to be beneficial.)

I hope this answer helps further.
Please give feedback.

Dr T Chandrakant.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

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31 Year Old, Non-sexually Active Female (for About 2 Years)

31 year old, non-sexually active female (for about 2 years) started experiencing abdominal pain above the belly button a few days ago with low grade fever (100.3) and nausea, then spread to left side of abdomen with nausea and no fever, then went to the right side of abdomen with nausea and no fever. Stools are super soft. Stool samples have been sent to the lab. No sign of cancer via stool results. Not all the results are in yet. Abdominal Cat Scan with contrast came back as normal (except a benign mass on the liver). Went to ER 3 times in the last few days (including today): All 3 Blood Work Labs and 3 Urine Tests came back normal. IV Toradol and IV Tylenol did not help. Compazene & Benadryl Combo. just put patient to sleep. Had allergic reaction to Bentyl. Has allergies to Reglan, Morphine, Albuterol, Prozac, Phenegran, Amoxicillan. Occasional Social Drinker. Vapes on a daily basis. Has had 3 Colonoscopies in the very distant past (2010, 2012 & ?). Pain level started out as a level 8, is now down to a level 5 with nausea. Taking Nauzene for nausea here at home. Not knowingly exposed to anything. Works with Schizophrenic adults. No travel outside of the U.S.A. and not anywhere away from home within the U.S.A. No abdominal surgeries or female reproductive system surgeries.