Brief Answer:
You have multiple issues going on both gynecologic and medical.

Detailed Answer:
Hello, and I hope i can help you today. I have reviewed your medical history and your previous question to help provide you with the best advice.

It is normal for a woman who ovulates to grow a cyst on her ovary every month. These cysts house your egg which ruptures at the point of ovulation. There normally is a small amount of pain and internal bleeding with ovulation, and many women have a twinge of pain when this happens. But some women can have heavy internal bleeding that can land you in the hospital and require surgical intervention, like you had. It sounds like they removed your appendix at that time too, and you got peritonitis requiring antibiotic treatment.

I highly doubt at this point if your pelvic symptoms have anything to do with your ovaries (because you have pain with and without a cyst found) and if it does have a gynecologic cause, your lower pelvic pain can be caused by your uterine fibroids. Even though your largest fibroid is 4 cm, you say you have eight of them and this can make your uterus total volume quite significant. Your fibroids swell premenstrually, and that swelling can give you symptoms of bloating and swelling.

However, in your upper abdomen, it is unlikely that any gynecologic condition could be causing your pain and bloating. Any condition of the GI tract... from acid in the stomach to ulcers, and lower down... colitis, gallbladder disease, and even food allergies all can cause upper abdominal symptoms.

So as far as your gynecologist is concerned, it would be helpful to know the exact size of your uterus (and the fibroids put together). If your uterus is very enlarged, removal of the fibroids and/or the uterus may result in relief of your symptoms, and removal of the ovaries will permanently resolve a problem with ovarian cysts. However I only recommend this as a last resort and after all other possibilities of the cause of the pain have been ruled out.

I think actually the appropriate next step would be to see a gastroenterologist- which is a doctor specializing on the GI tract. You may need an ultrasound of your liver and gallbladder, as well as an upper endoscopy or colonoscopy to rule out any digestive causes of your symptoms. Also if you have not had one already, a CT scan can rule out a pelvic abscess which can cause persistent pain after peritonitis.

I hope I was able to answer your question today and that my advice was helpful. If you need anything further, please do not hesitate to contact me again.

Best wishes and I hope you feel better, Dr. Brown

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Brief Answer:
You are very welcome

Detailed Answer:
Thank you for using healthcaremagic.com

If you are satisfied with my service, please close the question and post a review.

Warm regards, Dr. Brown

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