Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Abdominal Pain When I Lay Down?
Question: i have abdominal pain when i lay down at night, right before i have to urniate and right after, usually three times a night. no pain during day, tho small appetite makes me feel full.
urine stream is ok during day, weak at night. some leakage during day.
have been diagnosed with irrtabowel syndrome over the years.
dull lower abdominal pain, up to about a 7 or 8 on pain scale. no loss of weight.
also, when sitting on surfboard , very difficult to urniate, but when laying down easy and a lot.....
concerend about prostrate, bladder cancer or? had colonscopy 1.5 years ago showed nothing.
thank you. 62 yr old male.
also i had double hernia procedure , testicle area, via laser, 4 years ago in argentina.
apendenx removed in college.
urine stream is ok during day, weak at night. some leakage during day.
have been diagnosed with irrtabowel syndrome over the years.
dull lower abdominal pain, up to about a 7 or 8 on pain scale. no loss of weight.
also, when sitting on surfboard , very difficult to urniate, but when laying down easy and a lot.....
concerend about prostrate, bladder cancer or? had colonscopy 1.5 years ago showed nothing.
thank you. 62 yr old male.
also i had double hernia procedure , testicle area, via laser, 4 years ago in argentina.
apendenx removed in college.
Brief Answer:
I would like you to answer a few questions.
Detailed Answer:
Hi,
I am Dr Muhammad Ahmad.
I have looks into your query in detail and will try to help you, but for better understanding and fruitful discussion I would like you to answer some of my question.
1- Which part of abdomen does it pain?
2- Do you have urinary frequency issue?
3- Any urine exam done recently?
4- Any ultrasound (pelvic ) done recently?
5- Is there any family history of bladder or prostate issues?
6- Used any testosterone enhancement meds ever?
7- Any long exposure to pains, dyes or any chemicals?
8- Does pain get relieved after urination?
9- Any history of Urinary Tract Infection?
I am looking forward to your answers.
I would like you to answer a few questions.
Detailed Answer:
Hi,
I am Dr Muhammad Ahmad.
I have looks into your query in detail and will try to help you, but for better understanding and fruitful discussion I would like you to answer some of my question.
1- Which part of abdomen does it pain?
2- Do you have urinary frequency issue?
3- Any urine exam done recently?
4- Any ultrasound (pelvic ) done recently?
5- Is there any family history of bladder or prostate issues?
6- Used any testosterone enhancement meds ever?
7- Any long exposure to pains, dyes or any chemicals?
8- Does pain get relieved after urination?
9- Any history of Urinary Tract Infection?
I am looking forward to your answers.
Above answer was peer-reviewed by :
Dr. Raju A.T
1- Which part of abdomen does it pain?
below belly button.
2- Do you have urinary frequency issue?
now only at night, have had before during day, but now up 2 or 3 times each night with weak stream and lower abdomen pain before and after.
3- Any urine exam done recently? 1.5 years ago, all was ok.
4- Any ultrasound (pelvic ) done recently?1.5 years all was ok.
5- Is there any family history of bladder or prostate issues? not that i know of.
6- Used any testosterone enhancement meds ever? no
7- Any long exposure to pains, dyes or any chemicals? no
8- Does pain get relieved after urination?
gradulally. start before and lasts till i fall back asleep. no pain during day before or after, only at night.
9- Any history of Urinary Tract Infection? no
below belly button.
2- Do you have urinary frequency issue?
now only at night, have had before during day, but now up 2 or 3 times each night with weak stream and lower abdomen pain before and after.
3- Any urine exam done recently? 1.5 years ago, all was ok.
4- Any ultrasound (pelvic ) done recently?1.5 years all was ok.
5- Is there any family history of bladder or prostate issues? not that i know of.
6- Used any testosterone enhancement meds ever? no
7- Any long exposure to pains, dyes or any chemicals? no
8- Does pain get relieved after urination?
gradulally. start before and lasts till i fall back asleep. no pain during day before or after, only at night.
9- Any history of Urinary Tract Infection? no
Brief Answer:
Seems like Prostate hyperplasiea.
Detailed Answer:
Hi,
Thanks for writing back,
Your answers were really helping and now I am not in any doubt that your history and description is very consistent with Prostate hyperplasia it doesn't look close to bladder cancer, why? I will explain it as well in a bit.
Your problem DOES NOT seem to be severe yet, it seems to be developing with time, I will also like to mention here is that there is very little chance that it would be a prostate cancer because
1- You don't have any major risk factor.
2- Usually 1st prostate enlarges and then with time it develops to cancer, but in your case it seems that it has just started to enlarge yet, hasn't reached the pinnacle of enlargement and so I expect it to be benign hyperplasia.
There are instances when it directly becomes cancer but without risk factor history, testosterone use or hormonal imbalance, this is a rare occurrence.
What part of prostate can be enlarged?
It can't be told for sure without running some tests but seems like the middle lobe (median lobe) of prostate as it pushes on the urethra it causes bad stream, and it gets hard to void urine this difficulty can manifest as bladder pain which you mentioned as pain below umbilicus. This can also cause mild bladder inflammation.
Why it doesn't look like a bladder cancer?
1- You have no exposure to paints, chemicals, dyes.
2- No family history, suggestive.
3- Bladder cancers usually develop over some years, your urine test 1.5 years back was normal this doesn't support it as a diagnosis.
4- Bladder cancer USUALLY presents with PAINLESS bleeding... Your problem is neither painless, nor it has bleed.
5- Bladder cancers don't really involve frequency issues and their stream doesn’t change with body position.
SUGGESTIONS:
I will suggest you to visit a urologist as soon as possible to get a better diagnosis and prompt start of treatment.
Your doctor might use following diagnostic aids for a better diagnosis of condition and severity.
1- Digital rectal exam.
2- Ultra sound pelvis with filled bladder. This tells many things like post void volume, bladder and prostate condition, which part is enlarged, how much enlarges, is it cancer or not, and what treatment is required.
3- Urine examination.
4- May be cystoscopy.
5- Other blood works
6- Rarely a CT scans but that's done in case of cancers mostly.
7- Blood PSA levels this is prostate specific antigen and its value tells if it's simple hyperplasia or it's developing/ has developed, into a cancer.
What are the treatment options?
It basically depends upon the severity of the problem and diagnosis, if it is just hyperplasia and well within range of what can be controlled by medicine, you will be started with meds.
If your doctor thinks it needs intervention, they might suggest TURP which is very no invasive and removes extra part of prostate through urethra without any real dangers and risks.
In severe cases whole prostate can be removed and these days’ robotics and minimally invasive surgery techniques have made it really safe and easy for patients.
I suggest you not to worry and get an appointment soon with a urologist.
Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health!!
Seems like Prostate hyperplasiea.
Detailed Answer:
Hi,
Thanks for writing back,
Your answers were really helping and now I am not in any doubt that your history and description is very consistent with Prostate hyperplasia it doesn't look close to bladder cancer, why? I will explain it as well in a bit.
Your problem DOES NOT seem to be severe yet, it seems to be developing with time, I will also like to mention here is that there is very little chance that it would be a prostate cancer because
1- You don't have any major risk factor.
2- Usually 1st prostate enlarges and then with time it develops to cancer, but in your case it seems that it has just started to enlarge yet, hasn't reached the pinnacle of enlargement and so I expect it to be benign hyperplasia.
There are instances when it directly becomes cancer but without risk factor history, testosterone use or hormonal imbalance, this is a rare occurrence.
What part of prostate can be enlarged?
It can't be told for sure without running some tests but seems like the middle lobe (median lobe) of prostate as it pushes on the urethra it causes bad stream, and it gets hard to void urine this difficulty can manifest as bladder pain which you mentioned as pain below umbilicus. This can also cause mild bladder inflammation.
Why it doesn't look like a bladder cancer?
1- You have no exposure to paints, chemicals, dyes.
2- No family history, suggestive.
3- Bladder cancers usually develop over some years, your urine test 1.5 years back was normal this doesn't support it as a diagnosis.
4- Bladder cancer USUALLY presents with PAINLESS bleeding... Your problem is neither painless, nor it has bleed.
5- Bladder cancers don't really involve frequency issues and their stream doesn’t change with body position.
SUGGESTIONS:
I will suggest you to visit a urologist as soon as possible to get a better diagnosis and prompt start of treatment.
Your doctor might use following diagnostic aids for a better diagnosis of condition and severity.
1- Digital rectal exam.
2- Ultra sound pelvis with filled bladder. This tells many things like post void volume, bladder and prostate condition, which part is enlarged, how much enlarges, is it cancer or not, and what treatment is required.
3- Urine examination.
4- May be cystoscopy.
5- Other blood works
6- Rarely a CT scans but that's done in case of cancers mostly.
7- Blood PSA levels this is prostate specific antigen and its value tells if it's simple hyperplasia or it's developing/ has developed, into a cancer.
What are the treatment options?
It basically depends upon the severity of the problem and diagnosis, if it is just hyperplasia and well within range of what can be controlled by medicine, you will be started with meds.
If your doctor thinks it needs intervention, they might suggest TURP which is very no invasive and removes extra part of prostate through urethra without any real dangers and risks.
In severe cases whole prostate can be removed and these days’ robotics and minimally invasive surgery techniques have made it really safe and easy for patients.
I suggest you not to worry and get an appointment soon with a urologist.
Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health!!
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
