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What Causes Constant Abdominal Pain, Swelling And Red Marks On Abdomen?

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Posted on Mon, 16 Mar 2015
Question: I had undergone a cesarean delivery on 17:11:14. After that from 3rd day she is feeling a constant pain in her abdomen, coupled. Earlier, when contacted to consultant gynaecologist, she said its normal and part of healing. But the problem persisted and grew further, coupled with swelling and redness of marks on abdomen. The problem effected the daily routine of my wife, even so she could not sit, and move without help.We done MRI scan on 12:01:15 which revealed "edema on scar site/ normal bowel movement".A treatment was run for a week at hospital including antibiotic dose of pipzo, amikacin through iv, which did give the relax, but the problem again resurfaces after one week.We searched on internet about the problem and got information about abrasions during surgery, which requires another surgery to treat it.




In cntinuation with my chat with u sir u have prescribed my wife XXXXXXX qith a g3nexpert test and test for stool zn strainig ..can u pls let me know where can these test be conducted in XXXXXXX i mean the labs that conduct this.also the second ultrsonologist called that 3 cm lump as necrosis what is that..i googled on net and find that exremely dangerous.is that so.,what is going wrong with my wifes body..how can we find thatfinding no ways..pls guide
doctor
Answered by Dr. Arun (20 hours later)
Brief Answer:
TB should be ruled out in your wife...

Detailed Answer:
Hello dear,

Thank you for your contact to health care magic.

I read and understand your concern.

Yes, have communicated by your wife and seen the reports attached by her.

We can think of TB after receiving such a long antibiotic therapy. Because TB won't respond to routine antibiotics. Its picture in appearance is also a same as that appearing in the USG.

To rule out this tuberculosis and necrosis I suggest your wife with stool for ZN staining and GeneXpert test. Test should be done on aspiration sample from necrosis.

There are plenty of laboratory doing such tests. I know a one lab which is doing such tests that is Drlalpathlabs but you can choose any of the NABL accredited laboratory.

I will be happy to answer your further concern here or on bit.ly/DrArun.

Thank you,
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Arun (37 hours later)
I have got that stool test done reports are still awaited..The surgeon whom I was consulting has prescribed me a chest x ray and tb gold test..x ray chest came normal and tb gold test was also negative.got the mri done today ..I m enclosing the teports received so far..pls guide..I went to my gynae also.she has prescibed me sumag ointment twice a day
Hot fomentation
Zinase d tds

I m alredy taking montair lc for my allergic asthma prob.and rabicip l and zevit as prescribed by my surgeon.can i take the med given by my gynae along with them..pls guide how to proceed further

Are the medicines given by my gynae again a hit and trial??

Had it been a necrosis wouldnt that come in mri??

Am I really having an infection that is fatal ((whatever is this fluid collection or necrosis is??))as every doc has its own saying??

Pls pls help

Is it safe to take this med again after a long list of various medicines taken..the sympotoms I m feeling is becoz of medicines or not taking them..pls tell my every query in detail would be greatful
doctor
Answered by Dr. Arun (13 hours later)
Brief Answer:
Conservative management is necessary...

Detailed Answer:
Hi XXXXXXX

Thank you for asking query.

I review all your reports attached herewith.

From the report it is obvious that it is not the TB infection and necrosis.

Post operative wound and its impression is seen which is normal phenomenon in all cases of cesarean section or surgeries.

Your hemogram report is showing some values on higher side but it is not suggestive of any infections or necrosis. TB Gold, GeneXpert is negative ruling out the tuberculosis infection which is further supported by the USG and MRI reports.

You should continue your drugs like asthma medication which is right and should be continued.

Your surgeon prescribed you a pain and acidity medication. Gynecologist prescribed you a symptomatic treatment. You can sum up the drugs & there is not a problem in combining it. Even though after a long list of drugs you can take the above drugs. It will not harm you but will benefit to you in current situation.

Your current doctors are guiding you in better way, its not a life threatening condition and so you should not worry.

In present situation conservative management should be adopted which consist of wait and watch, pain killer and healing enhancer.

You can take the above medication along with serratopeptidase and chymotrypsin(healing enhancer) which helps in pain and healing. It will help healing the wound and relieves the pain gradually.

Your wife should also start doing mild exercise and yogas. In such a situation it also gives benefits too. Effects starts gradually but will be built up later.

You can ask for further queries here.

Thank you,
Dr Arun Tank
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Arun (12 hours later)
thanks doc if it is a case of abdominal TB ,,will that have come in tb gold test or any other we need to go for any other test that will actually tell if there is abdominal tb or not

what is sumag ointment used for.is it safe to apply keeping in view the overall symptoms of my wife.. along with zinase d.

are we missing on anything..that needs to be checked

yesterday she accidentally consumed very fine particles of glass while deinking milk from a glass bottle...what should be done

i have read a term nacrosis fascitis on net...is there any chances of having that..
doctor
Answered by Dr. Arun (11 hours later)
Brief Answer:
No chance of TB....

Detailed Answer:
Hello XXXXXXX

There are two to three evidence that support that you are not having TB infection.

1. Negative GeneXpert test.

2. Negative TB Gold test.

3. Absence of swelling abdominal lymph nodes.

As we are having this much evidence in support of your negativity regarding TB there is no need to further testing for TB.



Sumag ointment contains the sulfacetamide sodium which is antibiotic and used to cure the infection.

Zinase D contains the Diclofenac sodium along with serratopeptidase it is used as pain killer and healing enhancer. As per your wife complaint this drugs are worth taking.

You already taken most of the approach to treat your wife, so there is no need to take further approach. Only wait, watch and conservative approach is necessary.

Care should be taken that we should not consume the glass. If the glass particle is fine than consuming large quantity of banana can help you to remove that particle.

If the particle is large and sharp than local surgeons opinion is necessary. because in some cases intestine perforation can occur.

Necrotising fascitis is flesh eating bacterial disease. It is very serious infection. The severity of which is very obvious and can be clear with history alone. So there is no possibility of any of such infection in your wife.

You can ask me for further clarification here.

Thank you,
Dr Arun Tank
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Arun (8 hours later)
thanks for the detailed reply

if u can understand my concern the radiologist who conducted my latest ug made me afraid by saying i m having severe infection.pls elaborate the first remark of hypoechoic track that is avascular and 27mm and 4_7 mm wide.that suggested tuberculosis..i got scared a lot wen i googled this and since then it is not getting off mymind doc


i went to my physician and aftrr seeing my usg he asked me to get a ct abdominal done and tb gold test.but since i was afraid of ct scan radiations i went for a repeated mri that revealed adhesions and soft tissue track..why is there a contadiction of reports in usg and mri...should i have got a ct scan done.???

i wenr to my surgeon again and he said this findings are normal post op of adhesions and track..wen everything is normal then y do i feel so tired with so many weird symptoms despite taking proper rest and diet too.

i consulted ny gynae also who prescibed me sumag and zinase d as i have mentioned earleie after my physical assement and reports

now can i follow this treatment of
rabicip L in morning
tds zinase d
zevit
rabicip at night with montair lc and seroflo 250
sumag ointment bd
hot fomentation tds

shoul i really follow a conservative approach of wait and watch..can i really afford that as im really very scared from that usg report of avascular track. i personaaly also feel my body is giving me someverybadsignals tht i have never ever felt though thw clinical findings are normal

i m attaching that usg report and mri
doctor
Answered by Dr. Arun (15 hours later)
Brief Answer:
Need for YOGA and Exercise with conservative approach...

Detailed Answer:
Hi XXXXXXX

Thank you for asking query. Please find your answer below in point wise manner.

1. First hypo-echoic track seen has probability of tuberculosis and we have excluded it by the GeneXpert and TB Gold test. So forget about the TB now.

2. CT scan has some advantage over MRI in case of abdominal pathology. But each has some merit and demerit in terms of visualization and detection of pathology. In current scenario you are not having any possible abnormality in abdomen and so there is no need to get you CT scan done.

3. Yes, Your surgeon seems to be right as it is more of healing tissue finds post operatively. For your tiredness and laziness, you should start doing mild exercise and yoga. Please remember that this will take some times but you will definitely feel better after some time.

4. Yes, in current scenario Below medication is right for you and should be continued.
a. Rabicip L in morning
b. Zinase D three times a day.
c. Zevit
d. Rabicip at night with Montair LC and Seroflo 250
e. Sumag ointment two times a day.
f. Hot fomentation three times a day.

Yes, For you right now conservative approach is right and should be followed.

I have gone through your USG and MRI report again, there is nothing abnormal.

Please adopt healthy living habit that include healthy eating, exercise and good sleep. Forget about the TB, necrosis etc.

Thank you,
Dr Arun Tank
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Arun (11 hours later)
thanks doc

i agree with ur point,but my wife is complaining of her detrioating health again and again ..despite taking proper rest she still feels very tired..since yesterday she is having vomiting even after eating diet like idli and bread..she is complaining of breathlessness with some swelling in nose and ear on left side ..she feels as if something is stuck in her food pipe area. she is feeling a lot of tavhycardia whe she lies on her back and while passing motions and sometimes while sitting and walking too.it is like tremors kind of feeling.her backacheb is increasing dat by day withpain in right side under rib area. and difgiculty in vision
earlier also wen she was complaining about her symtopms .doctors have ignored her saying she is having anxiety as her first usg in january didnt reveal allvthis nd had a normal report of usg and mri,but wen her symtopms were not decreasing we went for a repeat usg and mri that reveled this problem of soft tissue..the doctors might be right with the approach as nothing is coming in her blood work except elevatec esr,but there is something wrong going on which is troubling her a lot as she is not anxious at all and has never ever faced or complaint of having such issues..i really want to listen what she and her body is giving signals because this time ivreally dnt want to get her problem aggravated to this extent just because she is not having fever or blood work difference..there must be something that is bothering her and i just want to figure that out..i dnt feel a conservative approach at this time can work because we kept that in januray also listening to doctors saying and ignoring her symptoms but later on that turned to be something else. bigger.we dont want this to happen again pls if u can understand my concern...there has ti be some way doc that can tell what is happening wrong with her..can i go for any hormonal test or any test that would tell whats wrong happening in her abdomen...i dont want to lose her.she is takig multivitamins and gud diet with proper rest too still she feels very tired..her immune system was always weak since childhood because of her allergy problem..is she getting much affected by this .,she had a surgery of her eye too in the past and had developed viral karatistis in her one eye at that time .,

attaching her latest report of urine and stool culture and haemogram..

she has also been prescribed muccaine gel today tds..

pls guide doctor in a detailed reply..pls help
doctor
Answered by Dr. Arun (20 hours later)
Brief Answer:
Observation and healthy life style is all that is necessary...

Detailed Answer:
Hi dear XXXXXXX ,

Please find your answer below in point wise manner.

1. Plenty of drugs which your wife are taking may be the reason for gastritis and vomiting. Adding a domperidone in the antiacidity regimen is helpful. Your wife can take Pantoprazole and domperidone sustain release tablet instead of Rabicip. Please maintain good habit of walking for at least 10 minutes after your diet. This allows the food to go below the stomach and helps avoiding gastritis and reflux.

2. Rest of your complaints like breathlessness, chest pain etc. are because of the anxiety. Your wife is feeling this because she is having anxiety of having some serious illness. So avoiding anxiety and stress will play a good role in controlling such a symptoms. You can give her clonazepam tablet under your doctors guidance. This will help in anxiety and stress. It will be better that if she able to control the situation without drugs. Many patients can benefit by psychiatric counselling I also suggest you must visit once.

3. Radiology reports can vary from machine to machine and from judgement of doctor to doctor. That is why some stating tuberculosis like lesion and some stating adhesion etc. But such reports should be clinically correlated. Adhesion is the only possibility in your wife case which should be correlated clinically and treated surgically. You can ask that to your surgeon after clinical correlation.

4. In my opinion there is no need to do any hormonal tests or any other tests. Only observation with healthy life style is necessary for your wife.

5. I reviewed the report you attached and all are fine. Muccaine gel is anaesthetic jelly and helps in relieving severe pain.

You can ask me your further queries here.

Thank you,
Dr. Arun Tank
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Arun (16 hours later)
thanks doc,for thedetailed reply

1...pls guide me regarding the surgeon part...can the adhesions mentioned in mri report be the cause of her bowel obstruction and constipation?i consulted my surgeon and he says to ignore them as this happens post surgery ..can we afford them to ignore like this..?will they heal of their own or will even get aggravated in coming future

2... will a further surgery will be required?.can u suggest the topmost surgeon in XXXXXXX ..

3..,.the surgeon conti ued the treatment of rabicip and asked to invlude high fibre and roughage diet..sometimes despite takung all the medicines she is still feeling as she is not properly freshed and till the time she is not she have a very rapid heart rate while sleeping and sitting too.With the feelung of nausea ans aometimes vomiting too ..she has tried clonezapam too as one of the doc has given that her in XXXXXXX month wen all they were thinking this to be anxiety..she was given melzep 0.5 at that time but that didnt work too as i feel she doesnt have that

4...can the symptoms she is facing can be becaoz of bowel obstruction?If yes ,what could be done..is surgery the only option..?.i yesterday googled some physical therapist in florida who solve these adhesions from deep tissue massage..do u have any idea about that.is tht worth for her adheaion problem

5...also can she continue to take her iron (anofer sp),calcium(supracal) ,nuroday 150 ,and bifilac hp with tbe above treatment of multivitamin ,zinase d and rabiciP L. and muccaine gel .can she take becosule instead of zevit..which multivitamin is benefical in her current stage..in the month of XXXXXXX she was on pan d also but couldnt get fresh so doc has changed that to rabicip then..can all this medicines be taken together..pls if u can prescribe the time and diration gap with which she can take along wifh her asthma medications too
doctor
Answered by Dr. Arun (22 hours later)
Brief Answer:
there is no need for surgery right now

Detailed Answer:
Hello XXXXXXX

Thank you for asking query. Please find your answer in point wise manner.

1. No, adhesion wont be cause for obstruction. Obstruction has different clinical presentation like severe vomiting, pain and massive abdominal enlargement. It will heal in mean time and you can ignore it.

2. No, there is no need for surgery right now. I dont belong to XXXXXXX so I dont know the best surgeon there but you can select big corporate hospitals like medanta, apollo or national institute like XXXXXXX

3. Good exercise and yoga can help your wife to fight with this problem. In my opinion wait and watch is requires in this case.

4. No, We haven't seen any such cases solved by deep massage. But if you think you could be benefited by it than you can opt for it with your own risk. Bowel obstruction will have large presentation of symptoms, It will not present will small presentation.

5. Yes your wife can take the iron(anofer sp), calcium(supracal), nuroday 150 and Bifilac HP with the above treatment of multivitamin zinase D and rabicip L. and muccaine gel. Becosule and zevit are both multivitamins and can be used interchangeably. With asthma medication there should be a gap of atleast for to five hours in between.

Rabicip should be taken half hour before the meal. rest all should be taken after the meal. Rest of the drugs and schedule should be prescribed by treating doctor keeping in mind whole of your situation like body habitus, physical condition etc. So better you go to your nearby doctor they will give you full schedule of how you want to take all the drugs prescribed to you.

You can ask for the further queries here.

Thank you.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Arun

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Practicing since :2008

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What Causes Constant Abdominal Pain, Swelling And Red Marks On Abdomen?

Brief Answer: TB should be ruled out in your wife... Detailed Answer: Hello dear, Thank you for your contact to health care magic. I read and understand your concern. Yes, have communicated by your wife and seen the reports attached by her. We can think of TB after receiving such a long antibiotic therapy. Because TB won't respond to routine antibiotics. Its picture in appearance is also a same as that appearing in the USG. To rule out this tuberculosis and necrosis I suggest your wife with stool for ZN staining and GeneXpert test. Test should be done on aspiration sample from necrosis. There are plenty of laboratory doing such tests. I know a one lab which is doing such tests that is Drlalpathlabs but you can choose any of the NABL accredited laboratory. I will be happy to answer your further concern here or on bit.ly/DrArun. Thank you,