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What Causes Lower Abdominal Pain With Normal Leukocyte Count?

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Posted on Fri, 31 Oct 2014
Question: I have been having some issues for the past three weeks. I diagnosed myself with the chikungunya virus as there seems to be an outbreak on the island and I exhibited the symptoms of fever, headache, loss of appetite, a little diarrhea and some joint pain. After about a week or so I was back to normal. I took panadol multisymptom to treat the symptoms. My appetite was back which I was happy about. About three days later I felt sick when I woke up and after a bowel movement, which was somewhat watery, I threw up but I suppose it was only stomach acid. I assumed food poisoning since I ate some left over pizza the night before. I went to a doctor and explained my symptoms and he focused on the diarrhea and told me to stop eating for 6 hours and drink clear fluids. I honestly think that made me worse and I lost my appetite again. I had quite a bit of stomach discomfort and some stomach pain and I constantly felt weak and empty as if i had not eaten in a while. I went on a diet of soup and ensure since I have found it difficult to eat and I gradually started to introduce solids primarily fruits vegetables and chicken.

I started back work on Monday but I still didn't feel well and found it difficult to focus due to feeling weak and empty along with stomach discomfort. I went to a new doctor that examined me and I felt some pain in my lower right abdomen and he said it might be appendicitis but that it was unlikely as I would be in more pain and he took my blood pressure and sent me to do an ultrasound and blood test for which he ticked CBC and ESR. The blood tests came back normal but the ultrasound revealed a fatty liver. He also took my blood pressure again and told me that both times it was 150/90. He said when I come back if it is still high then I will have to go on medication. He ordered another round of blood tests for liver and kidney function, which I will be doing tomorrow. I still have no appetite and feel lethargic. I'm 31, roughly 190 pounds and about 5'8. Any thoughts on what could be wrong?
doctor
Answered by Dr. Deepak Kishore Kaltari (1 hour later)
Brief Answer:
Likely to be due to persistent symptoms

Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day
Dear Mr XXXXXXX

Lower abdominal pain with normal total leucocyte count and normal Ultrasound is unlikely to be due to Appendicitis.
Following Chikungunya, many individuals may have persistent or recurrent symptoms attributable to either joints or Gastrointestinal tract. The peristaltic activity of stomach is reduced causing bloating and vomiting. The peristalsis activity of intestine is increased causing loose motion. The blood pressure also could fluctuate.

I would advise you the following

1. Probiotic
2. Combination of acid suppressant like Pantoprozole along with gastric motility increasing drug like Domperidone will be helpful

3. Eat meals in small quantity more frequently.
4. Do have yoghurt or curd in diet.
5. Avoid alcohol /carbonated /caffeinated beverage
6. Reassess the blood pressure after 6 Weeks of having Chikungunya. If still high you will require antihypertensive medication
7. Do not be worried about fatty liver if liver function test are normal. Repeat ultrasound after 6 weeks


Do get back to me if you need any further assistance, will be glad to assist you.


Take care

Best regards
Dr Deepak Kaltari
Consultant Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepak Kishore Kaltari (14 hours later)
Thank you for the reply. Are the drugs you recommended available over the counter? I did the blood test today but I won't get the results until Monday when I go back to visit the doctor. The insulin test in particular will take two weeks. Is there any reason he would be testing for HEP C? I seem to have a little diarrhea or watery stool today. Any cause for concern? Is that what you meant by loose motion? Any help with the appetite? The doctor prescribed "tres-orix forte" for my appetite, two teaspoons at night before meals. I have taken it twice with no luck yet.

If the blood pressure is still high on Monday should I go on meds or wait six weeks and do another test? Would it be safe to wait?
doctor
Answered by Dr. Deepak Kishore Kaltari (28 minutes later)
Brief Answer:
The medicine are over the counter

Detailed Answer:
Hi
Dear Mr XXXXXXX


Hepatitis C is usually considered in differential diagnosis in case of individual presenting with loss of appetite.
The medicine advised by me are available over the counter.
If your previous blood pressure was normal (before getting Chikungunya ),then you can wait for 6 weeks for reassessment of blood pressure. Yes it would be safe to wait for another 3 weeks. As the blood pressure is mildly elevated .
Few episodes of loose motion there is no cause for concern.

For loss of appetite follow the medicine as advised previously.


Take care


Best regards
Dr Deepak
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Deepak Kishore Kaltari

General Surgeon

Practicing since :2002

Answered : 3195 Questions

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What Causes Lower Abdominal Pain With Normal Leukocyte Count?

Brief Answer: Likely to be due to persistent symptoms Detailed Answer: Hi Welcome to Healthcaremagic Greetings of the day Dear Mr XXXXXXX Lower abdominal pain with normal total leucocyte count and normal Ultrasound is unlikely to be due to Appendicitis. Following Chikungunya, many individuals may have persistent or recurrent symptoms attributable to either joints or Gastrointestinal tract. The peristaltic activity of stomach is reduced causing bloating and vomiting. The peristalsis activity of intestine is increased causing loose motion. The blood pressure also could fluctuate. I would advise you the following 1. Probiotic 2. Combination of acid suppressant like Pantoprozole along with gastric motility increasing drug like Domperidone will be helpful 3. Eat meals in small quantity more frequently. 4. Do have yoghurt or curd in diet. 5. Avoid alcohol /carbonated /caffeinated beverage 6. Reassess the blood pressure after 6 Weeks of having Chikungunya. If still high you will require antihypertensive medication 7. Do not be worried about fatty liver if liver function test are normal. Repeat ultrasound after 6 weeks Do get back to me if you need any further assistance, will be glad to assist you. Take care Best regards Dr Deepak Kaltari Consultant Surgeon