Brief Answer:
Constipation or bowel problems might be the cause

Detailed Answer:
Hello,
Thank you for asking at HCM.

I carefully read your question and understand your concern.

As you explain the examinations have ruled out urinary infections or urinary problems, you have had normal gynecological exam and ultrasound and also normal cervical and vaginal cultures that might rule out gynecological infections or masses.

You mention above the issues with constipation. If all the rest of the issues have been excluded with tests, urinary and gynecological issues exclueded, than the remaining cause of pelvic pain is bowel pain and the most common cause is constipation.

To help with constipation you need to watch the diet and try to avoid fast food and junk food but have plenty of fruit and vegetable and drink plenty.
Being as active as you can helps a lot with bowel habits also.

Psillium or other fiber supplements daily help your bowel funciton better.
Some lactulose syrup might help with stools to be softer and easier.

There are also some routine checks for the age that i do not see you to have mentioned and that are very important:
1. pap smear - even though the cervix might seem normal to inspection still pap smear needs to be performed every 3 years till 65 years of age
2. colonoscopy- is a test for the bowel and is recommended to be done evey 5-10 years in all patients 55 years old and above.

Diverticular disease and diverticulitis are complications of bowel due to constipation and can cause pelvic pain and might not be evaluated with the above tests. abdominal xray or CT scan might be needed to rule those out.

So to conclude I would say:
1. watch the diet as explained above
2. take psillium supplements at least once aday
3. take lactulose syrup 1-2 table spoon a day
4. if no improvement with these in a few days or any worsening you will need to see a doctor.
5. you will need some routine tests: pap smear and colonoscopy.
6. Stool test for occult blood test and for ova and parasite and stool culture might be needed also.
7. as mentioned an abdominal xray might be helpful for bowel problems.
8. if you have not checked yet your blood sugar levels and lipids in the last 5 years you might need to have those tests done also as a general healch check.

If the pelvic pain is still not better or identified with the above tests than sometimes CT scan is performed to check the pelvis.

I hope this is helpful and answers to your question

Kind regards

Dr Antoneta Zotaj

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