What Causes Severe Abdominal Pain, Urethral And Bladder Pain Post Child Birth?

Posted on Thu, 31 Mar 2016

Question: I am a 33 year old female. I gave birth to twins 4 months ago. I recently started having severe abdominal pain that seems to radiate throughout my entire abdomen. It lasts 3 or 4 days then subsides then returns in about a week although sometimes I feel fine for two or three weeks. I have had an endoscopy and a colonoscopy and both are normal. My only other symptom is bladder and urethral pain when I urinate. I have been tested for a uti which is negative. What are some other reasons for these symptoms besides GI. I am also about 15 pounds lighter than I was before I got pregnant.

Answered by Dr. Grzegorz Stanko (57 minutes later)

Brief Answer:
Please give some more details.

Detailed Answer:
Hello!

Thank you for the query.

Before answering your question, I need to know some few more details:
1. Have you had C-section?
2. Do you breastfeed?
3. Have you had abdominal ultrasound or CT? If so, please attach the results.
4. Does the pain start after foods intake?
5. Do you have any nausea, vomiting, diarrhea, constipation?
6. Do you have your cycle back?

I`m looking forward to hearing from you.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (8 hours later)

Both babies were delivered vaginally. I am currently breastfeeding as much as possible but not producing enough milk to exclusively breastfeed. I had an abdominal ultrasound that was normal. I had an ultrasound and hiatus scan of my gallbladder which both came back normal. The pain does generally start pretty soon after food intake and comes with nausea but no vomiting or abnormal bowel movements. I have not started my cycle back. I have been having a slight fever of 100.0 intermittently even when no pain is present.

Answered by Dr. Grzegorz Stanko (13 hours later)

Brief Answer:
Gastroscopy should be done.

Detailed Answer:
As the pain starts right after a meal, stomach issue is the most probable reason. It can be peptic ulcer or just stomach inflammation. You may have lack of appetite with it.
And this can not be diagnosed with an ultrasound. I suggest you to have gastroscopy done.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (1 hour later)

As I stated in my initial question, I had an endoscopy to look for ulcers and stomach lining inflammation which came back negative

Answered by Dr. Grzegorz Stanko (2 hours later)

Brief Answer:
Small intestine narrowing can act like that.

Detailed Answer:
Than the next step is to check small intestine.
When take the food, it stimulates whole digestive tract. And it greatly stimulates small intestine. Now if there is some kind of narrowing in the small intestine (caused by adhesion or invagination), the food can not pass this part of digestive tract freely. So it gives abdominal pain as the food is being pushed hardly through narrow area. It appears as nausea, some kind of bloating and finally ends with stool.
It is quite characteristic for small intestine invagination to appear suddenly and than disappear for some time (few days or weeks). So it could be it. Unfortunately invagination can be seen in the ultrasound or CT only if this test is done during the pain.

The best test to diagnose small intestine narrowing is CT enteroclysis.
I hope that the stool test and stool culture test for chronic bacterial infection were already done.
It would be also worth to try Rifaximine treatment. This special antibiotic can set you free from the symptoms if the pain is caused by bacterial overgrowth in the small intestine.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar