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What Causes Stabbing Pain In Abdomen With History Of Bladder Cancer?
Question: Complicated question. History of central serrous retinopathy (33 YO), Bladder cancer (36, 39) treated with TURBT and BCG immunotherapy, no further recurrances. Spontaneous tonsillar hemhorrage (37). At 40 YO (2010), suffered an acute incident where felt like small shocks going off in chest wall, only lasted a few hours. Chest pain developed over next several weeks, felt very small hard bumps on ribs under skin. What I believe was reactive arthritis started in shoulders. Stabbing bilateral abdominal pain.
Went to GP was told neuritis, nothing evident on x-ray, was worried about bladder cancer mets, sent for bone scan. Bone scan found several areas of increased uptake, one in particular an schlerotic lesion with increased vascularity in skull margin. This was not able to be biopsied but followed on CT for 1 year, no changes. Diagnosed as osteoid osteoma.
Stabbing pain continued in abdomen for one year, diagnosed as "Stress" by local GP. Quit all alcohol consumption, went from BMI 29 to 24, noticed dozens of painful fatty nodules formed on chest wall and abdomen. Self treated month long course of doxy. Biopsied as lipoma, Infectious disease specialist cultured for BCG TB, negative.
2012 Self referred to specialist at UCSD, diagnosed lipomatosis as a form of "Dercum's disease", but a delayed type hypersensitivity reaction to possible BCG.
Took every blood test and genetic test available, Lynch Syndrome, Cowden's, etc.. through UW genetics all negative. Developed fast onset dupuytren's disease, Started suffering from chronic fatigue, paresthesias, brain fog, "MS-hug like symptom in chest".
After TRT, determined low testosterone due to Hashimoto's thyroiditis, genetic test indicates H63D/H63D homozygote with high serum iron, low ferritin. Treatment with T4 and T3 combination alleviates symptoms significantly. H-Pylori IgG positive, father has history of familail Barrett's/GERD.
At the onset of symptoms in 2010, was drinking moderately daily, eating quite a few oysters for the first time in my life (like 2 dozen a week for a couple months).
Two theories I want to run by a doctor.
#1 - CSR has been associated with H. Pylori infection, could the chest/abdominal pain, bloody diarrhea be an overgrowth of H. pylori due to Esophagitis? H. Pylori feed off of iron, my genetic polymorphism has my transferrin saturation very high on average. http://www.ncbi.nlm.nih.gov/pubmed/0000
H. Pylori as also theorized as a cause of developing Hashimotos.
#2 - Could this be a Yersina Enercolitica infection that wasn't diagnosed? I was BBQing a lot of live oysters, have high serum iron, had diareeh, the "lipomatosis" in the chest area, one doctor thought it was fatty scar tissue. Could the high serum iron "leaking" have gotten caught up and screwed up my lymphatics, cause subcutaneous fatty scarring or hypersensitivity reaction in that area? The schlerotic bone lesion be an spot of Yersina osteomylitis?
The progression stopped gradually after I took a month long treatment with Doxy. The pain faded away in 2013 and I have been trying to cope with the aftermath for a few years. Still suffer from brain fog and weird paresthesias, bowel function is normal, some GERD. Is there any way I could have an infection with H. Pylori causing some of these lingering symptoms? Is it possible to have an occult yersina infection after all this time?
Went to GP was told neuritis, nothing evident on x-ray, was worried about bladder cancer mets, sent for bone scan. Bone scan found several areas of increased uptake, one in particular an schlerotic lesion with increased vascularity in skull margin. This was not able to be biopsied but followed on CT for 1 year, no changes. Diagnosed as osteoid osteoma.
Stabbing pain continued in abdomen for one year, diagnosed as "Stress" by local GP. Quit all alcohol consumption, went from BMI 29 to 24, noticed dozens of painful fatty nodules formed on chest wall and abdomen. Self treated month long course of doxy. Biopsied as lipoma, Infectious disease specialist cultured for BCG TB, negative.
2012 Self referred to specialist at UCSD, diagnosed lipomatosis as a form of "Dercum's disease", but a delayed type hypersensitivity reaction to possible BCG.
Took every blood test and genetic test available, Lynch Syndrome, Cowden's, etc.. through UW genetics all negative. Developed fast onset dupuytren's disease, Started suffering from chronic fatigue, paresthesias, brain fog, "MS-hug like symptom in chest".
After TRT, determined low testosterone due to Hashimoto's thyroiditis, genetic test indicates H63D/H63D homozygote with high serum iron, low ferritin. Treatment with T4 and T3 combination alleviates symptoms significantly. H-Pylori IgG positive, father has history of familail Barrett's/GERD.
At the onset of symptoms in 2010, was drinking moderately daily, eating quite a few oysters for the first time in my life (like 2 dozen a week for a couple months).
Two theories I want to run by a doctor.
#1 - CSR has been associated with H. Pylori infection, could the chest/abdominal pain, bloody diarrhea be an overgrowth of H. pylori due to Esophagitis? H. Pylori feed off of iron, my genetic polymorphism has my transferrin saturation very high on average. http://www.ncbi.nlm.nih.gov/pubmed/0000
H. Pylori as also theorized as a cause of developing Hashimotos.
#2 - Could this be a Yersina Enercolitica infection that wasn't diagnosed? I was BBQing a lot of live oysters, have high serum iron, had diareeh, the "lipomatosis" in the chest area, one doctor thought it was fatty scar tissue. Could the high serum iron "leaking" have gotten caught up and screwed up my lymphatics, cause subcutaneous fatty scarring or hypersensitivity reaction in that area? The schlerotic bone lesion be an spot of Yersina osteomylitis?
The progression stopped gradually after I took a month long treatment with Doxy. The pain faded away in 2013 and I have been trying to cope with the aftermath for a few years. Still suffer from brain fog and weird paresthesias, bowel function is normal, some GERD. Is there any way I could have an infection with H. Pylori causing some of these lingering symptoms? Is it possible to have an occult yersina infection after all this time?
Brief Answer:
There is a possibility of Y. enterocolitica, although I would not worry abt
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have carefully gone through the details as well as the documents provided by you. The stabbing pain in the abdomen could indeed be due to gastritis which is often aggravated by H. pylori. Although it is possible for Y. enterocolitica to be another probable causative agent, I would not get quite concerned about it. There are antibiotic regimens that can help you to get rid of H. pylori. I hope that Y. enterocolitica will also get controlled with the same medications, if it is at all present.
Apart from the anti H. pylori regimen, you need to take care of your lifestyle. Take small but frequent meals. You have already got rid of alcohol. Avoid spicy food as well. Oyesters can often be hard to digest and can give rise to abdominal cramps. If taken raw, it could also give you a reinfection. So, you have to weigh the risks and benefits.
Hope that helps.
Regards
Dr. Diptanshu Das
There is a possibility of Y. enterocolitica, although I would not worry abt
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have carefully gone through the details as well as the documents provided by you. The stabbing pain in the abdomen could indeed be due to gastritis which is often aggravated by H. pylori. Although it is possible for Y. enterocolitica to be another probable causative agent, I would not get quite concerned about it. There are antibiotic regimens that can help you to get rid of H. pylori. I hope that Y. enterocolitica will also get controlled with the same medications, if it is at all present.
Apart from the anti H. pylori regimen, you need to take care of your lifestyle. Take small but frequent meals. You have already got rid of alcohol. Avoid spicy food as well. Oyesters can often be hard to digest and can give rise to abdominal cramps. If taken raw, it could also give you a reinfection. So, you have to weigh the risks and benefits.
Hope that helps.
Regards
Dr. Diptanshu Das
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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