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Suggest Treatment For Pain In My Middle Abdomen Along With Cough

Posted on Mon, 6 Apr 2015

Question: Hello. I am experiencing a tearing type of pain in my middle abdomen when I cough or laugh. This just started yesterday, and has not relented. I have a history of abdominal adhesions, and during a hysterectomy done in 2013, my OB/GYN inserted mesh to prevent the adhesions. My concern is additional adhesions, as well as possible mesh issues. I have an appointment with my OB/GYN in May, but want to know if this is something that I should have addressed sooner, as well as what the pain may be. Thank you for your assistance!

Answered by Dr. Grzegorz Stanko (10 minutes later)

Brief Answer:
Adhesions or hernia can be the case. Consult doctor sooner.

Detailed Answer:
Hello!

Thank you for the query.

Pain when coughing or laughing can be caused by a hernia. I assume that you have had some abdominal surgeries before (including hysterectomy). This causes possibility of hernia appearance in scar area. In such case, the pain should be localized close to such scar. Some bulge can be visible in scar area when standing and coughing.
Adhesions are also a possibility. Especially that you have a tendency to have them. Mesh wont prevent adhesions creation. Adhesions can give many different symptoms including bloating, diarrhea, cramps or just a pain described by you.

I suggest you to do not wait till May. It would be advisable to consult general surgeon sooner. At least abdominal ultrasound and abdominal x-ray should be done.

Hope this will help. Feel free to ask further questions.
Regards.

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

Follow up: Dr. Grzegorz Stanko (5 hours later)

Thank you. I will contact my Dr.'s office in the morning to request a sooner appointment.

As an FYI, the pain has become more consistent. (As in, not JUST hurting when I cough or laugh)

What might be the cause of this? The same suggested diagnosis as before?

Answered by Dr. Grzegorz Stanko (4 hours later)

Brief Answer:
Most probable diagnosis stays the same

Detailed Answer:
Suggested diagnosis is still most probable.
Just one more thing. Please make a simple test. Push gently the painful area, hold it for a second and release the pressure suddenly. If the pain gets more intense when releasing the pressure than when pushing, it might be an urgent case and ER visit is necessary.
Please also check your heart rate. Higher than 100 is also alarming.

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

Follow up: Dr. Grzegorz Stanko (21 hours later)

Hello. Had BP checked, 120/85. Pulse 117. Also ran low grade fever all day; however it appears to have broken, and is actually now lower than normal 98.6 farenheit. Also, no rebound pain.

However, bloating has set in, and abdomen feels "full", like I could pop, almost. Like a pregnant feeling, but impossible due to hysterectomy.

Also, feeling like gall bladder attack after eating dinner tonight. Again, no gallbladder.

Trying to see Dr. tomorrow. Have appointment already for 3/18.

Answered by Dr. Grzegorz Stanko (12 hours later)

Brief Answer:
Please consult your doctor as soon as possible.

Detailed Answer:
Your pulse and fever indicate some kind of infection. It would good for you to see your doctor as soon as possible.
Regards.

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

Follow up: Dr. Grzegorz Stanko (4 hours later)

Thank you. My doctor was out of the office today. Though I spoke with his colleague last night, who advised me to call the office today to be seen, the receptionist refused to schedule me sooner. She advised me to see my GP, which was not possible, due to a pain management appointment this morning. She advised me to address the issue with pain management. Of course, there was NOTHING that they could or would do.

My doctors office is now closed for the weekend.

Should I take myself to the ER?

Answered by Dr. Grzegorz Stanko (10 hours later)

Brief Answer:
ER visit seems advisable.

Detailed Answer:
Waiting whole weekend is not a good idea. Please check your pulse once again, if its still high, do not wait and go to ER. Blood work (CBC and CRP), urine analysis, abdominal ultrasound and abdominal x-ray should be done to rule out any life threatening conditions.

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