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Could the small bowel be causing a lump in the lower right abdomen?

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Crohn's Disease
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Posted 8/15/2015 2:14 PM (GMT 0)
I am in a medical limbo. I have an arthritis diagnosis. A big lump in my lower right quadrant which can be quite painful at times has started to act up today. I had a colonoscopy which ruled out Crohn's. Two days ago I had immense heartburn for a little over 24 hours. And now this sharp stabbing pain at the location of my lump as well as full body aches and diarrhea. My gp is thinking it's a muscle but isn't really sure why it's happening, even if it is a muscle for sure.

I can't take anymore limbo - is it possible for the small intestine to live down in the lower right quadrant?

Post Edited (Manda30) : 8/15/2015 8:18:56 AM (GMT-6)

Posted 8/15/2015 2:30 PM (GMT 0)
Sometimes it takes forever to get a proper diagnosis. I'm sorry for all you are going through. Maybe you should call your doc back for more blood tests and a stool culture to rule out infection. I have no idea how to answer your actual question.
Posted 8/15/2015 2:51 PM (GMT 0)
I had blood work done the other day and it was all good, no infection. This is all happening after taking an NSAID for a few weeks.

I just can't believe that after a year, the most that has been done is a prescription for an anti inflammatory that kills my stomach. And no real answers. I'd have a fibromyalgia diagnosis if it wasn't for inflammation in my blood and this big grapefruit lump in my lower abdomen.

I'm so frustrated, I think I need to add a therapist to my list of doctors to help me get through this.
Posted 8/15/2015 4:26 PM (GMT 0)
NSAIDs notoriously mess up your gut, so if there is even a possibility of an IBD it is not a good idea. Can you go to a univerisity center for another expert opinion? I don't know what else to suggest
Posted 8/15/2015 4:59 PM (GMT 0)
No, no teaching center around me. I think I'm tapped out and won't get any more help medically until something new presents itself. My gp said he doesn't want to keep coming up with empty tests so for now, he's just waiting........
Posted 8/15/2015 5:07 PM (GMT 0)
I certainly agree with stopping the NSAID.

I don't have any ideas, I'm afraid. A lump makes me think of a hernia, but I'm presuming tests have ruled that out already?
Posted 8/15/2015 5:08 PM (GMT 0)
If you feel pain as food passes in that spot then it is not the muscle.
Your terminal ileum is in that area.

Hernia?

Immense heartburn could be signaling the area is starting to obstruct.

Post Edited (Homeboy) : 8/15/2015 11:12:55 AM (GMT-6)

Posted 8/15/2015 6:28 PM (GMT 0)
I had a colonoscopy and my colon was great. She got into the TI and it was good as well. But I don't know how far in she went. As far anyone is concerned, my bowels have been satisfactorily examined. Today is the first time I've had pain there for months. The area is always somewhat inflammed, the size of the lump changes. I got a really good picture of how big the lump is a few weeks ago and it was only mildly irritated then, no pain. Just irritated. It looked like a ball under my skin.

It isn't a hernia. I had an ultrasound and a ct scan and I don't have a hernia. It's really weird and I don't see how they can't image anything when it's so plainly obvious to the eye and to touch.
Posted 8/15/2015 6:31 PM (GMT 0)
Ball under my muscle, I should clarify. It isn't a hernia. It's hard and I can't push it in.
Posted 8/15/2015 6:41 PM (GMT 0)
Which is what leads me to wonder if the problem could indeed be the small bowel down in my lower right quadrant. Bc it seriously can't be anything else. It's been looked at over and over. But my small bowel hasn't been looked at.

I have had soft stool for years. Never have heart burn. And all of a sudden I become constipated over and suffer from reflux and then get the sharp pain around that lump back. It just seems like too much so quickly from the NSAID. I'm no doctor but I can string together the correlations here.

I know my text probably wreaks of frustration but I just don't get how after such trouble, I'm no further ahead than when this all started. Aside from the arthritis diagnosis. I guess that's somewhere......
Posted 8/16/2015 12:58 AM (GMT 0)
It seems like the CT scan should have shown something...so your small bowel has been looked at in that way. Did they ever do a barium swallow with a small bowel follow through test? You swallow some contrast dye and they watch it snake through your small bowel to see if there are strictures or abnormalities. I don't know what else to suggest.
Posted 8/16/2015 1:06 AM (GMT 0)
Just the ct and the scope, nothing else. Like you said, the ct should've shown something. Even if this lump is muscular, it should've shown it. Which makes me question my ct - why isn't it showing anything when there's such an obvious lump?
Posted 8/16/2015 1:38 AM (GMT 0)
I have had a grapefruit-sized lump in my lower right quadrant before and it was a mass of inflamed bowel consistent with my Crohn's Disease. I guess I was lucky because I had the CD diagnosis for years and almost everyone (doctors/ER staff) assumed it was inflammation from my Crohn's, but I did have one doctor think it was a pulled muscle (??) - hurt wwaaaayyy too much for that. It was a horrible stabbing pain whenever I moved. Could it be that for you? I will say though, I had numerous CT scans at the time (in and out of the hospital several times before finally getting it all removed via surgery) that all showed the inflamed bowel on the scans. Did they have you drink a contrast for the CT scan you had done? These types of imagining are imperfect, but unfortunately they are all we have. I have had times when doctors were sure I had a huge abscess from a CT scan and it just turned out to be more inflamed bowel, so they are never 100%. If you are still having trouble, I would request another or ask for an MRE - which uses magnetic imagining instead of radiation and is safer. Good luck!
Posted 8/16/2015 2:45 AM (GMT 0)
I have had this pain for years - prior to the mass showing up. I went to the doctor and ultrasound ruled out appendicitis. That was 3 years ago now. I've had three pain flares total and it does fee like stabbing pain. The lump came up with the second bout. The pain was gone for about 8 months but the mass would wax and wane in size. It started getting bigger a couple of weeks ago and now the pain is back. It isn't constant stabbing pain. It'll come in bouts lasting a few minutes. But if I press it, it hurts.

I did drink contrast with the ct, an hour before if I remember correctly. Also, by the time I had the ct, the pain had been gone for months and the lump was small, not what it is now.
Posted 8/16/2015 3:10 AM (GMT 0)
It probably isn't Crohn's. Just a bad case of IBS with unrelated issues presenting as Crohn's.

But I do think my small bowel needs further examination just to be sure, due to the lack of other explanations.

I feel like I'm pulling straws now. While the Vimovo sure took my aches away, it seems to have caused more grief over all :( And I just don't know what to do anymore besides talk about it.
Posted 8/16/2015 3:11 AM (GMT 0)
Inflammation from Crohn's definitely comes and goes. It is the nature of the illness....flares and remission. Ask your doc if he is willing to order an MRE or CT scan when your pain is at its worst and see if they can see it. I know how hard it is once a doc thinks they have ruled everything out to get them to do more testing, but I agree with you that there should be some explanation for a palpable lump like you are describing. Can you go to the ER when you are at your worst? You are in Canada, right? I'm in the US, so I don't know your medical system.
I never had a lump like you describe, but before I was diagnosed, I had severe anemia. They did all the tests...colonoscopy, small bowel follow through and upper endoscopy and everything came out completely normal. They just gave me iron infusions and shrugged it off. When the anemia came back 6 months later then they repeated the colonoscopy and pill cam and I was diagnosed with Crohn's. So sometimes tests look normal, but something is really wrong. I know how frustrating that can be.
Posted 8/16/2015 3:31 AM (GMT 0)
I'd need to go to the ER if I wanted an immediate CT. I don't want to do that unless it's absolutely necessary. It's hard to gauge what is and isn't pain that needs to be examined anymore. Even if my doc ordered one when my pain is present, it would likely be 6 weeks until I actually had an appointment for one. It took 8 months to go through the medical system last time.

You know, it's sad but I almost feel like taking the Vimovo may just create the new symptoms my doctor is waiting for. If it's IBD, it'll present itself.
Posted 8/16/2015 4:07 AM (GMT 0)
And the biggest caveat is, if I didn't stop the nsaid, would I even be feeling the pain how I am now had I kept taking it? I only stopped it bc it constipated me so badly. It wasn't solid stool. I just couldn't physically move my bowels. I've had diarrhea for so long that any change in consistency and I can't release it. That was the first time in years that I went that long without passing a bm. Id rather have diarrhea! My aches are worse today than they were when I started the vimovo.
Posted 8/17/2015 3:27 AM (GMT 0)
Well, if you do have Crohn's, then I don't think taking an NSAID to make yourself worse is a good idea (is that what Vimovo is?) I do think that if you can go to the ER when the pain is really bad and the lump is very obvious isn't a bad idea, given that it can take 6 weeks to get a CT ordered using the regular medical system.

If you have very mild IBD, it may go into remission on its own, or it will get worse and become more obvious and detectable by medical tests.

Try to hang in there in the meantime. I know it's really hard, but eventually things will either resolve or get worse and you will move on from this stage in your life.
Posted 8/17/2015 2:37 PM (GMT 0)
I know waiting for something to pop up and worsen is less then ideal but at this point, I need to work with what I have. And the NSAID works so well for my joint pain and aches, I need to take it. I'm doing it as smart as I can, breaks when my aches calm down.
Posted 8/17/2015 4:56 PM (GMT 0)
It could totally be a partial obstruction? What you describe is exactly what I am going through.
Posted 8/19/2015 2:12 AM (GMT 0)
First off sorry to read that you are having problems, especially problems ya can't figure out. There isn't much that can be more frustrating. I was thinking did they rule out it being a swollen lymph node?
Posted 8/19/2015 3:18 AM (GMT 0)
Thanks :) They ruled out pretty much everything bc the ct was clear. But with this big lump that is so visible, I think I need them to open their minds that the ct may have missed something. But tell that to a doctor. ..
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