What is the cause of lower abdominal pain?

I have severe lower abdominal pain: crampy, intense, nonspecific, with no apparent cause?

• I have been experiencing this daily for over 10 months! I take painkillers every day, sometimes narcotics don't even help! I have had exploratory surgery looking at my ovaries, uterus, and tubes, also a quick look at my bowels. My gynecologist said everything looked just fine and that she doesn't know why I have this pain. It feels like menstrual cramps but it is not. I take birth control and antidepressants in an effort to control the pain. It is worse when I eat certain foods (gluten, dairy, beef, eggs) but even if I don't eat these things I am still in some amount of pain. Exercise does not affect it positively or adversely. I have been tested for celiac, which I do not have. My gastroenterologist just did an endoscopy/EGD and found nothing wrong in my esophagus, stomach, or small intestine. Please, if you have had a similar experience, what was causing it? I can't keep living with this severe pain!

• Answer:

  So sorry you are having such a problem! Okay, phew, let's see. 1. You need to get a copy of your GI doctor's records, to see what exactly he noticed/didn't notice. You need to see if he took at least 4 biopsies of your duodenum when checking for Celiac Disease. If he didn't take that many, the chances of a false negative test are way up. You didn't mention a biopsy, but I'm assuming he took one, as the damage from this disease is frequently not visible to the naked eye. If there were any eosinophils, that's a good indication that you have food allergies. If there was any inflammation, also a good 'food allergy' possibility. I ask this because I cannot count how many people I know who were told that there was 'nothing wrong,' but who found out later that there were issues found. The doctor just didn't think they were significant, so didn't mention them, even if the patient was having problems. It's a really good idea to check and see for yourself. Were you ever given the blood test? If so, if it was positive, based on studies done in this area, the chances are good that you actually have it. Many people who had positive blood tests and negative biopsies eventually developed positive biopsies when they continued eating gluten. Basically, their intestines just hadn't been damaged enough yet to be positive. There is also non-celiac gluten intolerance, which there's no test for yet. 2. When you don't eat the foods that bother you, how much do you 'not' eat them? Do you avoid just the basics, or do you avoid all cross contamination, all ingredients derived from these foods, etc...? I know numerous people with allergies or celiac disease who could not get rid of their pain and problems without being extremely careful about eliminating every trace of the 'bad' food. As an example, someone with celiac disease can still get sick if they KISS someone who has recently eaten gluten. But most people who are doing the diet as a trial don't avoid it to that level. 3. Have you ever been allergy tested? Food allergies that are milder - don't give hives - can still cause a lot of internal problems and pain. Also, if you have hay fever allergies, inhaling will always get you to swallow a few of these, and in some people this causes a lot of gastro distress as the inside of the body reacts, too (think of itchy, puffy eyes, but it's your intestines instead, you know?). An allergy med might help, if these were the problem. 4. Did your gastro check you for an H. pylori infection (needs a blood test or biopsy), or Crohn's disease? (colonoscopy needed for Crohn's). Crohn's can be affected by foods, but it's different by individual, and it needs medication to help you for this one. 5. Have you been tested for vitamin deficiencies? I know many folks who have all sorts of trouble with their vitamin levels were low, frequently iron, B vitamins, or vitamin D.