Lower right abdominal pain

(South Dakota, United States)

I am 64 yrs old and for the last 2 yrs off and on have lower right pain four fingers over from the pubic bone also have been fighting a bladder issue that no antibiotics will heal feels like a full bladder always and pressure and burning up inside the bladder have seen 2 urologists and 1 med doctor and 2 chiropractors still no relief

What you've described sounds like you are suffering with a condition called Interstitial Cystitis, also called painful bladder syndrome.

This is a chronic inflammation of the wall of the bladder more often seen in middle aged women, though men and younger people do suffer with it as well.

The exact cause of this chronic inflammation of the wall of the bladder is not known, but it leads to the replacement of the normal elastic muscles of the wall of the bladder with tough fibrous material. Stretch on the wall of the bladder when the bladder is full of urine characteristically causes pain above the pubic bone, just as you have described (because of bladder wall fibrosis).

Other symptoms of interstitial cystitis are:
  • Passing urine frequently even in small amounts
  • Burning sensation and pain in the bladder
  • Having a rushing sensation to pass urine to avoid an accident
  • Lower Abdominal pain during sexual intercourse
  • Worsening "cystitis" during menstrual period.

This condition is often mis-diagnosed as
cystitis or bladder infection and patients are given one set of antibiotics to another, even when their urine test result comes back without any evidence of infection.

Antibiotics simply does not work with interstitial cystitis. And there is no known cure.

Treatment for interstitial cystitis include the trial of:
  • Sodium pentosan polysulfate capsules (sold as Elmiron in the United States) - This medication helps coat the wall of the bladder to provide some relief
  • Antidepressants like amitriptyline to relieve pain, and NOT for depression
  • Use of Antispasmodics like mebeverine and
  • Strong pain killers like morphine based medicines.

All the above medicines could be used together in one combination in severe cases of interstitial cystitis to gain some relief.

Apart from using medicines, experts in this condition advise avoidance of food and drinks that tends to worsen the condition like:
  • Red Wine
  • Onion
  • Cheese
  • Coffe and tea
  • Orange, grape and lime fruit juices
  • Food seasonings contain Mono-sodium glutamate - MSG

and a host of other items. These foods could be eliminated one at a time to see the effect.

Should your pain persist after all these trials, your urologist may be able to offer a bladder operation, though this should be the very last resort.

I hope that helps. Is this what you can discuss with your doctor?

Please do not hesitate to come back to us, should you require any specific information.

Dr Edema


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