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Are my symptoms from a hernia?
Dear Dr Towfigh,
While reading your excellent 2011 New York Times article on women experiencing undiagnosed femoral hernias, I felt a growing excitement that you were describing me. Your comments in this forum have also been very educational and I’m grateful to you for your efforts to help spread the word about this hidden cause of pain, especially in women. My doctor once mentioned the possibility of a femoral hernia to me, but there was no follow up.
My case is complicated by a 2011 abdominal surgery for chronic diverticulitis that went from laparoscopic to open because my right ureter was cut. My diverticulitis issues completely resolved as evidenced by a recent normal colonoscopy. However new symptoms crept in since the surgery.
I developed increasing right sided crampy abdominal, groin, inner thigh, tailbone and low back pain since the surgery. I feel an odd fullness in the right lower quadrant and if I do self massage can pinpoint several very painful spots.. Also my right pelvic bone feels sore when pressed. Sometimes the crampiness is to the right of my belly button. I was checked via X-rays on several occasions for intestinal blockages and none were found. Vaginal ultrasounds of the entire pelvic region along with a bladder and kidney work ups are all clear. MRIs of the lumbar spine show mild disc problems. The pelvic MRI was normal except for a right sided Tarlov cyst about 2.6 cm around, with sacral bone erosion. I’ve researched Tarlov cysts and my symptoms don’t quite match up but I consulted a specialized neurosurgeon and i may need surgery eventually. Since its very risky I’m trying to rule out all other causes of pain including a possible hernia.
I have constant pain but sitting in a recliner or lying on my stomach helps. Pain ratchets up in my right groin, and sometimes my tailbone or hips when i stand. Sitting for long periods is difficult. Walking at a regular pace used to be fine but lately hurts my right groin. The right sided abdominal pain varies in intensity but never disappears. It feels crampy somewhat like the diverticulitis did and during a flare up is accompanied by slowing of the bowels. When the pelvic crampiness jacks up, the back, groin etc pain gets much worse. The crampiness feels like a mini blockage to me, similar to the diverticulitis flares but milder. Could it be from a partially constricted intestinal section from a hernia? My GI doctor thinks I either have adhesions or IBS. I wake most nights with either back, groin, tailbone, pelvic or hip pain.
For pain relief, I’ve done lots of PT, 2 lumbar spinal injections, chiropractic galore, massages, stretching and exercise protocols, low inflammation diet, fiber, probiotics, anti-inflammatory herbs and acupuncture. The pain remains. I’m now very thin because I’ve little appetite due to pain. Ice packs, resting and a Tens unit help the most. I recently undertook pelvic floor PT and while it helped initially, it later seemed to aggravate the pelvic pain. The therapist and I feel much tightness and tenderness on the lower right side. she suspects adhesions from the colon surgery and a c-section in 1986.
I’m 63 and live in the Albany New York area. Can you recommend someone in my area who is knowledgeable about hernias in women and can do a proper work up? I’m willing to travel for the best treatment.
Many thanks for reading my post!
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7 Replies
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Are my symptoms from a hernia?
Dr Towfigh,
I’ve had the good fortune to meet with Dr Goldstein who was incredibly helpful in sorting through my various issues. He examined me and found a couple of very small lumps in the abdominal groin area where I have pain. He ordered an MRI enterography which helped eliminate strictures as a contributing factor, and which showed those small lumps were probably not lymph nodes. He then performed an ultrasound while I stood and coughed and this showed the tiny lumps had some movement of (I think) fluid. Dr Goldstein strongly suspects they indicate a femoral hernia. He was quite thorough in his testing. He cannot explain the peri umbilical pain, which I followed up on by doing stool cultures. These showed some pathogens which are being treated. Unfortunately I had also developed some upper right quadrant pain as well and my doctor wants to run gallbladder tests. So at the moment I am holding off on any decision regarding surgery for a potential femoral hernia.
Strange as it may seem, all of my myriad health problems developed after I was bitten by a tick 5 years ago that was mistakenly thought to be a spider bite but was actually Lyme and went untreated until recently. So I finally did a few months of antibiotics which helped the Lyme but then caused the GI dysbiosis and perhaps gallbladder problems. It’s going to take more time to sort through all my issues but I feel hopeful because I had pretty good health prior to the tick bite.
Thank you for your kind interest and help. This is a wonderful forum.
Marneyrose
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Are my symptoms from a hernia?
Did you figure out what was causing your pain?
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Are my symptoms from a hernia?
Dr Towfigh and Dr Goldstein,
Thank you for your thoughtful responses to my posts. I’m very grateful for your generosity in sharing your time and incredible expertise.
Dr Trowfigh, I had to look up CT/MR enterography and while reading about how it can reveal strictures in the small intestine, I almost started to cry that no one I’d consulted for these ongoing miserable problems ever mentioned this test. I know adhesions can cause strictures but I’ve been running in circles trying to determine if that’s the nature of my problem. I also know when adhesions cause problems they can be very difficult to resolve surgically or by any means. However it seems CT or MR enterography at least offers the chance for me to understand whether strictures are indeed the source of some or even all of my problems and then make an informed decision how to proceed.
I also never knew that cramping usually comes from tubular structures like intestines or the ureter. This gives me a better understanding of my issues. But I was wondering regarding hernias, whether some portion of intestine could get caught in the hernia and create a type of obstruction? And if so, could it move in and out, creating problems that come and go?
Given my family history of hernias I wouldn’t be surprised if one snuck in among the adhesions and scar tissue. I will be calling you soon Dr Goldstein! We are lucky to have someone with your talent and background in the Albany area. I wish my only problem was a hernia but look forward to trying to sort all of the issues with you.
With deep gratitude,
Marney -
Are my symptoms from a hernia?
I can’t mention everything on the website but I deal with all sorts of hernia and groin pain issues. These can be very difficult cases and I am not actively seeking them out but I will certainly give you my best shot at solving your problem.
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Are my symptoms from a hernia?
Some comments:
– hernias definitely have a genetic tendency. In fact in our study, having a female in the family (such as with your mother) has a stronger genetic linkage.
– I agree with Dr Goldstein. Your symptoms do not sound like a hidden hernia or a femoral hernia and let me explain why:– hernias do not cause tailbone pain
– hernias are also usually not crampy. Crampy pain is usually related to obstructions of tubular structures such as the ureter or the intestines.
– lying on the stomach is almost always painful with a hernia
– hernia patients almost never lose weight due to pain or fear of eating due to pain. If anything, they gain weight due to inactivity as most hernias are exacerbated with activities.I would look into internal hernias caused by adhesions or just adhesions alone as the cause of your pain. Though status studies may not show an obvious obstruction, an enterography (either upper GI study or CT/MR enterography) or reevaluation of your prior films may be able to show subtle differences in intestinal caliber or kinking which will lead one to diagnose adhesions as the cause of your pain. If it is so debilitating, and you are not thriving (massive weight loss, for example) and you are otherwise healthy, it may be worth it to perform a laparoscopic exploration, which is an operation.l but it may be worth it’s risks.
You need a general surgeon or a skilled and knowledgeable gastroenterologist who will take his time to look into all of this for you. If Dr Goldstein is offering you his expertise, I would chomp on it! B)
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Are my symptoms from a hernia?
Thank you Dr Goldstein for chiming in! Which nerves did you think are causing my right lower quadrant tenderness? The lumbar injections did nothing for me.
The lower right quadrant and groin are my central pain locations. It feels like right ovary pain. When I press on my abdomen in this area it is tender. The pelvic floor PT finds the internal tissues like the piriformis very tight and tender on the right side. I read an article by Deborah Metzger and this finding sounded very consistent with me.
My brother and my mother both had abdominal hernias btw in case it’s a genetic tendency. I used to do a lot of heavy lifting until I got this pain.
Btw I visited your website and also watched your video. You look extremely talented and personable but I was bummed at no mention of hidden femoral or other hernias in women. 🙁
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Are my symptoms from a hernia?
It sounds more like a nerve issue than a hernia. I would be happy to see you and try and figure this out. My office number is 518-272-0027. The practice web site is http://www.littlescars.com.
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