Abdominal Pain

[FSP25]

During the 5 years I have had PMR the main areas affected have been neck, shoulders and hip girdle. For the past few weeks I have had a lot of discomfort across my abdomen. Has anyone else experienced this or should I be looking for another reason? Am currently on a reduction programme as my Rheumatologist thinks my PMR is inactive. I'vebeen reducing the Pred by 1 mg per month. Next month I will be following the Dead Slow regime. I have other pain which is not thought to be PMR related and I'm waiting for an MRI scan. Would be grateful to hear from anyone who has experienced discomfort in the abdominal area.

[SnazzyD]

Hello,

Well, it's a case of working out if the abdo pain is the muscle layer relatively near the surface or underneath in the cavity. Any abdominal pain should be investigated by a doc really, much as we all like to steer clear of them. Quite a lot can be determined jspust by a knowledgeable prod without diving into scans etc.

[FSP25 in reply to SnazzyD]

Thank you for your reply. I suppose I know really that I'm going to have to bring it up with the GP. I'll be seeing her in a couple of weeks following blood tests and BP check next week so I'll mention it then if things haven't improved. I had Gastroenteritis 6 weeks ago and I've not really felt right since then. Thank you again for your reply.

[venezia1]

Your post has prompted me to write in, though it may not be anything related. I've had RA, GCA and Sjogren's for some years. For various reasons my pred reduction has been interrupted several times, and I am now on 9mg reducing to 8.5.

I accumulated a huge amount of fat round my abdomen which moves from side to side when I turn over in bed, though I am not overweight in the rest of my body. Recently I've been experiencing discomfort and nausea frequently, and have had ultrasound and doctor's "prods" to try to find out the problem, but to no avail. I've also become gluten intolerant. I'm even more tired than usual and have little energy. Is there any way of getting rid of this awful swollen belly? I knew to expect it on pred, but it seems to be getting worse rather than better as I drop the pred. Any thoughts welcome.

[FSP25]

I've got wobbly fat around my tummy but it's not felt uncomfortable before. It may be a consequence of dropping the pred as it now feels swollen and bloated. Hope you get some answers to your problem soon.

[SnazzyD in reply to FSP25]

So is it the fat that feels uncomfortable or underneath inside the tummy that the fat is sitting over? What might be helpful for the doc (and you) is if you make a diary of diet, timing of increase and decrease of bloatedness and pain, bowel and bladder habit, especially if it has changed. There are all sorts of digestive, muscular, glandular and organ issues that could cause this, so anything that can help with the detective work saves time.

I had recent increasing bloatedness and loose motion in the mornings that got worse at home but improved on holiday. Although my evening Pred has always made things go that way in the mornings, it was getting worse with reduction instead of better. The only thing that I was not eating on holiday at all was cabbage, sprouts, broccoli etc and in large amounts. With a bit of experimentation I solved it. A diary would not have helped in this instance because I was eating it every day, so had no on days and off days. Glad I had that holiday.

[FSP25 in reply to SnazzyD]

It feels muscular as it is tender when I bend or move. What you've suggested is good advice which I'll follow. It's an unusual situation for me as my stomach is normally very robust and I can eat anything but whether the gastroenteritis has upset things or it is related to the pred reduction I just don't know. Thank you again for taking the time to respond to me.

[PMRpro Ambassador]

And what exactly makes your doctor think the PMR is "inactive"? Until you have reached zero pred without a return of symptoms there is no way he (or anyone else) can know. If you have no symptoms and your bloods are OK it is just as likely to be the fact you are on the right dose of pred or higher.

As for the abdominal pain - no, can't put that down to "just" PMR until other things have been ruled out. My husband developed post-viral IBS a few years ago - it is a real "thing"!

What's the MRI for?

[FSP25 in reply to PMRpro]

Thank you for responding. I think the inactive diagnosis was based on blood tests and the fact that the pain that I have had now since last September is in my lower back, buttocks and thighs. It didn't improve with an increase in Pred right up to 30mg which led to both myself and the GP thinking something else was going on. Hence the referral to the Rheumatologist who is a PMR expert and is carrying out research into the condition. Her thoughts were that it was inactive and my problems are mechanical. The scans are on my spine and knee. I have had a trapped nerve in the knee since May which was caused by the Physio who was trying to relieve the pain in my back! Needless to say I am in extreme pain and the abdominal discomfort is just one more thing. My scans are next week and I see the knee specialist at the end of the month. I will request that the scan results are shared with my Rheumatologist and Physio when they come through. The gastroenteritis delayed everything by several weeks as I was in hospital for a few days and felt really ill when I got home. I'm hoping someone can piece all this together so that we can find a way forward. Thank you again for your time and wisdom.

[PMRpro Ambassador in reply to FSP25]

Low back, buttock and thigh pain is very often due to either piriformis syndrome or myofascial pain syndrome (MPS) - of which much has been said on the forums. Both are found more often in people with existing PMR - and myofascial pain syndrome has been shown to be caused by the same inflammatory substances as PMR. MPS leads to spasmed muscles - and although sometimes more oral pred helps it doesn't always. I get manual mobilisation massage by a physiotherapist and occasionally steroid or lignocaine injections - but I don't live in the UK. In the UK I depended on my Bowen therapist and osteopath to keep me upright.

[FSP25 in reply to PMRpro]

Thank you for that information. I was using a Physio which I discontinued after the knee episode as I lost confidence. I had a couple of Bowen Therapy sessions earlier in the year but these were interrupted when my husband became ill as it was a distance to travel. I opted for the Physio because it could be delivered locally but wish I'd stuck with Bowen. Once I have the scan results hopefully I'll know what I'm dealing with. Haven't done any research into purifier mid syndrome or MPS but will do so. Also very interested in what you mentioned about your husband having post viral IBS and will read up on that. I think it was viral as I wasn't given antibiotics only rehydration. When I was discharged they said the bowel may take time to return to normal. Thank you again I appreciate it.

[Hindags]

Did anyone suggest a probiotic to help restore your intestinal microbiota after the virus?

[FSP25 in reply to Hindags]

Thank you for suggesting this. I'll certainly give it a try.