Stomach pain - GP issue or A&E?

[Stomachpainadvice]

I’ve had a pretty complex medical history since the age of 16.

In 2011 I had bacterial pneumonia and a collapsed lung, so I have scar tissue on one of my lungs. In 2015 my large intestine perforated and I had it removed, currently have a reversal (small intestine connected to rectum) after a year of a stoma bag. Still have active colitis in my rectum.

I’ve also had my appendix removed (suspected appendicitis before bowel perforation) and gallbladder removed.

I also had a C section in 2020, and glandular fever which I was in hospital for for a week due to an inflamed liver in 2019.

I’ve got a lot of scar tissue from all of the abdominal surgeries, so sometimes with tummy pain it’s really hard to tell what’s what.

Today my bowels have been a bit weird. I spent an hour and a half on the toilet earlier, I don’t have gastroenteritis, it’s just I had this horrible urge to go that wouldn’t go away even though nothing was coming out (had been, so not constipated).

Happened again this evening, the urge was giving me pain under my right rib, and then I had some dark red rectal bleeding, but not enough that on its own A&E/GP would do anything about.

However I’ve spent the last hour with bad pain in my upper middle abdomen that was acute, but has now spread to the middle of my abdomen too. It’s like I’ve been kicked in the stomach with constant pain rather than cramps.

It’s really hurting and no position is making it even better. The thing is GPs are never any help because they always refer me to gastro because of my history and I have never actually been sent a letter or given an appointment.

Combined with the bleeding I am worried but not sure what the best route is. I don’t want to waste either a GP or A&E’s time but the pain hasn’t got any better at all over the last hour, and hasn’t gone for even short moments.

Any advice appreciated

111 seems a good place to start

111 or A&E. Might be perforated intestine/diverticulitis given your history, or pituitary gland. Best to get it checked out.

It's reasonable to go to A&E. They will take bloods and do a CT, I would think. You may have another perforation somewhere (hopefully not, but it needs to be checked out)
And they can also give you strong pain relief

A&E, as they have access to opinions from the surgical team. Given your history.

Ring 111 and let them advise you.

My friend had extensive 10hr abdo surgery late last year and was experiencing pain like yours recently. It was a blockage caused by scar tissue. She started vomiting as nothing could pass through her system. I'd suggest A&E. 111 can take a few hours.

I

A&E with your history and the bleeding.

Call 111 if you would like to be told to goto A&E by someone else. If you have persisting severe abdominal pain and you don't know what it is you should go there. If its settling, or you think it's very much like a flare of a similar pain you experience (which from what you say doesn't seem to be the case), then hold out for the GP.

If you call 111 and they say they'll send you an ambulance to "check you out" which isn't uncommon, what they're actually arranging is for you to wait 1-2 hours for someone to pick you up and take you to a&e, since a paramedic is unlikely to be able to safely exclude a serious pathology. I would only accept an ambulance if you are unable to make your own way safely, since you might as well get there 2 hours earlier in case it is an emergency!!!

I’m a doctor. Given your surgical history I’d say A&E. You are higher risk for adhesions than the average person. I’d get seen. Hope you’re ok.

Make it clear about your extensive surgical history when triaged. If you’re young enough to have had a c section recently they’d probably assume low risk for a perf or obstruction. But actually you do need to be seen by surgeons imo. I’m a medic, a registrar but I would be discussing you with the surgical reg if you were under my care with that pain and your history.

This is an old thread.