Any clues to help my adult dd?

[CurlewKate]

She's 25. For the past 18 months every 3/4 months or so she's had a day and a night of really severe sickness and stomach pain. Then a day of utter exhaustion, then 2 days when she slowly recovers. Always the same pattern. She's kept a food diary-no clues. She is healthy and happy. She lives with her partner, who isn't affected although it only started after they moved into their new flat. She's seen the doctor who did an h.pylori test-negative. No medication except the pill-and she hasn't changes that. She's going back on Thursday to talk about what to do next. She's not a complainer-and the pain makes her cry. She was practically never sick when she was a child. Any ideas? Oh, she's given me permission to ask on here and to answer questions.

Could she have a water-borne illness from a trip overseas? Something like Giardia or even E-Coli? Could she have an ovarian cyst that's filling and periodically bursting (the pain)?

I'm not a medical doctor but the symptoms you describe are similar to those I've seen in people who have these problems.

any gastro issues?

Who’s cooking for her before it happens? Is there a possibility someone is tampering with her food? 😬

I know they’re much more common in kids but the symptoms make me think of an abdominal migraine

Thank you. I don't think her boyfriend is poisoning her! 🤣. She hadn't been abroad before it first happened, so I don't think it could be that, but I did wonder about the water in the new flat....No issues of any sort until this happened. I didn't think adults got abdominal migraine? That's worth a thought. And I haven't ever heard of ovarian cysts- thank you!

Is the pain in one particular place or all over?

There’s more info on abdominal migraines here: https://www.nationalmigrainecentre.org.uk/understanding-migraine/factsheets-and-resources/abdominal-migraine/

There is also cyclical vomiting syndrome which might be worth looking into: https://www.nhs.uk/conditions/cyclical-vomiting-syndrome/

A friend of mine had cyclical vomiting syndrome and it does sound remarkably similar.
Although tbh even that just seems to be a diagnosis of exclusion.

Where exactly is the pain?

Low down near belly button or higher just under boobs? Central or to one side?

Can she describe the pain, is it sharp or twisting or cramp like?

Gallstones?

That's exactly what I was thinking but the aim is usually higher in the abdomen and OP has mentioned stomach which is usually lower.

OP if the pain is more to the right than bang on in the centre, and sits about where a bra band sits then gallstones could be a possibility.

During a flare up vomiting is common and also a sign that it needs seeing to as it indicates a proper blockage of the bile duct.

When I had them it felt like a stake, something much thicker than a knife, being shoved in through the front under my right boob right to my back. I was constantly vomiting and the pain did not reduce no matter what position I was in or meds I took. I ended up in A&E on my final attack, turned out I had a gallbladder infection and no amount of IV antibiotics would shift it so after 3 days on morphine and IVs they took the bloody thing out. It was so badly infected it had started to break down and adhere to other stuff so they had to wash out all around the area and put drains in for a couple of days. So I was in hospital Sunday - Friday. Thank god they took it out. No problems at all since it's been gone.

Where in her abdomen is the pain? Could it be gynae related - where in her cycle is she when she has it? Endometriosis can cause flare ups like this although the pill usually helps.

If it’s very low down pain like period pain I’d suspect something like ovarian cysts or endometriosis. I have chocolate cysts, which are linked to endometriosis, and they tend to cause cyclical pain but definitely not every cycle, it’s common for me to go 3 or 4 cycles with nothing.

My son had cyclical vomiting syndrome for years and it would happen every few weeks to months and always at the same time, early morning 6-7 am. He would be sick for a few hours then sleep for a while then be back to normal. I know for some people it lasts longer but not sure if pain is usually a symptom.

I know she is on the pill, but does the pain coincide with any particular part of her cycle- especially when she has the 1 week off the pill? I too was thinking something gynae. It really depends whether she is describing pelvic pain, or further up the body and actual stomach/indigestion type pains?

Abdominal migraine? My son can randomly be like this and I think that's what it is

Thank you all for your suggestions. It does sound like abdominal migraine-I didn't realise adults could get that. She agrees- but she's hoping it's one of the other things so it can be fixed! I don't think she's thought of it being gynaecological because of the sickness- but she's going to see if she can track back where in her cycle it happens. Thank you all again-and we're still open to suggestions!