Q: I am a 53-year-old woman with fibromyalgia. Seven years ago I began having pain in my left lower quadrant. As the months went on, this increased to also having nausea to the point I would sometimes vomit after eating. It was an extremely stressful period in my life. Back then I would start out my day with two Excedrin and a cup of coffee. It seemed like a great pain reliever at the time but all this caught up to me. I went through months of testing: gallbladder, vaginal ultrasound, checks for ovarian cancer, CT scans, a colonoscopy, and finally an endoscopy which revealed ulcers all through my esophagus and into my stomach.
Through the daily use of Prevacid, a low-fat diet, removing the people from my life who were slowly killing me and knocking off the pain meds on an empty stomach, the ulcers were gone in six months. I am much more careful now but every once in a while I get that lower left quadrant pain which is my reminder to straighten up and watch what I am doing. My point is – the pain is nowhere near the problem. Sometimes.
A: Thank you for sharing your interesting experience. The left lower quadrant of the abdomen is the area left of the mid-line and below the umbilicus in humans. There are a number of organs in this area, including a portion of the descending colon, the sigmoid colon, and the left ovary and Fallopian tubes in women. Pain can stem from bowel obstruction or inflammation, urinary tract infection, colitis, pelvic inflammatory disease, endometriosis or ovarian cyst in women, testicular injury in men, gas, indigestion, kidney stones and a number of other conditions. If pain, fever and leukocytosis are also present, acute sigmoid diverticulitis might be the culprit. Because of the numerous possibilities that must be ruled out or zeroed in on, a person such as yourself may be subjected to a great deal of testing which is not a shortcoming on the part of the attending physician but a normal progression toward diagnosis. And, because of the pain, anxiety, stress and inability to determine a cause rapidly, patients can fall into a deep rut, doing anything to feel better – even if only for a few hours. This is understandable.
Fibromyalgia is widespread musculoskeletal pain accompanied by a plethora of other issues. Symptoms often begin following trauma, infection and even stress. Pain may present between the shoulder blades, in the upper chest, hips, knees, and throughout the body.
The Excedrin you took relieves pain and fever. It is a combination of acetaminophen, aspirin and caffeine. This medication outwardly appears to be a likely initial step for control of your fibromyalgia. You don’t specify if you took extra strength, back and body, PM, sinus headache, tension headache, quick tabs or another form but side effects may include upset stomach, nausea and heartburn, salicylate-induced variant angina, conduction abnormalities, hypoglycemia, abdominal pain, peptic ulcers, esophageal ulcerations, and hypotension. Having said this, acetaminophen is generally well-tolerated when administered in therapeuetic doses. Excedrin Extra Strength comes in 250 mg acetaminophen/250 mg aspirin/65 mg caffeine. The back and body formula comes in 250 mg acetaminophen and 250 mg aspirin. The tension headache formula is 500 mg acetaminophen/65 mg caffeine. All are available over-the-counter and are not controlled substances.
Directions for use are to take no more than two caplets in a 24 hour period unless instructed by a physician. Well, when a person suffers from fibromyalgia, aches from head to toe and his or her level of pain is off the charts, I can understand these directions might be violated. And, as you experienced, the results can be devastating. It must be understood the fault doesn’t only fall on this one product. A single aspirin can be devastating for the wrong person. We all react differently. The blame must be shared with the user who may take more than the RDA and the physician if he or she recommended the product or knew about its use and failed to point out the potential hazards. We must educate ourselves before we pop something into our mouths without thinking. We want a quick fix – almost at any price. So again, thank you for giving every reader a heads up regarding how a simple OTC can escalate out of control.
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