Burning pain in lower part of the abdomen radiated to groin for two years

Dear Ask The Doctor:  Two years ago woke up with a burning sensation in LLQ, since then it is a constant burning in LLQ with left testicular pain and now pain up through left rib cage,, pains increase after bowel momevent and stays elevated for up to 4 hours after bowel momevent but burning sensation is a constant, now i also have vomiting that can only be calmed through injection of zofran or regulan. What could be causing all this?

Dear Patient:   The burning sensation that you described in your LLQ, most likely correspond to a Meralgia Paresthetica, this is a type of Neuropathy, which produces a pain occurring from a peripheral nerve inflammation not associated with the spinal cord called Neuritis. The pain in the upper anterior part of the hip and/or LLQ may radiate to the skin of the stomach, resulting from inflammation of a sensory nerve that goes near the Iliac crest and the superficial part of the hip. This type of pain tends to involve just a limited area only. The suggested strategy would be: conservative therapy, such as physical therapy, weight reduction to decrease abdominal girth, local moist heat application, Complex B vitamin, analgesics, and anti-inflammatory drugs as Ibuprofen and avoid wearing constrictive garments, belts, or braces that impart excessive focal pressure at the lateral aspect of the affected hip. If does not get better with these measures it is strongly recommend to be evaluated by a orthopedic surgeon and maybe consider the local corticosteroid injection which may provide more chronic relief of symptoms. You have to be patient because the improvement in these cases does not occur overnight. Regarding the bowel movements and nausea you better consult a Gastroenterologist.

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