The case of mysterious abdominal pain

Author: Dr. Michelle Durkin on 23 March 2021

Abdominal pain can be a tricky symptom to treat. There can be multiple causes, not just in the digestive system, but in other systems as well where it can mimic a digestive problem.

Often many tests are done like bloodwork, ultrasounds, X-rays, colonoscopies, and endoscopies. And all of them can be "normal".

So what do you do when you are told all of your tests are normal?

You stop thinking you have a pathology and you start thinking about lifestyle disease.

That means diet, sleep, exercise, detoxification, sunshine, stress management, and emotional health.

Here is a case to help illustrate.

K.M was a 43 year old female who presented at my office with right upper quadrant abdominal pain. It felt like a pinching and twisting pain under the ribcage. She rated the pain as a constant 5/10 (10=highest) with periods of 10/10. She had been prescribed Tylenol 3 and even hydromorphone to manage the pain.

K.M. had every possible test done. Blood work, colonoscopy, endoscopy, ultrasound, CAT scan, MRI. All were negative.

At her initial visit I recommended a medical food called Ultra Clear Renew by Metagenics, and a liquid fish oil called Omegalicious by Botanica. Both supplements were started at 1/4 of the regular dose and increased slowly over several days. I also recommended that she eat only pureed fruits, pureed veggies, and ground meats.


In her clinical history she had fatty liver disease which resolved when she went off the birth control pill, she had trouble with loose stool or diarrhea since childhood, she was often borderline anemic, she was classified as morbidly obese, and anytime she tried to eat healthier and lose weight eg. more veggies, she would get more diarrhea.

On her Bioimpedance Analysis measurement she had 52.3% body fat and her intracellular water (ICW) was very low at 42.3%. This number should be above 54.3% for her age group. The ICW is a reflection of detoxification.

All of these factors, plus the location of her pain led me to hypothesize that K.M was having significant difficulty with detoxification and biotransformation in her liver as well as malabsorption in her digestive tract.

One of the key requirements for healthy cells is proper removal of cellular waste products from the cell. When this doesn't happen toxins can start to accumulate. And when toxins accumulate, they can trigger an inflammatory response. The immune system recognizes the toxins as a foreign invader and initiates the inflammatory cascade. I suspected this was the cause of K.M's mysterious abdominal pain.

Turns out that what I suspected was correct.

After three weeks K.M was having formed bowel movements, no indigestion, and no upset stomach. Her energy was better and her sleep was better. The pain in the URQ was less intense with the exception of a four day period where the pain started to radiate to her back. Her ICW increased from 42.3% to 45.6%. A good improvement over that time frame is 1% and hers was 3.3%.

By this time K.M. was taking the full dose of her Ultra Clear Renew, 2 scoops 2X a day, and her fish oil, 1 tbsp a day. I recommended she add in sweet potato 3X a week, she could have raw or cooked veggies, continue with ground meats but also try some chicken and turkey as well as some good fats like olive oil, avocado, and coconut oil.

Six weeks later K.M. was having minimal pain. Usually only when lifting something heavy or if she ate more fat that day.

Six months later K.M. was eating a modified Mediterranean diet, continuing her medical food and fish oil, and no longer suffering from mysterious abdominal pain. Her energy was better than ever and her bowels had been "normal" for longer than she could remember. She had also lost 49.6 pounds, 36 pounds of which was fat.

These results were achieved by making it easier for her body to eliminate toxins more efficiently.

In putting less stress on her digestive system by simplifying the foods she was eating, and consuming a medical food that contained all the nutrients needed for her detoxification enzymes to work properly, K.M. was able to live pain free again.

And that is why you need to look at lifestyle factors if you are told "everything is normal."

If you think reading this case might help someone you know, please feel free to share. Thank-you to K.M. for letting me share her results!

Now I would love to hear from you! Have you ever been told everything is normal? Leave a comment below and I'll be back next week with another edition of Doctor as Teacher Tuesday!

4 Replies to “The case of mysterious abdominal pain”


What a fabulous success story. I love to hear these stories, that point back (always) to what you stated – diet, exercise, sleep, sunshine, stress relief. Keep educating and being a great motivator, Michelle!


Very informative and interesting! Thank you for sharing.

Dr Michelle Durkin ND

Thanks Lynn!

Trish Pollard

It sounds like similar problems to what I have.

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