Three years later, the patient experienced “sharp” right-sided abdominal pain. The specialist performed a colonoscopy that showed only a 'tortuous bowel.' She was told that this finding confirmed her diagnosis of IBS-D. Nine years after the onset of her severe menstrual symptoms and six years after the onset of her disabling abdominal pain and diarrhea, she was referred to a gastroenterology (GI) specialist. She pursued a second opinion from another gynecologist who also attributed her symptoms to 'bad periods,' without having conducted any additional testing. No additional diagnostic testing was pursued at that time. She saw her primary care provider for her severe diarrhea and was diagnosed with Irritable Bowel Syndrome with Diarrhea (IBS-D). She was continued on oral contraceptives by her gynecologist. Over the next 3 years, her dysmenorrhea continued, and she developed severe abdominal cramps, bloating, nausea and diarrhea. She immediately sought care from a gynecologist, who started her on an oral contraceptive pill to manage her symptoms, which were attributed to 'bad periods.' A 15-year-old girl with no prior medical problems developed disabling menstrual cramps and heavy bleeding at the onset of her first menstrual period.
