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@rc_tito82: Ready for Rocktober 🤘😝 #axialadventure #jeepgladiator #chicagoland #trailturtles_rc🐢

Tito Rivera
Tito Rivera
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Wednesday 07 October 2026 09:38:37 GMT
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When someone comes in with GI pain, we usually think about what is happening inside the stomach or intestines, or whether the nerves connecting the brain and gut are sending pain signals too strongly. But not all abdominal pain actually starts inside the digestive tract. MALS occurs when a ligament presses on the artery and nerve supplying the upper abdomen. SMAS happens when part of the small intestine becomes compressed between two blood vessels. Nutcracker syndrome involves compression of the vein draining the left kidney, which can cause abdominal, flank, or pelvic pain. May-Thurner syndrome occurs when a pelvic vein is compressed, potentially causing pelvic pressure, leg symptoms, or lower abdominal discomfort. These conditions can cause real pain in the upper abdomen, lower abdomen, back, or pelvis, yet they are often missed because they are not part of the usual GI evaluation. This is why I consider hypermobility the fifth vital sign. Recognizing it can completely change what conditions we consider when someone presents with abdominal or pelvic pain. #heds #mcas #hypermobility #mals #smas
When someone comes in with GI pain, we usually think about what is happening inside the stomach or intestines, or whether the nerves connecting the brain and gut are sending pain signals too strongly. But not all abdominal pain actually starts inside the digestive tract. MALS occurs when a ligament presses on the artery and nerve supplying the upper abdomen. SMAS happens when part of the small intestine becomes compressed between two blood vessels. Nutcracker syndrome involves compression of the vein draining the left kidney, which can cause abdominal, flank, or pelvic pain. May-Thurner syndrome occurs when a pelvic vein is compressed, potentially causing pelvic pressure, leg symptoms, or lower abdominal discomfort. These conditions can cause real pain in the upper abdomen, lower abdomen, back, or pelvis, yet they are often missed because they are not part of the usual GI evaluation. This is why I consider hypermobility the fifth vital sign. Recognizing it can completely change what conditions we consider when someone presents with abdominal or pelvic pain. #heds #mcas #hypermobility #mals #smas

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