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    IUD and gas
    ARU410 posted:
    I just got the copper IUD inserted yesterday. I am having the most painful gas pains and bloating under my ribcage. Even bad lower back pains and nausea. Is this normal?
    J_Harrison_Hohner responded:
    Dear ARU: Gas pains and bloating under the rib cage are not common symptoms following Paragard IUD insertion. My best GUESS is that the lower back pains and nausea are related to the recent insertion in this way. Cramps from the uterus are very common following IUD insertion. In part cramps are caused by prostaglandins. Common menstrual cramps are caused by the release of prostaglandins from the lining of the uterus. Prostaglandins create both the cramps of labor and menstrual cramps by making the uterus contract. There are also receptor sites for prostaglandins in the bowel and central nervous system. Thus prostaglandins can produce not just cramps but also nausea/vomiting, diarrhea, headaches, and other "flu-like" symptoms. Ways to block prostaglandins can include anti-prostaglandin drugs (eg ibuprofen, naproxen sodium, ketoprofen, etc.). The actual cramps can be "referred" as pain to the lower back, and even inner thighs. If all you had were the cramps and nausea you could consider trying an ibuprofen-type drug coupled with taking it easy for 48-72 hours after insertion. Given the unusual bloating and "gas pains" in the bowels I would urge you to contact your GYN or family planning clinic and reporting the symptoms. Most offices have someone on for weekend call. By all means you should contact your IUD inserter first thing tomorrow morning. If the pain is escalating and there is no one to call you back on a Sunday night you may need to go to an ER if you are increasingly ill. Hope this all levels out on its own. I've had two out of three IUD insertions where there was significant discomfort after the insertion. Yours, Jane

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