Question Title: upper left abdominal pain / inability to take a deep breath

: : I am male, 36, in good shape, non-smoker. I have had a persistent dull pain in my upper left abdomen, immediately below the rib cage, for more than 2 months. It is on and off, but lately the number of good days I have seems to be on the decrease. The best way I can describe the pain is that it resembles the "stitches" that runners/joggers get soon after starting their run. It sometimes radiates to the back, and causes cramping on my upper left chest. It's usually present when I wake up, and may go away in the early morning (like today, thank god!), or stay for several days. It is *always* accompanied by inability to take a deep breath. When I try, the pain stops me. I also have the sensation that I am being poked by tiny needles on my left side, over my left love handle.

: : I am currently taking a muscle relaxant prescribed by my doctor targeting my intestines because he thinks this might be IBS. However, my bowel movements are fine, and I do not have constipation or diarrhea. I can't really say this medication has helped me. I have had a few pain-free days since starting this medication, but I'm not sure it's because of the medication.

: : Earlier this year I had:
: : - *MAJOR* stress due to a temporary move overseas; for this I took antidepressants, for about 2 months.
: : - Thyroiditis; took beta blockers for about a month, and I was fine afterwards.
: : - A bad flu; lots of coughing; took antibiotics.
: : - True IBS; I had constipation and diarrhea on and off, and irregular bowel movements, where the shape of my stool was either very thin (like a string) or loose like pebbles.

: : For the above I had an ultrasound, MRI, and endoscopy done, and all were fine.

: : All of the above took place the first 6 months of this year. Then I moved, and felt better for a while, until this pain started. However, I am still under some stress, as currently things are not quite right in my life.

: : I am able to exercise vigorously. My appetite is great, and I am watching my weight, as I have a tendency to gain weight with this appetite. My pulse, and my blood pressure are excellent.

: : The pain, however, really bothers me, mostly mentally.

: : Not to leave anything out: I have been diagnosed with internal hemorrhoids, and had light rectal bleeding twice this year. However, I do not believe its related to my current condition.

: : Thanks very much in advance --

: : Todd

: ____
: Dear Todd,
: Given the persistence of symptoms, you should have a complete evaluation of your gastrointestinal tract. I assume that the MRI that was performed was of your abdomen. If this is incorrect, a CT scan of the abdomen is warranted. Endoscopy of upper GI tract and colon are needed. A small intestine barium study should be performed. Finally, you should ask your physician about the possibilities of lung or heart problems. It is possible that your symptoms are related to stress, but before reaching that conclusion your physician should exclude other treable diseases.

: This information is presented for educational purposes. Always consult your personal physician for specific medical questions.

: HFHSM.D.-rf
: *keywords: abdominal pain
: 0.2

Dear Dr. R.F.:

First, thank you for responding; this is a very helpful service, and I personally appreciate your help.

I have some follow-up questions:

- I had a chest x-ray taken, and both an EKG and an "echo" of my heart performed. All came out fine. Is this sufficient to stop worrying about the inability to take a deep breath?

- Since I posted my original question, my doctor asked me to double the dose of the smooth muscle relaxant (called Mebeverin). I started taking 200 mg prior to each meal, up to 3 times a day. This really made a huge difference. I have been pain free for the last full week. Also, my breathing problems have largely disappeared. Couple of times, when I got stressed out, the pain made a comeback, but at a very minimal level, at a fraction of its past intensity, and only for an hour or so. Given this situation, should I worry any more? Was there any permanent damage done to my system due to this?

- ***Most importantly***: When I stop taking the medication, will the pain come back?

Again, thank you for your help. It's hard to express my gratitude over email.

Sincerely,

Todd
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Dear Todd,
It seems as if your physician has found a way to control your symptoms. Based on what you have written, I do not think that you need worry about your inability to take a deep breath.

HFHSM.D.-rf

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