Digestive Disorders / Gastroenterology Expert Forum
Upper Abdominal Pain
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Upper Abdominal Pain

Hello, for about just over 3 weeks now I have had this upper just below the chest bone a pressure,gnawing type pain. Bad thing is that I have had this before over 2 and a half years ago; and about 7 months ago, both just went away. Now its back again and its lasting longer. I went to my regular physican Dr. she took a stool sample and there was no blood in my stool, she put me on Protonix which seems to do nothing. Another bad thing is that there is no other symptoms other then the pressure pain in the upper abdomen region, sometimes it go to my right side and to my back. Another thing is it comes and gos all the time. Sometimes I won't be there for hours then it will come back for about a hour or two, it doesn't seem to get any worst. I'm so tired of trying to figure this out. I have no insurance and its so hard to be running alot of tests. I have already went to a GI Dr. he just gave me more Protonix and wants me to come back in a month to run a scope down my stomach, he thinks I may have a stomach ulcer. The scope thing is 700 dollars. Do you have any other things that this could be? There is so many things that could happen in the abdominal region. Thank you.


By the way I have not lost any weight. I'm eating regular. No vomiting. Stool sometimes changes colors. I have been drinking the heck out of Gaviscon and Mylanta and nothing works.

Philip
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I would consider some sort of imaging test to look for ulcers or inflammation of the upper digestive tract.

If the endoscopy is not feasible, an upper GI series can be considered.  

I would also consider a blood test looking for H Pylori - a bacteria associated with ulcers and upper GI inflammation.

These options can be discussed with your personal physician or gastroenterologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b
20 Comments
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For the cost of that scope, you could get several months of insurance. You could also consider a state funded health program if you think you qualify. It sounds like gallbladder trouble.
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I am having the same problem as a previous posting.  I have pain in my abdominal area, sometimes around my navel and sometimes around my upper abdominal area, it almost feels like it is right under my ribcage. It also hurts in my back sometimes lower, upper and middle of back.  It also feels uncomfortable at times when I take a deep breath. Its not really pain but it feels full, its very weird.  I was diagnosed with gastritis last year, but this is not the same pain.  I am so worried that have something serious, and have not been able to sleep.  I am going to the doctor on Tuesday to see what is going on .  I am just worried because I have horrible insurance and If i have to have tests performed I will have to pay out of pocket.
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Hello, I know how you feel. I go to doctor after doctor with no results. I have no insurance so most of the doctors really don't want to do any tests on me. I have been dealing with this now for almost 4 weeks. I'm suppose to have a upper GI with the endoscope sometime in mid April; but in the mean time I'm still battling this weird fullness in my mid to upper abdomen and the pain in my mid to lower back. For me I'm just trying to trust in God for the help He is the only one that really knows what is going on with me. You do sound like your in the same boat I'm in. See I had this samething about 2 years ago and after around 3 doctors visits and 3 weeks pasting it just went away. Then It came back in Sept. of 05 then two weeks later gone again. This one has been almost 4 weeks with no going away. I am a struggler of Anxiety to so it's been really hard. Thanks for the comments. God bless.
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Avatar_n_tn
I have similar symptoms for more than 3 yrs, None of the tests/scans point to anything wrong, However if I follow the SCD diet, I feel better and symptoms reduce.
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Avatar_n_tn
I too have suffered for many years and get to feel like it is all in my head when I am trying to get answers, IBS is a term that used to be called spastic colon, which I was diagnosed with many years ago and now it is called IBS, IBS is actually a term given to something that science hasn't caught up with yet, they don't know what it is or what causes it, but they have to give it a name, personally I think the only thing that can't be seen on the scans etc is wind, not just normal wind but trapped and painful wind, however how can wind be found to be the problem? it is invisible, anyway I started using activated charcoal tabs when an episode comes on and it seems to ease the problem for a while, hope this helps
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I'm 30 yrs of age. Many of your symptoms are familiar. 6 yrs ago after college I began having reflux. My father had the Nissen surgury when he was in his 40's. I've been diagnosed with chronic gastritis and had had every test & med you can think of. My symptoms are a bit uncommon for normal gerd suffers. Next week, I'm finally getting the Nissen Fund. surgery praying it will solve my problems.

My main ailments which have been severe enough for hospitalization include:

Frequent:
- upper abdominal pain which I've thought to be diaphramic tears or hiatal hernia due to weight lifting, alchohol, indigestion & stress. I get this pain after drinking alchohol, carbonated bevs, meals with beans & heavy tomatoe sauce and primary during exercise brought on by tighting of the abs and bearning down while lifting. Rarely do I reflux food or stomach juices back into my mouth and rarely does it feel like this is happening. My pain stays centered under my sternum and upper abdominal region. I can have difficulty breathing during strenious cardio or weight lifting, especially when wearing tight clothing. This is very new to me being a track athlete in college and always wearing tight clothing to workout in or race in. Never experiencing ANY of these issues.

Adding to the pain and hard to differentiate when exercise is soarness in my chest wall and ribcage from a weight lifting accident 2.5 yrs ago. I was bench pressing and the bar slipped off my hands down ono my chest - 225lbs of weight. Luckily I hadnt broke anything but I have had chronic chest wall pain and inflammation in the chest wall and near the connecting points of the abs and ribs. Pain I feel during exercise, be it strenuois cardio or weight lifting is often very difficult to determine the source of the pain.

GERD symptoms, like mine appear to be cyclic. I'll stay away from weights, keep a strict gerd-friendly diet and cut out alchohol for a period of time. I assume my abs, diaphram, esophogas, etc heal during this time as the pain will subside. Eventually the exercise will pick back up or the diet will relax a bit and symtpoms will come back. Sometimes not right away.

The most difficult aspect of the last 4 yrs have been inconclusive findings from ph/motility tests, x-rays, ct scans, bravo study, gastric emptying test, barium swallow tests, ekg's, stress tests, blow tests, you name it - I've done it! My gastroenterologists or other specialists have never been convinced of what was truly causing my symptoms as nothing was screaming "heres the source!".

I will post again after my surgery next week. I was lucky to find the drs who had relationships with my fathers surgeon to approve the "go ahead" to perform the procedure on me. I can hardly blame their reluctance given my history. Whats the worse that can happen? This can help things or they stay the same.

My advice to any of you who are experiencing similar symptoms is this:

- #1 - keep the faith and manage stress. Anxiety can amplify all your symptoms and even create new ones. This is a hard task, especially at night (when your most likely readinf this stuff on the internet) and worrying about your health. Trust me, I know its easy to do this!

- #2, Take control of your problem. Record your symptoms in a diary. This is critical as many times you get a few minutes to try describe your symptoms to your specialist and this is not the easiest thing to do! We want to self-diagnose and can make it difficult for the Doctor to get a handle of your situation. And some doctors wont champoin your case, so you need to take control and demand further tests. We need to get our specialists to think out of the box sometimes. The standard tests & protocols dont work for everybody.

- #3 - rule out your heart & lungs foremost. Get your blood workup, possibly stress test on a treadmill, x-ray and scans if necessary. If you can rule out these precious organs, much of your anxiety will go away. Then, get the upper GI done. That will tell you if you have strictures in the espho & hiatal hernia (sometimes. hernias can be very tiny and come and go. Even the tiny ones can create pain, i think anyway).

- #4 - If acid medication doesnt work, DO NOT prolong trying different flavors of the same thing! If you can't say with certainly a drug is working... it's NOT. Some specialists will have you coming back time and again trying every drug on the market; protonix, prevacid, nexium, aciphex, zantac, you name it. At some point you need to stop the drugs and move on to the telling tests. Some good gastro's will have you do the tests right away. Others will keep perscribing you drugs hoping you go away. Personally, I had a very good gastronenterologist but she was also very popular so sometimes it could take months before I could see her.

- #5 if you dont want to dink around any more and want some quality of life back, get the surgery! That, I hope if my solution. If it's not, we move on to the next thing.

I'm not one to give you solutions as I'm still looking for one myself. And I'm no doctor so I can only give advice based on my own experiences. I just wanted to share my situation because I have read lots of simililar cases and I feel for all of you. This sh*t aint fun and it can create depression, lack of desire to be social with your buddies, family, etc. Hell, I know, I've been there.

Natron
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Avatar_n_tn
Thank God I found this website. I thought I was loosing my mind. I have had the exact URQ pain as you all have described. I've suffered with this every Spring for three years and even after a couple of trips to E.R. the pain is left unexplained.
Last year I went for Colonic Irrigation (which helped). This year it's Acupuncture.  WHAT ABOUT NEXT YEAR???? It is totally taking over my life. The pain is like a knife in the liver/gallbladder area and then it shoots into the back. This year is the worse ever because the pain started on April 12 and is still going strong. What the heck causes this? How can I prevent it? I have been diagnosed with IBS and Diverticulosis but... the pain is different.  My father died of Liver and Bowel cancer, so it is natural for me to jump to conclusions. However, I have had an ultrasound and a Barium and it shows nothing else but the above diagnosis. Does anyone think it might be food allergies? Or maybe prescription drug allergies?  I am on Diovan, Glyburide and Imovane. However, I have had a concussion since March 9 and I was taking Robaxacet, Gravol and Advil for pain etc. Maybe I just stressed my Gallbladder/Liver out? Any ideas... because frankly this pain is isolating me from everyone (I'm so miserable).
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Re: my last post... If anyone wants to respond my email is
***@****
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So.. I was doing more research about the pain we all seem to be experiencing... my Chiropractor suggested that perhaps it all stemmed from a RIB problem. Apparently, we have FLOATING Ribs and sometimes due to severe coughing or other uncomfortable stresses on the ribcage, these floating ribs can cause a great deal of pain (both in the URQ and across the stomach) and can even feel like a heart attack. Often we can feel that it is liver or gallbladder related but it is actually "rib related" and it can include muscle spasms and all the other symptoms that we seem to feel. So... If you think there might be something to it, you can research SLIPPING RIB SYNDROME or go to this website:
www.prolonews.com/slipping_rib_syndrome.htm
Let me know what you think - it makes sense to me because it describes all the symptoms I had that I thought were related to my digestive system.
***@****

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Avatar_n_tn
ONE TEST WHICH YOU ALL SHOULD CONSIDER IS THE HLA-27B GENE FOR ANKYLOSING SPONYLITIS, IT IS A CHRONIC FORM OF ARTHRITIS, IN WOMEN IT AFFECTS THE RICAGE,  I SUFFER FROM GI AND BREATHING PROBLEM, I AM 36 YEARS OLD AND HAVE BEEN HAVING PROBLEMS ALL MY LIFE, I THOUGHT THE PAIN I HAD WAS NORMAL, NOW I KNOW DIFFERRENT, IN WOMEN THEY CALL THIS DISEASE THE WHINERS DISEASE BECAUSE THAT IS HOW WE ARE VIEWED, WE FEEL PAIN DIFFERENTLY TO MEN, WE TOLERATE IT BETTER, THE DISEASE IS FOUND IN MEN MOSTLY SO THEY DON'T REALLY TEST FOR IT IN WOMEN  ALOT OF THE SYMPOMS TO DO WITH THE GASTRO ARE MIMICED BECASUE OF THE RIB INVOLVEMENT.
GOOD LUCK TO ALL
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Avatar_n_tn
I am amazed that so many people have this problem.  Ive been at it for about 5 years and have already had my gallbladder out, no help.  ive taken meds, drank the mylanta, ate, didnt eat, it just doesnt seem to help, and now it's worse.  it's good to hear, tho that others are experiencing this and Im not crazy. pam
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I wanted to add further to my post that ankylosing spondylitis can affect the rib cage, it affects the tendons, ligaments and joints. If you were to test positive for the HLA 27B gene, may not mean that you have AS, but how it has been explained to me is that the gene amplifies pain, meaning someone whom has the mutated gene will feel pain three times worse than the average person, it can affect the internal organs, most people think that it just affects the back, but i have been told by my dr that it can affect the person all over, sometimes the stoamch/ chest problems that you asscociate with gerd etc are in fact being postive for the HLA 27B This may seem a little off from what you have all been writing about in your posts but believe me after visitng GI doctors and spending alot of money on medical bills fro scopes etc drugs to relieve pain that I htough was gerd and now know that it is AS has brought me some relief to know that it is not in my head and that i am chronically ill with a disease / illness that is often overlooked by the general doctor becasue they don't normally run that test with the ANA ESR thyroid etc etc :) Plus they don't run the test because it tends to be men that have it but both my sister and I and now my son have tested positive and all have aches pains, in chest back and legs and stomach problems.
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I've had this for years, I don't want to say how many, I'll seem like the classic malingerer.  Anyway, my version of it is upper abdominal pain or pressure, right below the sternum, aggravated mostly by my lying down to go to sleep.  When it's pressure, it's like there are rocks inside, and they shift around.  (I often get mild palpitations with that.)  When it's pain it can be burning pain, or sharp pushing pain, as if something's moving around inside, something hard and something that could rupture my insides.  I get raised eyebrows when I mention that.  A few times the pressure has been so bad that I've broken out in a sweat, and these episodes tend to last about 15 minutes.  The pressure is so great it actually takes my breath away a bit.  The first time I got one of these attacks  thought "A-ha! Now they'll finally see it!", I thought it was so obvious, but it neither rang a bell for the doctor nor showed up in any of the upper GI tests I was sent to.  It's frustrating as hell, and it's getting progressively worse.  I had my gall bladder removed years ago, so I know it's not that, unless gall stones can show up again (my GP said no).  I took the H-pylori series of antibiotics, I was on Pantoloc, I've had my heart tested -- nothing.  And there are times when this problem is completely dormant, weeks and even months when no symptoms occur.  And then there are times like now, when I suffer every night before falling asleep (oh, I sometimes get woken up by this, so "relaxing" isn't the answer), and sometimes it continues through into the day or days, and there's no logic to either phase.  The only (and not always 100% dependable) pattern seems to be that the better I sleep, the better I feel, as my muscles seem to respond extra badly to fatigue.  If anyone can give me any helpful information, I'd so very grateful.
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Hi all,

I'm fortunate to find this discussion because three weeks ago I developed some of the symptoms mentioned here.  Specifially I'm having pain in the upper center abdominal area about 3x a week.  The pain is much worse at night and it sometimes wakes me up and/or keeps me awake.  It feels like a gnawing pain and does not feel like heartburn at all.  It doesn't appear to be aggrivated or relieved from any type of food, medication, exercise, alcohol, etc.  (I also didn't notice any relief from Tums.)  BTW, I'm a 30yr old male in good health, non-smoker, 150lbs., regular exercise.

I haven't seen the doctor yet but the research I've done so far leads me to believe it is an ulcer possibly caused by H. Pylori.  Oddly enough, my significant other started complaining about an upset stomach about three weeks ago as well ... this could support the H. Pylori theory (since it can be transmitted from person to person).

Any comments and advice would be appreciated.

-BR
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I have hit rock bottom! I am fed up with all Dr.s. They dont seem to want to help anyone who cant make them an enormous profit. I have been passed off from dr. to dr.  Ive tried so many medecines with no relief. It started almost 3 years ago. I had ct's x-rays and many expensive tests. 2yrs ago i had my gallbladder removed. Now my symptoms are much worse. The pain in my upper-rightabdomin never goes away. It hurts below my ribs in the front, side, and back. Sometimes radiates up acky behind my right shoulder. If I lay anywhere in that area feel like something large is in there. Since I have gotten sick, Ihave all of a suuden developed other serious illnesses. I now have high blood pressure and medication does not bring it down. I now havebeen told I have Emphysema, acid-reflux, IBS. Since my surgery, no dr has even touched me. They listen for 5 min. then give me more med. I have had an abdominal ct where "Nothing obvious was noted." I also lately have very sore legs-just tight all the time. I cannot afford to start the whole dr thing again. I am always tired. And I have had to quit my job. My wonderful husband works all the time just to keep us afloat. The whole thing is very depressing (Im on med. for that). Its hard for a woman to not be able to do what is expected. My children suffer cuz I am not happy or fun anymore. I know Im not crazy! This is real and I am running out of hope. I forgot to metion the often very yellow diarrhea and thick yellow burning vomit sometimes all day long- about 10x a month or so. Someone help me before I leave my children motherless.
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I have had the same simptoms as all of you for over a year without a correct or conclusive diagnosis. I recently read that the simptoms associated with an ENLARGED SPLEEN are similar to those that we all feel, and because the spleen has nothing to do with digestive or gastric functions, we all may be visiting the wrong specialist. In my next visit to the doctor I will ask for specific exams to detect an enlarged spleen.

I will keep you posted on the results of my exams.

You can write to me at ***@****

Visit http://www.merck.com/mmhe/sec14/ch179/ch179b.html if you guys want further information.
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Avatar_n_tn
I have had the same simptoms as all of you for over a year without a correct or conclusive diagnosis. I recently read that the simptoms associated with an ENLARGED SPLEEN are similar to those that we all feel, and because the spleen has nothing to do with digestive or gastric functions, we all may be visiting the wrong specialist. In my next visit to the doctor I will ask for specific exams to detect an enlarged spleen.

I will keep you posted on the results of my exams.

You can write to me at ***@****

Visit http://www.merck.com/mmhe/sec14/ch179/ch179b.html if you guys want further information.
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Avatar_n_tn
Thanks so much for posting here.  My mind is blown!
I have had pleurisy (inflammation of the lining of the lung) ever since I can remember.  I'm 33 now.  Since I was 18 or so, I've taken MASSIVE amounts of IBProfen when I have an attack (4 every 4 hours for a few days.  Once or twice a month).  Often on an empty stomach.  I joked that if I DIDN'T get an ulcer that I'd be amazed.

I always thought an ulcer felt more like heartburn and didn't last more than a few hourse, so I'm not sure if that's what I have now.  

For almost a year, about once a month I get an "ache" that starts in the middle at the base of my breast bone.  This ache gets worse and worse over the course of two days... spreading first down my right side (to the right of my belly button), and finally to my left side and around my back.  The ache becomes full-blown pain at the end of the first day and all through the second (so bad that I can't stand up straight and walking is almost impossible).  On the third day it lets up a LITTLE and gets progressively better over the next 4 or 5 days or so.

Does this sound like an ulcer to you?  I'm also wondering if my pleurisy (which, until I was around 18, was mis-diagnosed as asthma) is that floating rib syndrome someone mentioned.  Would an X-Ray show something like that?  Because I've had them and no one mentioned anything about it.  Thanks!
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Hi bottom of the bottle,
I'm so sorry for what you're going through!  I don't know if this will help AT ALL, but you might want to think about taking pro-biotics (you can get them at most health-food stores).

If you've taken anti-biotics, they can cause all kinds of stomach upset.  Also yeast infections, IBS, etc...

Your body needs GOOD bacteria to regulate everything.  (FYI, you don't have to have been on antibiotics to have the above problems, of course, but gastro-intestinal stuff always seems worse after taking antibiotics)

My husband had IBS and started taking pro-biotics and it really REALLY helped him!

I try to take them when I remember, but they need to be refridgerated and taken on an empty stomach, so I often forget.  It sounds like you're at the end of your rope, so I wanted to mention them.  They might really help!

Also, maybe talk to an acupuncturist or someone at your local health-food/vitamin store.  They might be able to help too.  Fish oil (Omega3) is supposed to be great for you (for everything). Whenever I talk anyone (non-doctor), that's the one thing they say to take.  Doctors aren't infallible, and they tend to think that if THEY can't find a cause... then it's all in your head.

Another thing that MAY help is "The Master Cleanse".  (type it into Google and you'll find out more about it.  It's also called the "Lemonade diet")  I don't know if it will help, or if it's even good for the problems you're having.  It's worked wonders for some people.  Do some research and make up your own mind.

FYI, my sister-in-law is a very good doctor and she's always been very derisive about suppliments/acupuncture/ect... her dad had prostate cancer for years and she'd been putting him on all kinds of things before he finally said "enough".  He started researching alternative medicine, got very much into it, and has "beat" the cancer.  Now my sister is (slowly) changing her mind about alternative medicine and is looking into it herself.  She told me that in all her training and schooling to become a doctor that she was never required to take a course in nutrition.  That seems INSANE to me!  

Anyway, I thought that was pretty interesting.  My point is, a doctor isn't going to tell you to try probiotics.  They're most likely not going to tell you about fish oil.  If the doctors aren't working for you, maybe it's time to try other methods.

Good luck! All hope is not lost.
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Avatar_f_tn
I have had many of the same problems so a lot of research has been done. It may be a spleen problem.
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