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[palmtreecity]

Hi there. I'm a 35 y/o female, non-smoker, rare drinker (1x/mo), married, no kids.  About once per month or more, I get upper left abdominal and chest pain radiating to my neck, left arm and shoulder, accompanied by dry throat, burning up throat sometimes, back pain, belching, passing gas, rib sensitivity over heart area and an overall feeling of pressure and occasional sharp pain in/around left side. When I lie down, the pressure increases and hurts worse.  It's typically accompanied by mild nausea and frequent loose stools/diarrhea (and then I swing back to either normal bowel movements or constipation). Sometimes I also feel lightheaded, weak or my hands will tremble or cramp up (at times, wakes me up at night) and I feel anxious.

I have been to the ER about this three times now, concerned that it could be heart-related and to the doctor more times than I can count.  Apparently, I do have a minor ST-wave irregularity, but after a good treadmill stress test (and basically no cardiac risk factors, including low cholesterol) and multiple tests for enzyme irregularities, everything came back as OK for my heart.  I've had pericarditis and pleurisy years ago, but they say that it's not that now.  The cardiologist at the hospital and ER docs say that it is either GI-related or costochondritis or some other rheumatalogical disorder. I've also been barely below normal on potassium levels.

Now, I've been to the GI doctor before about this.  He said that I might have a "motility disorder."  I have no idea what that means.  He did a colonoscopy and it was normal.  I took a lactose intolerance test (normal) and H.Pylori (normal).  I've had fecal stool samples for parasites (normal).

To make matters more complicated, I had frozen shoulder several months ago which still hurts a little on and off.  I had elevated ANA levels but a double-stranded DNA test was normal (does this rule out Lupus?).  The internal medicine doctor said I might have polychondritis and not to worry about it. Just take pain meds (but I get blood/diarrhea off NSAIDS).

I've also been sent to a physical therapist who said that I have ribs that may be popping out of place regularly (subluxation) that could be causing the chest pain. She also thought that I suffered from "lax ligaments" (I can bend my thumb down to touch my wrist).

And, I have ovarian cysts that grow to 3cm - 5cm per month and then rupture...and then the cycle starts all over again (every month).

I also had a thyroid test about 9 months ago.  I was still in the normal range but closer to the hypothyroid side (4.4, I think).

After hearing all of this, I'm hoping that you can point me in the right direction(s) to get some answers about what's causing the problem and how to fix it...and to clear up some of the ambiguity about and probability of the various diagnoses that have been given. My ovarian cyst problem was misdiagnosed for almost 5 yrs.  This issue has been going on for almost 3 yrs.

Thank you!

[Kevin Pho, MD]

Further evaluation of the upper left quadrant can be done to evaluate the pancreas, spleen and upper GI tract.  

This can be done with an upper endoscopy and CT scan.  If negative, more specialized testing can be considered with a 24-hr pH study or gastric emptying scan.  

Blood tests can be considered to evaluate the pancreatic enzymes.  

These options can be discussed with your GI physician.

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_

[palmtreecity]

(I keep forgetting to add pertinent info) I'm not overweight.  I'm 5'6" and 125 lbs. although I don't exercise regularly.

[palmtreecity]

Ah!  Just thought of something else.  They've said that my liver function is normal as is my kidney function.  I am not diabetic (that I know of) or pregnant.  I do occasionally have pain around the gallbladder area, but they've done a CT-scan and sonograms of that with no evidence of gallstones or clogging of the bile duct (or whatever you call it)!  I saw someone's post about splenic flexure syndrome and wondered if any of my issues could be caused by that.

Thanks again!
Jen

[Nursgirlie23]

Hi, I just wanted to add that pain from your spleen can be referred to your left shoulder/shoulder blade.  I had my spleen removed about a year ago, and prior to that I was having a lot of pain in my left shoulder/left chest area.  
I also have chronic pancreatitis, which causes pain in the left quadrant of my abdomen, sometimes it is in the right upper quadrant.  It causes nausea, vomiting, diarrhea, gas, bloating.  All things which you have mentioned.  With acute pancreatitis your amylase and lipase levels in your blood would be highly elevated.  With chronic pancreatitis however those levels no longer raise.  They diagnose Chronic panc through ERCP's MRCP's and stool tests for fecal fat, and fecal elastase.  Might be something to think about?