What is this!!!

I have severe pains in my upper/mid abdomen. My first attack was the worst (a month and a half ago). My symptoms match that of adrenal dysfunction and pancreatitis,. I had a physical and CT scan which found cysts on both ovaries and maybe fibroids. They are going to do an Ultrasound to determine if they are in fact fibroids or something else. The PA-C did not pursue an upper abdominal Ct scan at the same time although he said that you can see the liver...so I'm not sure if you could see other things or not.(the PA-C said he thought I was complaining more about the lower abdomen). In his defense I have also had mental confusion and find it very difficult sometimes to keep my thoughts organized verbally.But I am very displeased that they lost some blood work.
When I had my first attack I had no insurance. Once I had insurance, the pains and swelling decreased in size and frequency. The last one was a week and a day ago. It took 6 days to recover, less and less each time,(so it seems). I didn't go to emergency then because I had just finished all the tests and was going to be talking to the PA the next day. You can imagine my discouragement and hopelessness when I found out that all the tests were normal. (the ones not lost). I can't seem to blame my attacks on any contributing factor. When I have an attack It feels like someone is sqeezing hard then releasing repeatedly and I have to concentrate on rapid breathing through the mouth to try to control the pain. I also can not talk. Then it usually takes me days to heal, and anything (food/drink)can trigger another one during this healing time. It always feels like there is a mouse nibbling in my upper mid region. It feels bruised, sometimes burns. They also did a gallbladder function test and its fine. If I poke the swollen area I will make myself feel sick. But it was much more swollen & tender before and I would be sick in seconds if you poked it (just making it to the toilet in time). For two days (during the first attack)I was peeing and pooping (black and raw) blood and then I never have again. My stools were a gold clay color (mostly) and I am a very "regular" vegetarian.
The PA thinks that it might be anxiety but I am at the happiest place in my life right now, personally and professionally. My file was recently passed over to an MD and I am going through more tests soon. I am 97 lbs, was 128. I had to quit working(ECE teacher, sales person, business owner) and singing with a big band. Singing was painful and deep breathing is difficult,(can't hold my pitch)I have no energy, very pale and I'm very scared. So too is my husband. I am burping all the time (100+ a day) and my stomach growls a great deal. No flatulance probs. It's all at the top end. HELP!Also have re-occuring sinus infection and plugged right ear...don't know if that's related.  I hope this is enough information. Any questions I should ask the doctor?

[Kevin Pho, MD]

Hello - thanks for asking your question.  

You are describing upper abdominal pain.  You had one episode of black and raw blood.  A "gall bladder test" (not sure which one - an ultrasound?) was negative.  CT scan showed cysts on the ovaries and fibroids.  

There are many causes for upper abdominal pain.  The first thing that comes to mind is dyspepsia.  This is simply defined as upper abdominal discomfort (i.e. either pain or bloating etc.).  The causes for this includes peptic ulcer disease, GERD, gastritis, cancer or esophagitis.  The definitive test to rule this out would be an upper endoscopy.  Alternatively you can also do a barium swallow as an initial test.

Gall bladder disease can also cause these symptoms.  You stated you had a normal gall bladder test.  If this was an ultrasound, then it makes it less likely.

Pancreatitis can also be the cause.  To evaluate this, an abdominal CT would have to be performed.  A serum amylase and lipase may also be considered to see if the pancreas is irritated.  

You may also want to consider a 24-hr pH study to evaluate for GERD.  If positive, then treatment with a proton pump inhibitor may be helpful.  

With any presence of blood (either black or raw), I would pursue an upper endoscopy.  This can evaluate causes such as cancer, ulcers, or gastritis/esophagitis that may cause your symptoms.  If the upper endoscopy and ultrasound is negative, I would then pursue a CT scan for further evaluation.  

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.

Thanks,
Kevin, M.D.