Abdominal And Flank Pain

[twinkletwinklelittlestar292]

I have pain in my left side of my back in the bottom of my ribs / also on the right side at times but it hurts much worse on the left side and the pain is not as continuous on the right side as it is in my left side. Pain is radiating from the area of the lett side across the mid section of my back and causing burning pain to go up my back. It causes pain into the front left side of my abdomen when I am sitting back on the couch, otherwise do not hurt much there, the pain I have in my abdomen is located in upper middle area / sometimes it tightens. My left side & back hurts worse if I lean over or when I am in bed laying on my right side (makes my left side hurt extremely worse) or laying on my left side (makes the abdominal pain worse) & laying on my stomach (makes the abdomen pain & left flank pain extremely worse). The pain in my left side is a dull ache to a thobbing pain and sometimes it gets numb. Tenderness is located in my back left side at the bottom part of my ribs and on down somewhat and in the upper middle of my abdomen and over into my left side at the bottom of my rib cage. If you hit down my back with your hand - it makes the flank pain worse, and is much worse on the left side. I have been having this flank pain since September. I am wondering what could be causing me such a problem. I have had tests done and nothing has been specific enough for a diagnosis of the problem. Would also like to know if my hemoglobin and carbon dioxide level being high could be indicating what the problem may be or if anything else I've told you could be indicative of it. My hemoglobin has been elevated since December 12th. But since they are just mildy elevated, does that mean it's nothing to worry about? Below are results from the tests I've had done: Results of blood tests in December - Hemoglobin 16.9 H (reference 11.2-16.0 gm/L) / Hematocrit 48.9 H (reference 33.6-48.0 %) / Granulocytes 77.3 H reference 25-75 %) Results of blood tests in January - Hemoglobin 16.1 H (reference 12.0-15.0 gm/dl) / Carbon Dioxide 34 H (reference 22-29 mmoL/L) Results of full MRI on spine: normal Results of Cystoscopy/Retrograde: Severe Intercystial cystitis, persistant urinary tract infections and left kidney slower than the right one) Results of barium CT Scan: kidney's unremarkable, possibility of fatty liver and many areas of low density seen on the spleen of unknown etiology with the largest one being 1.2 cm. I was told by my pcp that these are probley multiple cysts in the spleen & liver which is a common condition and nothing to worry about and that wouldn't be causing me any pain because my spleen isn't swollen but my gastrenologist said she'd do surgury if the pain got any worse but my pcp said he would not recommend it nor having a biopsy done. And I really do not understand their difference in opinions on this. Can you help? I'm at the point that I don't know what to think anymore !! But what I do know is that something is wrong even if my test results are inconclusive. Thank you.

[Kevin Pho, MD]

Tough to say without examination.  With the CT scan being non-revealing, that is a comforting measure.  Other things that can cause left upper quadrant tenderness would be the various forms of dyspepsia (i.e. an ulcer, GERD or inflammation of the upper digestive tract), as well as pancreatic disease.  

I would consider an upper GI series or upper endoscopy to further evaluate the upper GI tract.  An H Pylori test can be done to evaluate for a bacteria associated with inflammation or an ulcer.  

To evaluate the pancreas, the CT scan is a good start.  You can also consider blood tests to evaluate the pancreatic enzymes (i.e. amylase and lipase).

I would discuss these options with your personal physician or in conjunction with a GI 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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[twinkletwinklelittlestar292]

I'm still very confused. Would the blood tests not be anything to be concerned about? I wondered if the hemoglobin might be somehow related to my spleen or could continous UTI's cause it to be elevated? I have GERD but it has not been causing much problems since last summer. I also have a hiatal hernia but have never had any known problems with it. I know I don't have any ulcers and my pancreas is fine. But I have severe cystitis of my bladder - could that cause such pain? I honestly would have trouble believing it could. I've had cystitis & gerd for several years and that has never has caused me pain where I'm hurting on my sides. Could the cysts in my spleen be pinching a nerve? Just wondering because it's radiating across my back. But the soreness is in the bottom part of my ribs. Thanks much for the reply!!

[ozark]

usually with flank pain and especially with thudding that area with your fist might indicate a  kidney infection...have you ever beentreated for pyelonephritis cos thats what it sounds like......good luck

[jewelspet]

I have pain just like you, infact I had to take a double take to see if I had written that!!   I am in pain at present in L.flank and upper left rib, upper l. quandrant and L.back.
I also have a bad back and thoracic back pain which makes part of it hard to detect But - the flank pain has been hurting a month. I finally went to Dr. and UA showed Kidney infection. I was put on antibiotic for 7 days that she felt would "knock it out".  10 days later and still hurting I went back Friday and she did another UA.  Infection is worse! She put me on another (different) antibotic (antibiotic) and I'm to see a Urologist on Tuesday.  

I was already set up for a Endo & Colonoscopy Mon. and I'm on nothing but liquids today for that.  (lots of constipation problems I've had for yrs.)  Hope I can make it till Tues.  

The pain was a little better yesterday in the flank and worse again today.  I don't know if I can take a pain pill today while I am on just liquid or not.  
Good luck Twinkle.  I'd see a Urolologist & Gastrologist.

[Sweetklj]

I have the exact same pain mine is from the left side under my rib cage and radiates allt he way to the left side of my back. It almost feels like someone took a knife and sliced a real deep cut on me but there is nothin there. I have alot of stomach issues and know those types of pains but this pain is very flank, different and annoying and actually seems to be gettin worse by the hour. I have a dr.s appt on the 3rd of Aug but i'm almost wondering maybe i should go to the ER. Any suggestions?

[Sweetklj]

to add to my Question/Comment, Twinkle have u been vomiting? I have for the past 2 weeks and had weight loss and now the pain.

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