Left side pain - hot - when I massage it, I burp!

(I used "Misc" for a topic question because I'm just not sure)

I get a hot area of pain in my back, mid-left quadrant, like under my ribs, I guess.  Many times I also have pain in my left side in the rib area.  At times, this pain is ever-present; sometimes it’s gone, until I eat.  When I massage the back area, I burp!   At night, sometimes it's impossible to sleep on my left side.

I've had Xray and CT scan - nothing found.  I’ve had a colonoscopy and an endoscopy; diagnoses were IBS and "inflamed esophagus," whatever that means, respectively.  Neither requires any meds, but how am I supposed to cope?  (And how do you diagnose IBS from a colonscopy?)  I do have acid reflux from time to time, too.  I manage that with OTC, usually a course of Prilosec, and when it gets better I can go a long time without taking any.  

Today I was pain-free and enjoying a really great day until I ate lunch – a few stalks of celery, a fresh tomato, a couple of slices of deli meat and cheese and a plain mini-bagel.  I thought this would be a nice healthy lunch but now I’m hurting all over again.

I’d gladly avoid certain foods if I had any idea of what to avoid.  I do try to avoid acidic foods for the acid reflux.  I need to eat healthily and lose weight, too.  So frustrating, and downright painful.  

[Kevin Pho, MD]

A colonoscopy doesn't necessarily diagnose IBS, but can exclude other causes for the symptoms.  I agree with the workup thus far, and the upper endoscopy is a thorough check for inflammation of the upper GI tract as well as ulcers.

More specialized tests can include a 24-hr pH study to evaluate for GERD, as well as esophageal motility testing to look for dysmotility and a gastric emptying scan to exclude gastroparesis.  

If GERD is suspected, a longer course of a prescription-strength proton pump inhibitor can be prescribed, or a surgical consultation considered if medication cannot improve the symptoms.

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 Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd