Pain in the upper left abdominal area under rib

Dear Doctor
I have had pain under my lower left rib on and off for a few years. The pain I would describe as spasm  like. They have run blood, ECG, MRI (using the pancreatic protocol) and colonoscopy.  All negative.  But still I have the pain.  It is worse at night while lying down. It seems to flair up for months and then calm down for a month and then flare up again.  Sometimes it will flare up in my upper left abdoman and the next night will transfer to by back. Recently it resurfaced and is worse after eating.  I may have several boughts of pain a day and then no pain at all other times of the day.  I have not lost any weight.  I did have a PE during delivery of my 3rd child.   All genetic test for clotting disorders were negative.  Could it be intestinal angina? NI also develop acid reflux on and off from time to time.  My blood pressure and cholesterol are normal. Any ideas?
Thanks  

[Enoch Choi, MD]

Left sided upper abdominal pain can be from the pancreas but a MRI is a good way to look at problems there.  It can also be from other gastrointestinal disorders such excess acid in the stomach that can irritate or even ulcerate the intestines or esophagus.  This is a common cause of discomfort after eating.  Although colonoscopy looks at the lower intestines (colon) it does not look at the esophagus, that's evaluated by an upper endoscopy (EGD esophageoduodenoscopy).   It's worth asking for a second opinion, a Gastroenterologist is the kind of doctor that performs EGDs.

Intestinal angina usually causes abdominal pain that is less well localized - meaning that the pain is often times over the whole belly rather than in one quadrant than another.  Intestinal angina worsens when more bloodflow is needed to the intestines, such as after a meal.  Intestinal angina is often accompanied by atherosclerosis in other bodily systems, which can help increase the possibility of intestinal angina if someone has cardiac angina, transient ischemic attacks, or other narrowed arteries.

Enoch Choi, MD

[bubbles410]

Also I forgot to mention I have had 2 endoscopy scopes in the past two years as well as a urine test duringone of these eopisodes.  I am 107 pounds and 44 years old and the PE was 3 years ago.

Regards

Bubbles 410