Re: abdominal pain

Posted By HFHSM.D.-rf on May 28, 1998 at 06:51:21:

In Reply to: abdominal pain posted by bettyann on May 20, 1998 at 13:15:28:






I have had pain in my upper left quadrant for about 1 year, with an increase in severity over the last two months.  I had mono last summer, and it was assumed the pain was from my spleen, although ultrasound and CT indicated spleen was barely enlarged.  
The pain often is a constsnt dull aching, with periods of very sharp and sudden pain.  At times the pain will shoot straight through to my back.  My internist though I may be having an excessive amount of acid in my colon, and placed me on prilosec.  Although that medicine aided my indigestion, it did nothing for the pain.  The doctor than placed me on dicyclomine and referred me to a gastroenterologist, which I am waiting to see.
My grandmother had colon cancer, and I am worried about the possibility of having it too.
_____


Dear bettyann,
Left upper quadrant abdominal pain can be due to a number of conditions.  Diseases of stomach, pancreas and colon are the GI sites that can produce pain.  Kidney problems can also produce pains similar to those that you describe.
You do not provide any information regarding, age, previous and concurrent medical problems, current medications, factors that improve or worsen the pain, etc.  This information would facilitate prioritizing the possible etiologies.  Even though we do not have this information, I do have several general comments.  1) If the Prilosec is not helping your pain, you should stop the medication.  There are other less expensive treatments for indigestion.  2) Pancreatic disease (chronic pancreatitis in the appropriate setting) can cause the pains that you describe.  3) Colon cancer could present this way but it is unlikely.  The age at which your grandmother developed colon cancer and your current age would influence the concern regarding this possibility.  4) Finally, most patients that have this type of pain do not have a definitive cause identified and are often called Irritable Bowel Syndrome.  The factors that cause these pains in Irritable Bowel are currently unknown.  It is recognized, however, that the pain is often associated with defecation problems.  Increased fiber in the diet (either by eating more vegeatbles, whole wheat bread or by taking commercial formulations e.g. metamucil) can regulate the bowel pattern and improve the pain.
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by your physician.
If you want, we would be happy to see you in the Division of Gastroenterology at Henry Ford Hospital, in order to review your records and initiate treatment to improve your symptoms.  You can arrange an appointment with Dr. Fogel, one of our experts in the investigation of abdominal pain.  He can be reached by calling the Henry Ford Physician Referral Line at [phone].
HFHSM.D.-rf
*keywords: abdominal pain, irritable bowel syndrome, pancreatitis, coon cancer
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