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Gastroenterology (Expert Forum)
Chronic back pain and abdominal pain
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Chronic back pain and abdominal pain
by jgrossi, Jan 21, 2005 12:00AM
Three years ago I suffered from some form of virus (2 weeks fever, vomitting, lost about 9 lbs., no appetite). Seen my primary care, then went to ER, given fluids and some blood work was done. Elevated liver enzymes was it and after two weeks they returned to normal.
Refered to Infectious disease specialist and he ran a battery of test all were normal except for titer test for CMV and said that we was probably what caused my symptoms above. Then about 3 months after that (still not feeling my normal self), I began to experiend mid upper back pain that was felt to left part of my back. Over the past couple of years the discomfort has gotten worse and for a little over a year the pain is also in my upper left abdominal region, more of a dull ache sometimes sharp. This discomfort in my back and front is almost constant and really interferes with my day to day life. During this time I have seen multiple doctors (2 Neurologists, 1 Pulmonologist, 2 Infectious disesase specialists, 1 Gastroenterologist, 1 urologist) and have had many test:
CT and MRI of brain and spine - Normal
CT of chest and abdomen - Normal, except for hemangioma on Liver (had MRI and ultrasound of liver everything is good)
two Abdominal ultrasounds - Normal
Endoscopy - Normal (mild gastritis)
Colonoscopy - Normal
CBC - Normal
Liver Function - Normal, except ALP was slightly elevated a couple of times over a 4 month period, had isoenzyme done it was normal told not to worry about it
CA-19 - Normal
Pancreatic enzymes normal
ESR Multiple times - Normal
C Reactive Protein - Normal
Misc. other blood test all normal
Cholesterol is high, told it was hereditary, on Vytorin it is now 156 and LDL went up 10% and triglycerides went down as well.
Diagnosed with Acid Reflux disease take prevecid.
My doctor now wants me to see a Psych. who specializes in Pain Management.
Here is my concern of all the test they have found nothing, but the discomfort and pain still exists and is not getting better. It seems this is something I am just going to have to deal with, but it trully is no way to have to live. I am fearful that there is something they have missed, your thoughts?
I have always been a thin person prior to the start of all this 5'10 about 157 lbs., but since this I have put on tons of weight I weigh close to 190 lbs. now. My doctor has told me that if this were something life threatening ie. cancer, I would more than likely be dead by now because it would be everywhere and it would have alread manifested itself.
I also have this weird thing that almost every time I eat and I am done, I cough real hard almost like I am gagging but I don't throw up, more so after larger meals.
All of this has definately affected me (sleep, personal life and work life). I am a male, married and chid on the way 29 y/o smoker (I am going to quit), non-drinker.
Sorry for the long note, but any insight sure would be nice.
Thanks,
Refered to Infectious disease specialist and he ran a battery of test all were normal except for titer test for CMV and said that we was probably what caused my symptoms above. Then about 3 months after that (still not feeling my normal self), I began to experiend mid upper back pain that was felt to left part of my back. Over the past couple of years the discomfort has gotten worse and for a little over a year the pain is also in my upper left abdominal region, more of a dull ache sometimes sharp. This discomfort in my back and front is almost constant and really interferes with my day to day life. During this time I have seen multiple doctors (2 Neurologists, 1 Pulmonologist, 2 Infectious disesase specialists, 1 Gastroenterologist, 1 urologist) and have had many test:
CT and MRI of brain and spine - Normal
CT of chest and abdomen - Normal, except for hemangioma on Liver (had MRI and ultrasound of liver everything is good)
two Abdominal ultrasounds - Normal
Endoscopy - Normal (mild gastritis)
Colonoscopy - Normal
CBC - Normal
Liver Function - Normal, except ALP was slightly elevated a couple of times over a 4 month period, had isoenzyme done it was normal told not to worry about it
CA-19 - Normal
Pancreatic enzymes normal
ESR Multiple times - Normal
C Reactive Protein - Normal
Misc. other blood test all normal
Cholesterol is high, told it was hereditary, on Vytorin it is now 156 and LDL went up 10% and triglycerides went down as well.
Diagnosed with Acid Reflux disease take prevecid.
My doctor now wants me to see a Psych. who specializes in Pain Management.
Here is my concern of all the test they have found nothing, but the discomfort and pain still exists and is not getting better. It seems this is something I am just going to have to deal with, but it trully is no way to have to live. I am fearful that there is something they have missed, your thoughts?
I have always been a thin person prior to the start of all this 5'10 about 157 lbs., but since this I have put on tons of weight I weigh close to 190 lbs. now. My doctor has told me that if this were something life threatening ie. cancer, I would more than likely be dead by now because it would be everywhere and it would have alread manifested itself.
I also have this weird thing that almost every time I eat and I am done, I cough real hard almost like I am gagging but I don't throw up, more so after larger meals.
All of this has definately affected me (sleep, personal life and work life). I am a male, married and chid on the way 29 y/o smoker (I am going to quit), non-drinker.
Sorry for the long note, but any insight sure would be nice.
Thanks,
Doctor's Answer
by Kevin Pho, MD, Jan 23, 2005 12:00AM
, Jan 23, 2005 12:00AM
You have clearly had a comprehensive evaluation. The good news is that if there was any serious disease present, it would have shown up on the one of the tests that you have had.
If there is an association with food, you can consider more specialized GI tests - including esophageal motility testing as well as a gastric emptying scan. These tests would rule out esophageal motility disorders as well as gastroparesis respectively.
However, if every test is non-revealing - I would agree that a pain management referral would be a reasonable next step. If 7 doctors are unable to pinpoint the cause of the discomfort, there are some cases where no disease can be found (i.e. idiopathic) and the symptoms themselves should be treated.
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
If there is an association with food, you can consider more specialized GI tests - including esophageal motility testing as well as a gastric emptying scan. These tests would rule out esophageal motility disorders as well as gastroparesis respectively.
However, if every test is non-revealing - I would agree that a pain management referral would be a reasonable next step. If 7 doctors are unable to pinpoint the cause of the discomfort, there are some cases where no disease can be found (i.e. idiopathic) and the symptoms themselves should be treated.
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
http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/
Most doctors never check for parasites either. What did you do just before you caught your "virus"? You can try a colon cleansing kit at a place like GNC. My friend is trying that now and said it is helping. He used this link:
http://www.drnatura.com/
Make sure they check you for hepatitis too. There are a lot of great doctors out there but as sad as it is, there are twice as many who found out how to make a living by charging insurance companies to jerk people around.
have pain in upper left stomach area, just under diaphragm. This
may be a little higher than where your pain is (but "adominal (abdominal) area" can be a large area). With all the tests they gave you, did they ever do an upper GI/barium x-ray? This was the only test that found my problem. If the stomach becomes more strangualted, it can result in death. Surgery is necessary, so I'm told.
I have never had any medication for IBS, but it is something I can discuss with my PC.
Also, I have had a barium x-ray, that is how my reflux disease was found.
I thing the doc on the forum is right and the many doctors I have seen, it is something that I will have to manage with Pain Management.
Thanks again.
It is called Hiatal Hernia Syndrome by Theodore Baroody.
He talks about many of the symptoms you are experiencing.
The reason I have the book is because I am having serious gastrointestinal problems.I'm searching for the answer just like you.There has to be an answer - all we have to do is find it. Have faith!!!