Longterm Localized Acute Intestinal pain

[Heather__0__0]

Posted By  HFHSMD.-rf on January 21, 1998 at 22:55:48:

In Reply to: Longterm Localized Acute Intestinal pain posted by Heather on January 17, 1998 at 18:43:36:

: Approximately 2 years ago I began to experience a sharp pain in my
  left side at a level equal to my naval.  This pain has remained with
  me ever since it first started.  It feels like a knife in my side.
  There is no other sign or symptom such as constipation or diarrhea.
  The pain doesn't seem to intensify or go away at all.  I can be
  woken up in my sleep and I am generally aware of it all day.  The
  tests I have done include urine and blood work (I don't know exactly
  what they tested for).  I have also had an abdominal xray and ultrasound
  that showed I have gallstones and a benign cyst on my ovary that
  the doctors say are nothing to worry about.  Could gallstones create
  referred pain in this area which seems to be quite far removed from the
  gall bladder?  I have also had a vaginal exam and pap test which all
  were negative.  I worry that cancer could be causing this.  Can you
  suggest any possible causes for this pain?  It has been suggested that
  I have a test that would examine the lower intestinal tract by the
  use of some camera that would be inserted anally.  If this proves
  negative I understand the other options are barium swallow or exploratory
  surgery.  Any advice would be greatly appreciated. Thankyou for any
  help. Heather.

[HFHSM.D.-rf]

Dear Heather,
Abdominal pain is a common complaint for individuals who consult with a gastroenterologist.  There are a large number of possible causes for pain.  The probability of any specific condition causing the pain is influenced by the location of the pain, factors that make the pain better or worse, patient’s age and concurrent symptoms.  Therefore, it is difficult to provide a detailed list of diagnoses of conditions that could cause your pain.  However, it is possible to provide a list of structures that can cause pain in the left navel region.  Inflammation of the stomach, pancreas, colon or small intestine can produce pain to the left of the navel. Evalaution of these possibilities can require X-ray studies and/or endoscopy, insertion of a video camera into the gastrointestinal tract.  The test that you mention in your letter is a colonoscopy.
Your letter indicates that your physician considered kidney disease, another possible cause, and evaluated this possibility with a urine test.  It is necessary to know exactly what type of urine test was done to be certain that kidney problems are not the cause of your pain.
It is unlikely that gallstone pain (to be more precise pain from an inflamed gallbladder) is being referred to the left side. Gallstones usually cause abdomen pain in the center of the abdomen between the ribs.  Typically "gallstone pain" is a steady discomfort which gradually increases over 30 to 60 minutes, remains constant for another hour and then gradual subsides.  Pain can radiate to other parts of the abdomen, to the back, and to the scapula or tip of the right shoulder.  Many older textbooks state that eating fatty foods precipitates the pain associated with gallstones. In the last few years, however, we have recognized that the association between fatty foods and gallstone pain is not as great as had been proposed.  
Given the frequency with which cancer is diagnosed, many people fear that any abdominal pain can be a symptom of cancer.  Although cancer is usually not the cause of pain in the absence of other symptoms, it is incumbent on the physician to evaluate patients for cancer.  
With regard to other possible tests, you should have appropriate barium or endoscopic studies.  You may want to ask your doctor whether he thinks the information from a CT scan of the abdomen would help him investigate possible causes for your pain.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution, please call 1-800-653-6568, our Referring Physicians Office and make an appointment to be seen with Dr. Fogel one of our experts in the investigation of abdominal pain.
HFHSM.D.-rf
keywords: abdominal pain, cholelithiasis, biliary colic
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