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Gastroenterology (Expert Forum)
Middle Epigastric pain and possible mass?
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.
Middle Epigastric pain and possible mass?
by inspired, Jul 11, 2005 12:00AM
For the past 4 months, I've been getting occasional mid-upper epigastric pain radiating to the mid spine, occurring within 5 minutes to 2 hours after meals, lasting for 2-3 hours.
For the past 2 weeks, these same attacks have increased to 1 to 3+ times daily, no matter what I eat, painful to the point of rapid heartrate, perspiration, restlessness and tears.
Additionally, centered about 2 inches below the sternum, I have a very tender spot which is where the pain originates and on palpation is a hardened very tender area 2 cm wide by 3 cm long.
The pattern of pain and location with these attacks are different than previous gallstone attacks I had 5 years ago. It is to the point where I don't want to eat because I am afraid of the subsequent painful attacks.
Additionally, I am on desiccated thyroid 120 mg and have hypoglycemic episodes which existed before the hypothyroidism diagnosis.
Any ideas on what could be going on and the proper course of treatment would be very much appreciated. Thanks.
For the past 2 weeks, these same attacks have increased to 1 to 3+ times daily, no matter what I eat, painful to the point of rapid heartrate, perspiration, restlessness and tears.
Additionally, centered about 2 inches below the sternum, I have a very tender spot which is where the pain originates and on palpation is a hardened very tender area 2 cm wide by 3 cm long.
The pattern of pain and location with these attacks are different than previous gallstone attacks I had 5 years ago. It is to the point where I don't want to eat because I am afraid of the subsequent painful attacks.
Additionally, I am on desiccated thyroid 120 mg and have hypoglycemic episodes which existed before the hypothyroidism diagnosis.
Any ideas on what could be going on and the proper course of treatment would be very much appreciated. Thanks.
Doctor's Answer
by Kevin Pho, MD, Jul 12, 2005 12:00AM
, Jul 12, 2005 12:00AM
Various causes of dyspepsia should be considered. This can include an ulcer, GERD, or inflammation of the upper digestive tract.
An upper GI series or upper endoscopy would be reasonable initial tests. You can also obtain blood tests looking for H Pylori - a bacteria that is associated with ulcers and inflammation.
If the GI workup is negative, you can go the cardiac route and consider a stress test to exclude coronary disease.
Regarding the hardened, tender area - this is difficult to say what it is without examination. If there is a mass in the area, a CT can be considered for further evaluation.
These options can be discussed with your personal physician.
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.
http://www.straightfromthedoc.com
An upper GI series or upper endoscopy would be reasonable initial tests. You can also obtain blood tests looking for H Pylori - a bacteria that is associated with ulcers and inflammation.
If the GI workup is negative, you can go the cardiac route and consider a stress test to exclude coronary disease.
Regarding the hardened, tender area - this is difficult to say what it is without examination. If there is a mass in the area, a CT can be considered for further evaluation.
These options can be discussed with your personal physician.
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.
http://www.straightfromthedoc.com
