Upper Left quadrant pain

[TooMuchStress]

I am 26 years old,female and about a year ago I started feeling a general discomfort under my left rib cage, so I paniced and got a endoscopy and colonoscopy, all came back clear. So as time went by the pain continued and I paniced again, thinking it was pancreatic cancer, I had a ct scan which showed a kidney stone on my left kidney which i have had removed but everything else was fine and still have the pain. I have malabsorption issues too. My doctor did blood work, checked amylase and lipil err whatever and it was fine. He did a ca 19 9 and that was fine. The pain is getting worse, it hurts through to my back up to my shoulder blades. It feels like alot of pressure, like someone is jamming there elbow through my upper stomach. I have spurts of sharp pain shoot through my lower abdomen sometimes. I noticed I cannot eat as much as I used to, and I have indigestion alot. I am convinced its a problem with my pancreas but my doctors think it is in my head. I have had 3 ct scans in the past year and my doctor offered to do a 4th, in all fairness only one was for my abdomen, the other two were looking for the kidney stone with no dye. I am worried about the radiation exposure, and my pancreas.I dont know if I should just do the ab ct scan again and then just let it go if it comes up clear or go see a specialist, which i did about two months ago who did a colonoscopy which was ok. Im not asking to diagnose me, but please give me some guidance because my next stop is a shrink.

[Kevin Pho, MD]

The endoscopy and colonoscopy would rule out many of the major GI tract disorders.  I agree with the pancreas also being possible, and the CT scan would have ruled out this possibility.

Atypically, the liver and gallbladder can present with left-sided pain.  An MRCP can evaluate the biliary ducts.  

More specialized GI tests such as a 24-hr pH study (looking for GERD) or a gastric emptying scan (looking for gastroparesis) can be considered.

Blood tests for celiac disease can be done, as well as looking at non-GI causes.  This can include muscle pain, lung diseases or heart disease.  Obtaining an echocardiogram as well as imaging the lungs can be considered if these avenues are suspected.

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.
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