Upper left Abdominal pain

[victoras ruff]

I am a 48 year old female.  In August of 2002 I developed a sudden severe pain just left of my upper-mid abdomen which radiates into my back.  This occured about 20 minutes after eating and would continue for several minutes to hours.  My doctor diagnosed me with a stomach ulcer by my symptoms and by the fact that I had previously been treated three years prior for h-pylori bacteria and I was treated with the medications appropriate for this condition, but the symptoms never got any better.  It hurt for my abdomen to wiggle or to have any pressure on it so I had to quit wearing anything with a waistband, yet when I lay flat, such as for a doctor exam and he palpatates my abdomen the only real tender spot is the stomach-pancreas area.  The care here in Las Vegas is slow as you have to wait a month to six weeks for any doctor visit, so this has stretched out to be four years that I have been trying to get help for my severe pain.  I have just about quit riding in a car as it increases the pain and I am unable to eat more than 500 calories a day and am on a feeding tube as my weight got too low and taking 20mg of morphine every four hours. The pain goes away only when I fast.  The pain in my left side has not changed except that I now (last month)have pain on the upper right side to my back which is the same type of pain I've had on the left.  I have had three upper endoscopys which show mild gastritis.  CT scans are normal except for scaring from previous surgeries (c-sec-1981/partial hysterectomy-1988/gallbladder-1999) I developed an infection in my colon (bloody diarrhea/vomiting) in June and spent three weeks having tests run at Mayo clinic in Scottsboro, AZ.  They diagnosed me with very mild gastroparesis which they said involved both my stomach and last part of small intestine.  I believe that the reason that I had the colon infection/gastroparesis is the amount of pain meds I was on and I am not satisfied that it is a right diagnosis for the primary problem. as I have never vomited undigested food.  My Amalase level has never been elevated, but my lipase was 88 at last blood drawn.  My doctor said some of my liver enzymes were elevated when I had the colon infection, but normal at last check.  Should I resign myself to this slow death or is there something that could still be checked.  Have never had an ERCP.
Could it possibly be a duct problem which has been overlooked?
Thank you.

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation with CT scans and multiple upper endoscopies.  You have also been evaluated for gastroparesis.  

Further evaluation that can be considered would be a 24-hr pH study with esophageal motility studies to evaluate for GERD and motility disorders.  

Biliary problems typically present on the right, not left side.  However, atypical symptoms can present on the right.  If this is considered, you can consider an ultrasound to evaluate the liver and gallbladder.  If there is concern about the biliary ducts, an MRCP can be performed.  

If the tests continue to be negative, irritable bowel disease can be considered.

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

[JANIEL]

Finally, someone who knows what I am going through as well. I have pretty much the same issues. I had my gallbladder out 4 years ago and have been in pain ever since. Gastroparesis, bile gastritis, barrets esophagus, and sphinctor of oddi dysfunction. I hurt when I eat, upper right pain and tenderness. After 5 doctors and no help with the pain.  I have no more more doctor, because they can't fix me.  It does feel like a slow miserable death. I am sorry you are dealing with it. I am 95 pounds now and can't get weight on.  An ERCP is a good idea.  It will show a lot of good information.

[victoras ruff]

Thanks for writing.  I am so sorry for what you are going through.  It does sound very much like you and I have the same problem.  I know how you feel.  I hope we can keep in touch so we can perhaps help each other.  I very much want to live and be healthy.  I thought that I would loose my mind with this pain after one month of it, and here it is going on four years now.  I have always felt that my problem started with my gallbladder surgery (laporoscopy).  One week after surgery I woke up suddenly in the middle of the night with a pain I would rate on the scale of 1-10 a 20.  (Much worse than childbirth)  The healthcare people in ER could not give enough pain med to help.  It was like being raped.  Then the surgeon made a short stop at my bedside 8 hours later when the pain had subsided to say "I think you had a bleed."  I have a very supportive family, thank God, and still have hope.  My e-mail is ***@**** if you would like to contact me personally.  Keep looking up.

[JANIEL]

Wow, it is amazing how many of us there are out there with this issue.  I can't believe that there in no one that is better.  Scary thought.  I tried your email and it came back undeliverable.  Could have been my fingers.  My email address is nellie_1032***@**** if you either of your want to contact me. I hope that you are not having a real bad sick feeling day.  Keep your chin up.  Janiel