Upper left quadrant pain for 3.5 years

I'm having upper left quadrant pain for the last 3.5 years and its non-stop.I've consulted many doctors and the last one I met said I have IBS.The pain is just below my left ribs and seems to radiate throughout my left chest.

It all started when I was in college (I had no LUQ pain at the time), I was never able to void my tummy, I was able to to do so only partially. In the morning when I used to leave for college (32km away) taking a bus I would get terrible pangs to go to toilet but wasn't able to. When I reached the college there wasn't any toilet around so used to hold it....this went for some time....I always had digestive problems but I'm not sure why my LUQ pain started, maybe my college problems experiences are to blame.

I also had dental braces at the time and used to take painkillers (Ibuprofen) !

This pain is driving me nuts.I've had a USG, a partial CT scan of abdomen (partial because I wasn't bale to void my tummy so docs couldn't draw inference on the colon), and an endoscopy that said I have GERD.
I have a colonoscopy scheduled this friday.

Can anyone please tell me whats wrong? I have a feeling my splenic fexure is to blame, its location perfectly matches the place where my pain is, the pain is there all the time - ALL THE TIME, and I think it maybe be more of a physical injury resulting in something like a hernia ! Help me out !

[patient915]

Welcome to the gastroenterology community!  By "void your tummy" do you mean have a bowel movement?  Also not being able to have a bowel movement doesn't affect a CT scan so I'm confused why your CT scan was only partial.  Also endoscopies can't really diagnose GERD, they can only give the doctor a suspicion that the problem may be GERD.  The endoscopy will also often show a hernia, if one exists.  What problems do you have with your bowel movements?

[warrior4488]

Yes, I wasn't able to have a bowel movement.The ct scan was partial as in the report said "Colon distended with fecal residue", therefore docs couldn't draw any inference !

PS : I wasn't told I have to prepare the day before for a cat scan, was simply told to come empty stomach !

[mrsmup]

Hi,
I totally understand the pain your in.
  Please read my post ( Total Colon filled/coated with stool) Dec 17. I would not be surprised if you  are suffering from a redundant colon also.
  I have been trying to clear  myself with Dr orders for 1 month now.
  My Dr  perscribed tramadol which has helped make the pain half what it was.
  ggreg also answered my post with some great
info.
My Dr told me that the colon has pain receptors
In the nerves that react when it expands/enlarges.
  He said you can cut it in two and the pain
receptors would not react like when stretched.
I found that interesting.
Good Luck
Mrsmup

[warrior4488]

Thanks a lot !
Just one question, can LUQ pain (in my case just below the left ribs) be associated with the colon ?
I saw some diagrams and it seems the splenic flexure is exactly in the same place where my pain is !

[mrsmup]

Hi,
All I know is the colon starts on the right lower quadrant where the small intestine empties into it
near where the appendix is.
It goes up the right side (called the ascending colon).
Then it goes across the upper abdomen from right to left below the ribs (called the transverse colon)
Then down the left side to the rectum (called the decending colon)
You have a curve between the transverse colon and the decending colon /or many curves or extra length (redundant colon) which can slow down  the movement of stool -causing constipation or impaction/coated.
That is what was explain to me. As far as the other thing you mentioned about the spleen, I really have no idea or info on that. Maybe someone else will read and post on that.
The pain is physically and mentally exhausting
and I feel for you. Hopefully your colonoscopy will be full of info for you.
Mrsmup

[patient915]

The splenic flexure doesn't really have anything to do with the spleen (besides location).  The splenic flexure is just the curve your intestine makes in the upper right quadrant.

On the CT scan, having a colon full of stool doesn't really affect the quality of the other things the CT is looking at.  The standard procedure for a CT scan is to have an empty stomach (emptying your intestines doesn't matter) and sometimes includes drinking contrast and/or getting IV contrast.

[warrior4488]

My colonoscopy report came back. The report initially stated that the colon was oedematous and congested. A sample was sent to biospy which concluded it to be  a non specific colitis. I wonder if it has anything to do with my pain !

[TooYoungToFeelThisOld]

Hi! I have had the same upper left quadrant pain (below my left ribs, radiates to the back sometimes and lest chest). It's constant... They told me I have very mild gastritis/GERD and have been taking a PPI. However, after changing my diet and being on the PPI for 1.5 years I *still* have the constant upper left quadrant pain. I'm starting to suspect my spleen as well.

I just applied for an appointment at the Mayo Clinic in Arizona, so if you haven't got your situation straightened out, perhaps I can share my own experience with you!

Have you had any blood tests done, specifically liver panels? I've found that all of my tests reveal an elevated indirect bilirubin and high lipase. (Not sure if this has anything to do with the pain, but they can reflect problems with the spleen, which is where the pain is.)

[warrior4488]

@TooYoungToFeelThisOld

Are your BM's inconsistent and irregular....

As of now I'm treated for IBS, I just had a second colonoscopy which said everything was normal. My problems started of with irregular BM's as mentioned, when I was in college.

[warrior4488]

What is your pain like, does it hurt when you breathe or stretch your body. Spleen pain generally hurts by moving and can be felt, I saw this on internet coz I too suspected the spleen...I'm not sure whats causing the pain...but clearly my irregular bowel habits are to blame.

[TooYoungToFeelThisOld]

Hi!

Yes, my BMs are inconsistent and irregular, but I can't remember a time that they were regular. I just don't 'go' as often as other people, it seems, but I eat more than anyone I know. However, when I do it's always hard stools.

The way our pain started is definitely different, but the pain itself sounds very similar. The pain on my left side generally feels achy, dull, constant and localized. My chest often hurts when I breathe deeply, and my stomach often hurts if I stretch my body. The biggest, most disruptive symptom for me, is shallow breathing. Most of the time I feel I can't completely fill my lungs, and I don't sleep on my left side anymore because I can't breathe as well.

I've had a colonoscopy which produced normal results, as well as two upper GI scope procedures, CT scans, MRIs, MRCP, ultrasounds - and everything has looked normal so far, aside from what they call a mild case of gastritis and GERD. So I've turned to my blood which is producing abnormal results.

I just had blood drawn for a myriad of tests. If I find anything, especially related to the spleen, I will definitely let you know, just in case.

Is there any way of treating the IBS symptoms? Or rather, have you felt better recently? Or are you still experiencing the pain in your upper left abdomen?

[warrior4488]

IBS has no specific cure, but yes it can be reduced through some medications.
My pain hasn't changed, rather its turned into some sort of sharp pain under my lowest left rib. I have a feeling my habit of sleeping on the left side has somehow pushed my floating rib inwards causing the pain...still not sure....I'm sick and fed up. The medical care where I stay here in India is definitely not good enough.

I've had two colonoscopies, 1 upper GI endoscopy and 1 cat scan. I'll be having another scan in a few days.

[TooYoungToFeelThisOld]

That sounds absolutely miserable, and is about the same care I've received here in the States. >.< I always feel like doctors are in a hurry to rush me out of the door, claim I'm "fine" or diagnose me based on symptoms alone without checking in to it and/or confirming. I've run out of steam a couple times over the past 2 years, and just decided "screw it". But then my side will start to hurt and it lights a fire under my arse (no pun intended, lol!) and I start fighting again. Don't give up!

Also, what kind of blood work have they done? I assume they've done Vitamin B panels, Vitamin D, CBC, liver and basic metabolic panels? If not, you should definitely ask (read: demand) they do these to make sure it's not a bigger problem.

Also, re-reading your initial post I saw you also have GERD. This definitely causes a myriad of uncomfortable and painful symptoms. I just responded to a young girl here: http://www.medhelp.org/posts/Gastroenterology/Gastritis-or-asthma/show/1468277#post_7556796

You may find this useful.

I'm in the same boat and I know it's tough - I'm rooting for you. Good luck with your upcoming scan.

[warrior4488]

They've done CBC,ESR and liver function tests. Nothing with regards to Vitamin or metabolism. As for my GERD, it was only confirmed through an endoscopy...no other tests were done...my uncle who's a Doc in NY says its more like IBS after he consulted with a Gastroenterologist.

As for my LFT done over a span of 3 years my ALT/AST levels have been consistently high, Docs said it could be fatty liver(though I'm thin)...but still I'll be talking to my Gastroenterologist to check for hepatitis.BTW, my bilirubin levels are normal.

[Ace980]

It sounds like you have splenic flexure syndrome (SFS).  This causes pain under the left ribs when gas gets blocked there.  You must have good medical insurance.  The (so called) doctors treating you are milking you for every test they can come up with.  NO TEST WILL SHOW SPLENIC FLEXUE SYNDROME.  Also, you likely do not have IBS.  Check the Rome-III (Google it) criteria for IBS and see if your symptoms really match.  I wish I could give you some way you could be diagnosed and treated but unfortunately SFS is not recognized as a chronic condition in the USA.  The only CURE is surgery.  The Chinese medical community has long recognized this condition and how to diagnose it (barium enema) and treat it (remove the splenic flexure part of the colon).  No doctor in this country will even discuss removal of part of your colon.  They will be more than happy to remove your entire colon.   Good luck.

[warrior4488]

Thanks a lot. You bumped up a more than an year old thread. Well I'm in India so access to qualified doctors and medical care is hard, not to mention the expense. But I was fortunate enough to talk over the phone to a Gastro in the USA (an Indian Gastro btw) who did say it was SFS.

Thankfully my SFS is gone but not my IBS and along with it a barrage of painful symptoms & disorders are still present.