Weird pain that won't go away.

[Wackybody]

I am a 47 y/o female. 3 years ago, I got what felt like, a gas bubble stuck under my left rib.  I couldn't take a deep breath.  It lasted two days.  My stomach was distended.  When my stomach went down, the pain stayed for days.  It kept recurring, then felt better after a few months.  About 6 months ago, it happened again, only this time it won't go away.  The "acute" stage keeps recurring, leaving behind this chronic pain that is up under my left rib, shooting out mid to upper back.  When I roll over onto my back at night, this spot in my back feels like a pinchy pain.  Sometimes the pain is gnawing.  I have negative blood tests, negative ultra sound and negative endoscopy.  I take Aciphex. (Two months)  This helps the heartburn a lot, but my symptoms will not go away.  I cannot eat within 2-3 hours of bedtime, and am now having trouble with hypoglycemia in the mornings, even after breakfast.  I am a nursing student under a lot of stress, but this is my dream and I feel if I don't get help, I will not make it.  The pain is 75% of my waking hours.  Sometimes eating takes it away for awhile, then about 1 hour later it is back worse.  Sitting at the computer (hunched up) will make it worse, as does getting tired (from walking around) I can't take Levbid, because of the side effects.  It almost feels like the gastrid problem has done something to my diaphragm or some other part of the area, because sometimes, after an acute phase, the whole area seems sore.  I am at the end of my rope.  Any SUGGESTIONS?

[Kevin Pho, MD]

With a normal upper endoscopy, this would rule out some of the more obvious causes.  A negative ultrasound would make diseases of the liver and gallbladder less likely.  You may want to look at more specilized tests which can be causing your symptoms.  The first would be a gastric emptying scan looking for gastroparesis (delayed gastric emptying), which can be responsible for your symptoms.  The second would be a esophageal motility study.  Any type of esophageal motility problems can lead to the symptoms you are describing.  

If not already done, I would also consider tests for the pancreas, including a CT scan, as well as serum amylase and lipase levels.

You may want to consider a referral to a GI specialist to discuss these tests.  

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.
Medical Weblog:
kevinmd_b

[Wackybody]

I forgot to add that I had a negative chest X-ray and CT.