severe upper left quadrant back pain - plus

[jogt]

I've had severe gastritis and diarrhea for over 2 mos. and have gone off antibiotics, neurontin, and celebrex during that time.  Have had a negative CT scan and many negative blood tests (including hepatic panel)- except for high glucose - and negative culture for H. pylori.  The pain is nearly constant in some part of my mid-abdomen, but is horrendous when it goes to my back, left of spine, above the waist, and lasts for hours - usually starting in afternoon, and worsens with lying down.  Can't get in to see the G.I. specialist for 6 weeks - and in the meantime am suffering daily.  Sometimes, before the really bad back pain starts, I feel pressure on each side of my waist, as if someone was squeezing me with 2 hands.  If I breath in deeply, pushing out my diaphram that internal pressure gives a tiny bit of relief - but only Hydrocodone 7.5-500 alleviates the worst pain for about 4-5 hours.  Having ruled out liver and pancreatic cancer, but still suffering, what are the most probable diagnoses?  What happens next?

[Kevin Pho, MD]

You note a negative CT scan and negative hepatic panel and culture for H Pylori.  

The next test I would consider would be an upper endoscopy.  This would comprehensively evaluate the upper GI tract, looking for inflammation, an ulcer or any mass effect which may be causing your symptoms.

I would also consider an abdominal ultrasound to better evaluate the gallbladder and liver.  Another test to evaluate the gallbladder function would be a HIDA scan with CCK stimulation - I would consider this test if there continues to be suspicion of gallbladder pathology with a normal ultrasound.

Other tests to consider would be evaluating the pancreatic enzymes and making sure chronic pancreatitis isn't the case (this disease, as well as peptic ulcers can cause pain radiating to the back).  

In any case, the GI referral is the right next step.  You may want to discuss these tests at your consultation.

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.

Thanks,
Kevin, M.D.

[yoshi]

could be yeast infection (from taking antibiotics) and too much gas produced by your stomach.
there are several over the counter medication for neutralising gas,some like alka selzer has sodium,so read the label.
these medication will remove gas already in your body,it wont stop your body from producing more gas.

[Applegeek]

A heating pad and heating patches will help the pain until you can get into the doc.

[jack2044]

For 2 wks I have had pain in the upper left quat. it does sometimes raditate to the back. Also been having nausa.I have had an appitite though.I just had a baby 2 mo. ago . Could gallbadder cause any of this problem?