Left Upper Quadrant Pain

[justgotpaid]

I am 30 year old male, and have drank for about 10 years, mabie 12-30 beers a week.  I recently stopped drinking. I have upper left abdominal pain for 1 year 3 months.  I have had many tests done, endoscopy, colonoscopy, upper GI, Cat scan, liver/spleen scan, and numerous blood tests.  These include Hepatitis panel, 5 liver function tests over 1 year, HIV test, and CMV and mono testing.  The only things that have been found were H. pylori(negative on blood test, positive on byopsi), mild gastritis and esophogitis, mild reflux, one elevated alkal. phos. of 131, and elevated albumin of 5.3. The next blood test was normal. I was treated for the H.pylori. And my spleen measured 14 cm on 1/13/06, and 14 cm again on 6/26/06, and is considered mildly enlarged.  The GI doctor and the oncologist both told me that my pain was not splenic in nature, and was most likely reflux related.
     My question is could a 14 cm spleen be causing pain, and with no causes found for spleenic enlargement what causes this.  The oncologist did find an old EBV virus, but he said it was not active.  Could an old EBV virus casue splenic enlargement? The test was EBV VCA 4.54, and EBV nuclear antigen 3.48.  This mild spleenic enlargement has me very worried, because they cannot tell me why.  Is this chronic pain from gastritis and mild reflux.  I take previcid, but it really dont seem to help. I know with 2 specialist telling me it is not spleenic pain I should listen to them, but every time I hurt I relate the pain to my spleen.  Help please!!

[Kevin Pho, MD]

You have had a comprehensive evaluation that would rule out major of the major disorders.  The CT scan would make splenic disease less likely.  A spleen of 14cm is indeed enlarged, and may be the cause of the pain - although your physicians seem to have rule this possibility out.

Obtaining a blood count and viewing the peripheral smear can help with the diagnosis.  

If the tests continue to be negative with continuing pain, removing the spleen surgically can be considered.  However, I would continue to look for other causes first - including other GI causes (i.e. esophageal spasm, and delayed gastric emptying), musculoskeletal causes and evaluating the lower lung.  

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.
kevinmd_

[justgotpaid]

I recently read a study which indicated that larger healthy people may have larger spleens.  For instance, a healty 19 year old male, 6'2" had a spleen that was 16 cm long.  So since i am 6' tall, could it possibly be that I have a larger than normal spleen?