Upper left abdominal pain

[gia_antony]

I'm a 22 year old female and recently I've been having upper left abdominal pain, just below the rib cage. In the beginning it was a mild pain, like someone’s fist was pressing into the area, but it has continually gotten worse. The first time I saw a doctor he believed I had a stomach ulcer and gave me a week’s supply of antacid pills. The pain felt better for a few days, but was back before the pills were done and I had begun to feel pain in my lower right abdomen as well.

I returned to the doctor and he ran a CT scan of my abdomen. He discovered fluid in the abdomen and swollen lymph nodes. He did not believe that these were important. He prescribed an intestinal muscle relaxant. I took the pills for a few days with no change in the pain. I then developed a spotty rash on my legs and discontinued the pills per the doctor’s orders.

A few days later the pain had become severe. I could not sleep and could find no position in which I wasn’t in pain. I was taken again to the hospital and given antacid pill and intestinal muscle relaxants, which only mildly relieved the pain, and an endoscopy was scheduled. The endoscopy showed a healthy esophagus and stomach, with the exception of a polyp where the esophagus meets the stomach. The doctor did not feel that a biopsy was necessary nor that the polyp was the cause of the pain. I was given Pariet and Loxonin and sent home.

I am currently living in a rural part of Japan and have found the doctor’s willingness to find a cause increasingly difficult. There is little to no communication between myself and the doctor, so I do not know why they believe that most of their findings are irrelevant to my pain. I know that I have normal urine and CBC, with the exception of white blood cells in the urine and a mildly low white blood cell count.

Any information you could provide would be helpful. Thank you.

[Kevin Pho, MD]

I agree with the CT scan and upper endoscopy.  Another GI opinion can be sought to see if the polyp is worth biopsying.

More specialized GI tests can be done to exclude more uncommon causes.  This can involve a 24-hr pH study to evaluate for GERD and a gastric emptying scan to evaluate for gastroparesis.  

If negative, irritable bowel can be considered and appropriately treated with antispasmodic agents or tricyclic antidepressants.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com