Constant Mid Upper Abdominal Pain

[amc776]

I am a 27 year old female who has been having pretty constant mid upper abdominal pain-moderate for 3 1/2 weeks now.  It started when I was on Zithrmax for a sinus infection.  It is usually worse at night.  I have a history of hemangiomas(largest is under 3cm) and possibly 1 hepatic adnemoma which my doc says he is not concerned about.  I had a CT scan done in October.  My general doc sent me in for an UGI which came back normal and have had numerous blood work(pancreas, liver, CBC and h.pylori) all came back normal.  When pain is at its worst, it sometimes travels to my back, below my shoulder blades.  I also had my gallbladder out 2 years ago and had an ERCP the day before the surgery.  The pain can sometimes run to either the left or right side under my ribs, but mostly its in the middle.  It is located high in the upper abdominal region.  I have also tried Protonix which has really done nothing.  Like I said, the pain is usually worse at night but I do have "tenderness" almost always.In the last 3 1/2 weeks, I've had 2 days without any pain.  When I lie down at night, I sometimes have an empty stomach feeling.  I even have a hard time taking deep breathes although I do have a history of anxiety.  I feel very bloated and distended all the time.  I also tend to drink a lot of pop(not caffefine free) and I do  smoke about 10 cigarettes a day.  My general doc told me to make an appointment with an internalist which I am in search of. I have no fever or nausea and otherwise feel fine, only stressed.  Could something be related to the antibiotics?  Or is probably just a coincidence?  Any ideas would be greatly appreciated.  I have had 2 CT scans done in the last 2 years since they found the tumors on the liver ( found incidently from ultrasound on gallbladder).  Showed no growth on hepatic adenoma and possible 1 cm growth on hemangioma but general doc had tests ordered and there was never a side to side comparison done.  Liver doc thinks there may have not even been growth.  I had just had a baby 4 months before having the 2nd CT scan and I know hormones can make them grow.  Is there also a chance it could be anxiety related?  I had moderate pain tonight, ate pizza which then made it worse, took 2 tums and then pain subsided somewhat but that is not always the case. There feels like there is always a heaviness as more so than pain during the day. I know I gave you a lot of info but I thought the more the better to explain to you.  Any input would be greatly appreciated.

[mymomissick]

OH, sorry, I've only ever heard LOL means laughs out loud. Now that I see what you meant, sorry about that.

Ill ask my dad about the anti-depressant thing.

Take care,

Adam

[krisg]

just thought I'd let you all know that "spasm of the gut" was one of my many diagnoses that a "not so good" doctor told me long ago.  It also goes along with the "IBS" diagnoses.  If I had just settled for those diagnoses 4 years ago, I would still be fighting the "unknown" and going out of my mind with pain.

[tuff case]

Have not heard of stomach muscle spasms? Is this something new you are experiencing since the endscopy or was it a diagnosis from your endscopy?  If it is something new what exactly are you experiencing? Pain where? how long? what meds were you taking? take care TC

[tuff case]

Adam,
I am so sorry to hear that your mom is not doing well.  Having a Dr. that sticks with you and believes that there is something wrong and works with you to resolve the issue really helps to maintain a positive attitude.  I have three only 2 right now are convinced that the nausea is IBS, however I am working on convincing them otherwise.  My PCP that changed my medication to the Reglan has really helped me maintain a posistive attitude lately.  As for the reglan after my first day without nausea after 1 year and  5 months I was literally in tears I was so happy.  However since I stopped taking an Anti-depressent that I was on for the IBS I have found that I have good days and bad days.  Taking an Anti-depressent with the reglan is a recommended treatment for my motility issues.  The Dr. however is took me off the anti-depressent because of side effects I was having to the Anti-depressent.  However I have since found out that the other nerve medication (for dizzy spells) I was taking (topamax) was contraidicated to take with the anti-depressent so they may start me back on that next week, we will see.  I also do still have pain.  My original pain was URQ to the point that I times I could not lay on my right side.  My pain since the 2nd ERCP is LUQ under my rib cage to my back.  In fact it has been worse also since I now stopped the nerve medication and the anti-depressent.  Last night for instance I could not lay on my left side.  
I do not know if a combination of the 2 drugs might help your mom but if she is upset it may help in more ways than one.  Have her check with her GI.  The theory behind the anti-depressent is that since the digestive system is a 2nd nervous system, when you are depressed, stressed etc you digestive system is effected. Mine is effected because of my other nerve condition.
Which motility test is your mom considering? Please keep us posted on your mom. LOL TC

[tuff case]

Adam,

I guess it depends on where you are raise for the LOL.  Here it could either mean "Lots of Luck" or "Lots of Love".  Never heard of your expression before and definitely not my intention to laugh because I know this is definitely not a laughing matter.  Also about the diabetes I know we are different in that regard.  They do prescribe the Anti-depressent to those that do not have the Debiates but for things like IBS although I am not saying this is what she has because it does not sound like it at all.  It was just a thought because I believe it may have been helping me a little more than the reglan alone.  You just never know what might help sometimes. Wishing you and your family lots of luck and love!! TC

[mymomissick]

Her pain is constant, not spur of the moment. She rarely has a day you could even rometely call a good day. Maybe some days are better than others, but no day is good. Her quality of life is horrible. She wants to live her regular life and go to work and take long walks, but she can't really do it. On her best day she can walk a little and make it through a couple clients at work. It's upper right quadrant pain. Today she was saying the spasms were more intense than ever, like they were under her rib cage.

Right now we're determined there is a motility test that she can have done, and it carries no risk. But we've determined that the reason my mom is scared is not for this test, but for what the results could lead to. The results would either be inconclusive and make her emotional pain all the worse than ever, or it can lead to a recommendation for a major surgery, to remove some part of her intestines or something. This is what the specialist in SF thinks is going on, a motility problem in the intestine, not SOD. My dad, again, an internist, agrees with this. My mom is scared of a major surgery. She thinks she'll die in the surgery. She's always been thin and trim and fit, but now she's skinnier than ever. Her will is low. Her intense pyschological state about thinking she will die, could actually transend into a physical reality, and it could be some sort of self fulfilling prophecy, and then SHE COULD ACTUALLY DIE. In other words, to have the surgery, she would need, I believe, pyschological help, therapy, what have you, to prepare for it, to get her will up for it so she would survive it. My poor parents are at their wits end with this.

Thanks for this dialogue,

Adam