Pain in upper left abdomen

[barefootmama82]

Hi. I am a 25 year old woman who for the past 4 years has had persistent and growing pain in the upper left quadrant of my abdomen. It is an almost constant pain felt more acutely when I sit and most when I lay down at the end of the day. It was relieved significantly during my pregnancy (my daughter is 18 mos now) but returned even more severely soon after I had her. I have been to various doctors and undergone blood tests, x-rays, a colonoscopy, sonogram, and most recently a CT with contrast and barium. I have been told that I have a range of things from a detached floating rib (what?) which I don't have, to IBS but nothing of major concern. Most doctors just ask how my bowel movements are and prescribe citracel (1 spent 5 min with me and prescribed an anti-depressant to "relax my bowels?"). This past week, a CT revealed that I had a "slight dilation" of my gallbladder though not enough to raise concern with no presence of stones. An x-ray done a bout 5 months previous also revealed that I had slight swelling of my spleen but also "not enough to make mention of (even though it was mentioned)". The most recent doctor sent me away saying she could not find a cause and some people just have pain and that I was just too "in tune" with my body. I am so frustrated and tired of living with this constant pain. When I read up on symptoms, I keep coming back to chronic panrceatis but the last doctor said she ran a blood test for it after my CT (along with a liver panel) and it was normal. Should I keep pushing or just "live with it"? More importantly, what kind of doctor should I see for this because general practitioners don't seem to want the job!

[kaufy]

I am a 36 year old male who occasionally drinks wine but I also run at least 2 to 3 times a week (kind of off and on).  I had taken antibiotics last year form H pylori which my dermatologist found after recommending a blood test becasue I kept getting hives.  I noticed that I would also get heartburn frequently.  Well, since the antibiotics, the hives and heartburn are gone, but lately (as in over 6 months now), I have noticed that gas has really increased.  I have also had slight would I would describe as very slight growing pains on my upper left side stomach just under my rib cage.  I had tests taken which showed acceptable liver, kidney and glucose function.  The ultrasound showed fatty liver changes a couple of weeks ago.  They want me to come in for another doctor appointment and possible labs next week.  Should I be concerned?  I noticed that backing off of the caffiene helps a little with the supposed growing pains, but does nothing for the gas neither does what I eat help in that area.  Oh yeah, my cholesterol was historically been high and I stopped taking Crestor over 8 to 9 months ago.  It's probably back up again.  Just a little paranoid.  Any thoughts?  

[Kevin Pho, MD]

I agree with the testing thus far.

You can further evaluate the upper GI tract with an upper endoscopy, which can look for an ulcer or inflammation.  The CT scan would make diseases like chronic pancreatitis or splenic diseases less likely.  

More specialized tests can be done, including a 24-hr pH study looking for GERD or a gastric emptying scan looking for gastroparesis.  

If the tests continue to be non-revealing, irritable bowel disease can be considered and its treatment optimized with possible antispasmodic agents.

These options can be discussed with a GI 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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com