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Digestive Disorders / Gastroenterology Forum
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Avatar universal

Undiagnosed Persistent Upper Left Abdominal PAin

I am a 39 year old female. For the past 2 1/2 months I have been experiencing upper left quadrant abdominal pain.  It tends to localize below my ribs but above the navel, about 3 inches left of center.  My side also gets tender and my mid back gets muscle spasmy. The pain has sometimes feels like a very tender pulled muscle, but also will feel like a sharper twinge (similar to what I've experienced sometimes when jogging).  When the condition was most accute in 4 wks weeks ago, even my skin to the slightest touch was ultrasensitive - almost like a rope-burn type of sensation.  I also had a wiggly, twitchy feeling in the muscles there in the upper lft. abd. and into my left side/flank.

I have NO nausea, vomiting, diarrhea, or constipation. I have not lost any weight and energetically do not feel sluggish. My oral temperature ranged from 98.8 - 100 F.  I also have pain in my left groin that feels like a groin pull and also near the front of of my hip bone.  I've also noticed that occasionally my left arm feels heavy and weak, with the grip in my left hand feeling weak as well.

I have had xrays, IVP, ultrasound and CT scan.  Initially my urine dip showed blood and it was thought i might have a kidney stone, but in further testing the urine showed 0 - 3 red blood cells, which I am told are normal levels, and the IVP did not turn up anything.  Only the ultrasound turned up a very small (1.6cm) hemmorhaggic cyst on my left ovary. The gynocologist did not think my pain, being up so high,  was caused by the cyst, and instead felt the cause was visceral and definitely not gynocological or musculoskeletal.  The CT scan also showed normal, although I was told there was some fluid in my pelvic area, which was attributed to the cyst.  All of my blood work has returned completely normal, including amylase / lipase levels.

I was then sent to a Gastroenterologist who asked me some questions, concluded it was muscular and sent me home to take ibuprofen.  She did not do a rectal or scope me.  Stool sample results came back normal:  no e coli, no giardia, no parasites, no blood.

I have been prescribed darvocet, levsin, ibuprofen and naproxen, none of which have made any difference.

Also - have eliminated dairy, alcohol, caffeine from my diet and added extra fiber. I eat no red meat and haven't for approx. 20 years.  I have smoked on and off for approx 20 years, most recently less than 5 / day, but have been smoke-free since 1 / 1 / 2000.  I do have GERD, but treated myself with herbs and diet and have not had a reccurrence in about a year.

I am at a loss for which way to turn for help next.  My primary care physician seems to be at a loss as well. I also had some thoracic and cervical xrays to see if I might have a pinched nerve causing the pain - nothing apparent showed.

Can you help with any suggestions as to what might be the diagnosis, or references to someone in my area (Boston) who might be able to help? I am also concerned perhaps something was missed on the CT or KUB xrays.  Should I have a chest xray?  Ultrasound of my spleen / pancreas area?  Did the CT scan cover this?

I appreciate your time and consideration and any advice you can offer.
89 Responses
Avatar universal
Dear Carol D,
It is impossible to shed any light on your symptoms via the Internet.  Your symptoms are not suggestive of a gastrointestinal problem.  If, however, your symptoms persist then you should yalk to your primary physician and express your concerns regarding the possibility of gastrointestinal disease.  Your primary doctor could arrange for stool studies as well as decide if any type of endoscopy is needed.
Avatar universal
I, and many others, have been experiencing these exact same symptoms for many years...
very very frustrating with no end in sight...

Rob
Avatar universal

   HI JUST A SHORT NOTE TO TELL U I HAVE THE SOME TROUBLE.  HAVE HAD ALL THE TESTS U CAN HAVE AND NOTHING IS SHOWING UP.  THEN AFTER A WHILE THE DOCTORS THINK ITS IN UR HEAD CAUSE THEY DONT KNOW WHATS WRONG.  MAKES ME FEEL BAD I KNOW ITS NOT IN MY HEAD.  LET ME KNOW IF U FIND OUT ANYTHING.  I WILL DO THE SAME.

    THANK U
Avatar universal
I noticed that I mis-spelled the name of the test that I am having next week, It is called an MRCP, which stands for Magnetic Resonance Cholangio pancreatography.  I am also seeing a kidney specialist on the 29th as from my CT scan they did find that I have a kidney stone on my right side, although they really don't think this is my problem I still have to get it checked out further.  Just curious, do you notice any correlation between the pain and your menstrual cycle????
Avatar universal
I have similiar problems that Carol has. I am a 48 yr. old female, that recently quit smoking(after 26 years), I thought I was attributing all of my problems to that. I also have hypothyroidism, and with the lack of nicotine present, my dosage was increased and then this problem arose. I have been to my surgeon complaining of severe pain underneath my left rib cage, also, and sometimes it protrudes around my side almost touching my backbone. I had a gi series performed and it showed that the barium drank stayed right in my stomach and took 4 hours or so to pass through, that's when my dr. started treating me for an ulcerated piloric valve. Medication prescribed--300mg. zantac a day, with the latest drug being dolobid. I go for more catscans this coming week. Maybe this has helped you?? And Lord only knows this pain is certainly NOT in my head.
Avatar universal
Your symptoms, sound just like mine, I've got 3 gastro-docs scratching their heads.... I've had an endoscopy, a colonoscopy a CT scan, Tons of blood work stool testing urinalysis etc. They know I have esophageal spasms and reflux, I take prevacid and LIBRAX, I've lost about 38lbs. I have good days and bad days, I just had a bad time last weekend, they did the amylase and Lipase testing-Negative this coming week I am having an MRCO, which is an MRI of the pancreas, I'm so scared that I could have Pancreatic cancer, I'm in my early 40's and I have a 4 year old child, so the prospect terrifies me. My brother lives in the Boston area and he raves about the LEAHY CLINIC in fact he want's me to come up there, I just might have to... Good luck to you
Avatar universal
I noticed in the previous post that I misspelled the name of the test I'm having it's called an MRCP-Magnetic  Resonance Cholangio Pancreatography.  I have been having my problems since July. and I am reaching my wits end....When they did my CT scan , they did find that I have a small kidney stone on the right side and though they do not think it really has anything to do with my pain , they are sending me to a kidney specialist. Just curious, have you noticed any tie in to your menstrual cycle??When I ask if it could be hormonal or enzymatic , they look at me like I am nuts....Good luck to you...MMN
Avatar universal
Grammoo: does the zantac help? do you notice if eating affects the pain? In my case, I don't think it does.

MMN: I have been trying to determine if I notice a difference with my menstual cycle. This month I had the sharp twinge pain all day no change the day before my period.

Keep me posted on any diagnosis.  THANKS!
Avatar universal
Hello,
     Your systoms are alittle like mine. But I have a chronic uncurable disease of my pancreas called Chronic Pancreatitis .The cause of mine has not been found yet. I was dx at the age of 18yrsold in May of 1996 and now its 4yrs later I'm still trying to find the answers. I'm 23yrsold almost and as every year that goes bye I get more infections and attacks of my pancreatitis. The enzyme blood test that you said of the amylase and the lipase ,has results of numbers and not negative or postive ,but if you counts are alittle above normal or alot than you might have pancreatitis ,but this only one test that you need to firgurie out if it is or not. the other tests are,
ERCP with manomatory ,MRCP ,Ct.scans,EUS,ultrasounds, all of the pancreas and stomach.
The doctor who does this is a gastro.specialist.
. I hope this info.helps alittle.
I have to go now as for my pancreatitis is atcing up.
thanks for listening.
yours truly
tammi G.
18954 tn?1314301717
I just arrived home from a hospital stay.  The pain you describe is so similar to what I experienced.  My diagnosis is colonic splenic flexure distention.  I don't yet know the cause or treatment, but will post another note when I find out next week. I do know what happens to the colon.  For some reason the splenic flexure on the upper left quadrant of the colon, up to the rib cage and around the side fills up with gas and extends upward to the diaphram.  The gas is trapped and cannot be expelled.  Thus causing severe pain and cramping not unsimilar to a severe muscle spasm. This was found by a simple x-ray of the abdomen, then I had to have an emergency colonoscopy, to find out the cause of the obstruction.  I'll let you know
Avatar universal
I TO HAVE THE SAME PROBLEM,I'VE HAD JUST ABOUT EVERY TEST THEY CAN THINK OF,AND ABOUT 14 DIFFERENT MEDS.DOCTORS ARE ALL SCRATCHING THIER HEADS,I HPE SOMEBODY IN THIS GROUP CAN COME UP WITH THE RIGHT ANSWER...HAS ANYONES DOCTOR MENTIONED POSSIBLE ADHESIONS????SOMETIMES MY PAIN FEELS LIKE IT IS PULLING WHEN I LIE ON MY RIGHT SIDE...
Avatar universal
I have very same symptoms as Pam and doctor can not determine problem. I would like very much a followup from Pam.
Avatar universal
Does anyone ever feel this discomfort or pain on the right side?  That's where it seems to be affecting me.  My mom says that I have the same symptoms that she had when she first began having trouble with IBS.  The doctor thinks it's stress or all in my head, because he can't find any physical reason for this.  Any ideas??
Avatar universal
I'm amazed to see so many people with the same problem which has not been diagnosed--I have so little faith in doctors. I had the same side pain like a sideache after running almost.  Drs. said I had gall stones & removed my gall bladder.  Guess what? I still have the pain. Also suspect cyst on ovary on L.side. I am nearly 62 & quit smoking 20+ years ago. I'm wondering if there is something wrong with my spleen, liver, etc. I've found it does very little good to go to Dr. unless you have already diagnosed the problem. If you all find out anything, I'd like to hear. I have 4 or 5 friends with same problem.
Avatar universal
I am a 39 yr. old female and 2 weeks ago started experiencing the very same symptoms as described above- pain around the left back area that comes around side up under rib cage and sometimes is on right side under rib cage. I have had an uralysis, x-ray of chest and stomach which has shown nothing. The doctor also told me to increase fiber; however, I exercise and eat a good bit of fiber and don't really think that is my problem. I went from feeling great to having these awful pains. I have been trying desparately to think of what I have done differently and it recently dawned on me that about 15 years ago I ate (probably on an empty stomach) several pieces of sugarless candy and within a couple of hours I had severe stomach and left side pains. It was obvious that something in the sugarless candy caused the pain and I have been very careful to stay away from or eat very little sugarless candy or mints. Several weeks ago I began drinking (a good bit) of sugarless mocha coffe drink with aspartame+ and acesulfame potassium (sweetners). I threw the can away 3 days ago. The pain is not completely gone but I do think it is lessening and less frequent. I hope this is the problem and out of curiousity are there others that have this pain and are consuming the sugarless products?
Avatar universal
For the most part I eat "health food" - and defintely buy products without preservatives or artificial ingredients whenever possible. I defintiely haven't been consuming anything with aspartame ( I heard years ago that the stuff was pretty bad for you). Although - the idea of something in food causing the pain is one I have been contemplating.  Someone mentioned citric acid as causing similar symptoms.  I do believe I eat/drink things that have added citirc acid.  Anyone else heard of or experienced this?

I too already eat a lot of fiber in my normal diet (lots of vegetables and granola / mueseli / wheat bran in the morning. I was also told to increase fiber when they thought I had IBS - which they still haven't given up thinking yet - even though I have none of the typical symptoms ie.frequent diarrhea and/or constipation and lower abdominal cramping.

Today the side stich was pretty bad - like I had just jogged a few miles with this incredible pain.  The muscles closer to the center of my abdomen were also hard like they were knotted or in spasm, yet the original source of the pain did not feel muscular - it felt more intestinal or stomach related.  Yet I didn't feel nausea or gas.

I am very frustrated and it really can get depressing to not know what is causing the pain, having made a number of lifestyle changes (no caffeine, alcohol, dairy; lots of whole foods and herbal supplements for gastro) with no apparent effect on my condition. And no definitive answers or theories from the doctors (including the response to my post here.)

I hope you've discovered what triggers it for you.  Mine pain hasn't left since Dec 1 of this past year. It is always there to varying degrees of diffusion, yet I haven't lost a bit of weight and my appetite is just fine, as is my enery level for the most part.

Again - keep us all posted, if you would, about what you discover.

Thanks!

Carol D.
Avatar universal
I have had the same problem since the early 80's been to many specialist and no knows what to do all they say is IBS now it affects my urinary tract and all they say is they want me to try alosetron or dicetel 50mg.  I know nothing about either drug and my family has colon cancer in it.  I don't understand why a colonoscopy and all the other tests can't give any relief.  I have to eat very small meals or I get sick.  It is getting progressively worse.
Avatar universal
I have the same runners cramp on my left side under breast side and back. Doesn't feel like the muscles but something under the rib cage. I also have sharp pains in my esophagus. I had an endoscopy done and everything was normal. I have a 15 month old
baby that requires alot of attention, stress doesn't help. I have
strange stabbing headaches and the pain will travel from one side to the other. I wonder if these are linked I am always in pain, as soon as one stops the other kicks in.
Anyone with any info. would be greatly appreciated.
Sincerely concerned,
Sarah
Avatar universal
I have been having problems for almost a year now.  I was diagnosed with endometriosis.  The surgery didn't work so I was put on lupron.  I get my sixth shot today.  I was getting one a month.  I don't think it is working. I am sitting here in so much pain I can hardly stand it.  My doctor has been giving me darvocet for the pain, but says they are addicting and wants me to take only 2 a day if needed.  That just doesn't work.  She makes me feel like I should be better and it is in my head.  I don't know what to do.  Do you think I may have gastroparisis.  My lower abdomen is bloated and in pain and so is my back.  Any feedback appreciated.

Missjoshua
Avatar universal
I too have many of the symptoms listed above.  However, my left back and chest pain is mostly at night, especially in the early morning hours.  It started last Fall and progressed until I could hardly roll over at night.  The pain then started during the day also so I finally went to the doctor and found out that I had a urinary tract infection.  Was sent to a urologist who ordered a renal ultrasound.  Good news is that nothing was wrong with my kidneys.  Bad news is that I have gallstones.  Was sent to a surgeon who said that gallstone cause pain on the right side and not the left side.  He said I am not having enough gallbladder symtoms to have it taken out yet.  So, I don't know what to do next.  The surgeon told me to go back to my primary physician but she sent me to specialists because she does not know what is wrong with me.  So far my blood tests have all been normal.  Who should I see next?
Avatar universal
I am releived to see so many others are in the same boat as myself.  I started having a sharp "stitch" in my left side right under my rib cage about a year ago.  My rib area is very tender to touch but I don't feel it is the rib.  My dr. (back then) diagnosed me with Chostrocondritis (sp?) much to my agruing that I felt he was wrong.  He told me to take ibuprofin which obviously didn't work.  I went back to the dr. recently and he did an Xray on the chest/rib area whcih revealed no abnormalities.  I have not had a follow up appointment as I don't know what else to tell my dr.  I do have mild persistant asthma, but have never had this problem prior to last year.  I am 30 yr old f slightly overweight but very active (work out 5 days week)and otherwise healthy.. Recently (past few months) I begun to have reflux and frequent gas (burping) but am not sure this is related.  Sometime I experience mild bowel problems in that I feel constipated and may not have a BM for a few days and then I have soft BM's but I would not consider it diarrhea.  The pain is not as intense as it use to be when I first got it, but does feel like a runners stitch.  Anyone else have any suggestions?  Oh yeah, I have increased the fiber in my diet which helped to regulate my BM's, but the pain is still there.
Avatar universal
To Missjoshua:
Does the endometriosis actually cause you pain in your upper left side or only lower left?


To Michaele:
I have heard other people (including my chiropractor) comment that gallstones can cause pain on the left side, even though the gallbladder is on the right side. How did they find the gallstones - throught the ultrasound exam?

To Dawn:
I also had a doctor tell me chostochondritis migfht be invloved because my lower ribs were so sore, but I really didn't feel like there was something wrong with my rib. (My chiro didn't think I had an costochindritis, either.)  Most of the time my pain feels like a runners stitch, too. Although I also get a duller, almost pulled muscle-like soreness as well, that usually appears closer toward my center and down toward my navel a bit. Recently, too have been experiencing some mild bowel problems: gas, bloating, feeling of constipation.  When I have the bowel symptoms, my stomache, right int he center, also can feel crampy.  Starting to wonder if I don't have some form of IBS, even thought I don't have all the classic symptoms (diarrhea, constipation). The pain is also clearly different from what I experience with reflux (GERD) which I also have episodes of on occasion. Does any of this sound familiar?

I sawe a traditional Chinese doctor last week who thinks I have trapped gas in the intestine (probably at the splenic flexure area, where the intestine makes a right angle turn around the spleen just below the rib cage on your left side). He says the gas can cause the intestine to balloon out a bit and casue some soreness in the area.  Not entirely sure what I think of this theory but it's more than any of the traditional Western (allopathic) doctors have told me.

If anyone has any answers or cures (even partial cures!) sure would love it if you keep posting to this thread.

If anyone wants to email me directly my address is:  c_defeciani***@****
Avatar universal
sound like a digestive problem to me.  that can effect your spleen and if it becomes underactive, inflammation in the area can follow.  First, no meat, no dairy, no wheat and no sugar. If you have food sensitivities, you'll know about it fairly soon.  But it takes time for the inflammation to settle so eat Fish, olive oil, blackcurrent seed oil, evening primrose oil. No meat except lamb which will nourish the spleen and digestion. Take acidopholus culture in dry powdered form 3 g daily. Use bitters in herbal formulas from appropriately qualified people or buy Swedish Bitters from your local health store.  Most importantly take homeopathic Kali bichromium. Do yoga and tai chi or pilates.  Make sure your bowels are working really well. Take slippery elm and marshmallow tea regularly to soothe your digestion.  Do it now so you're not riddled with arthritis later on in life.  Drink celery juice - fresh every day.  Good luck.
Avatar universal
Hi again Deidre -

one other question I forgot to ask in my previous post:  do you know if they can test for an underactive spleen?  If so how (for instance, is it somethinbg that would show up in bloodwork?)

Thanks again -

Carol D.
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