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Ongoing Abdominal Pain - Diagnosis Longshot
Hi, post is anon because some people on here know me in reality...
Anyway, my girlfriend has had an ongoing problem for the past seven months which has yet to be diagnosed.
The pain comes in the form of a constant sharp ache on the left-hand side, just below the ribcage. It heightens and becomes a stabbing pain when she eats, and also sometimes at night. She finds the only relief from the pain at night is by sitting upright (and this isn't a relief, just the least painful). She also has constant nausea. The pain seems to be particularly exacerbated by alcohol, and foods in restaurants (high fat level? or richer and more complex to digest? dunno...).
A doctor has felt around the area and found no unusual masses or growths. She has had an endoscopy and no ulcers or things of that kind have been found. She has had an ultrasound of her pancreas and gall bladder and no problems were found in this area. She's had two blood tests, all with normal results.
She has been on anti-acid medication (original suspicion of gastritis) and IBS medication to no avail. She's been on an array of anti-nausea medications, to no avail. She has been on many different painkillers (various combinations of paracetamol, ibuprofen, cocodamol? codamine? and others), which in some cases whilst they dull the pain very slightly, do not make it leave and is still very uncomfortable to live with.
The quality of her life is pretty bad; she finds constant pain and nausea difficult to live with. She's lost about a stone over the last 7 months because it's difficult to eat when you constantly feel as if you're going to throw up, and eating to excess also exacerbates the pain. She’s had to go to A&E a couple of times because she’s been in such terrible pain, but has just been referred back to her GP.
I'm just at my wits ends really; obviously it isn't nice seeing someone you care about go through this. I know there are very few medical professionals on here, and obviously, she is seeing her GP on a regular basis (and others for second opinions) but this seems to be getting us nowhere.
Any suggestions whatsoever as to what it might, possibly, in a million years, as a long shot, be? All the obvious routes seem to have been gone down.
Anyway, my girlfriend has had an ongoing problem for the past seven months which has yet to be diagnosed.
The pain comes in the form of a constant sharp ache on the left-hand side, just below the ribcage. It heightens and becomes a stabbing pain when she eats, and also sometimes at night. She finds the only relief from the pain at night is by sitting upright (and this isn't a relief, just the least painful). She also has constant nausea. The pain seems to be particularly exacerbated by alcohol, and foods in restaurants (high fat level? or richer and more complex to digest? dunno...).
A doctor has felt around the area and found no unusual masses or growths. She has had an endoscopy and no ulcers or things of that kind have been found. She has had an ultrasound of her pancreas and gall bladder and no problems were found in this area. She's had two blood tests, all with normal results.
She has been on anti-acid medication (original suspicion of gastritis) and IBS medication to no avail. She's been on an array of anti-nausea medications, to no avail. She has been on many different painkillers (various combinations of paracetamol, ibuprofen, cocodamol? codamine? and others), which in some cases whilst they dull the pain very slightly, do not make it leave and is still very uncomfortable to live with.
The quality of her life is pretty bad; she finds constant pain and nausea difficult to live with. She's lost about a stone over the last 7 months because it's difficult to eat when you constantly feel as if you're going to throw up, and eating to excess also exacerbates the pain. She’s had to go to A&E a couple of times because she’s been in such terrible pain, but has just been referred back to her GP.
I'm just at my wits ends really; obviously it isn't nice seeing someone you care about go through this. I know there are very few medical professionals on here, and obviously, she is seeing her GP on a regular basis (and others for second opinions) but this seems to be getting us nowhere.
Any suggestions whatsoever as to what it might, possibly, in a million years, as a long shot, be? All the obvious routes seem to have been gone down.
Scroll to see replies
Reply 2
mr_person
Does she eat a lot of carbs? Or not much else?
Her diet is pretty decent and varied, so I assume she gets approximately the right amount.
Reply 3
Well im stumped! Being ill is bad but being ill and not knowing what is wrong is worse. Please keep us updated on any changes in her condition!
Hope she gets better soon
!
Hope she gets better soon
!Reply 4
It sounds so much like appendicitus but if a doctor has checked her up I doubt it is. There is a way to test yourself for it. Press deeply underneath the ribcage on your right hand side and see if you feel a 'spark' when you let go.
Reply 6
Why
It sounds so much like appendicitus but if a doctor has checked her up I doubt it is. There is a way to test yourself for it. Press deeply underneath the ribcage on your right hand side and see if you feel a 'spark' when you let go.
appendicitis? how in gods name does it sound like that.? constant sharp pain in the LEFT upper quadrant for seven months. I mean how does one arrive at appendicitis from that?
I'm stumped. I think anyone who claims to be anything other than stumped is silly. Because everything i would jump at - principally oesophagitis and peptic ulcer disease have been investigated. I'll assume there are no bowel symptoms (bar nausea) ruling out IBS somewhat (IBS isn't really a diagnosis so much as excluding everything else).
it could be really bad tietze's syndrome. it could be referred pain from the breast. but I'm sure both of these will have been fully investigated. the other alternative is one of the hundreds of weird and wacky syndromes which 1 in a 100 million has. who knows.
sorry I (and no one else) can't help.
Could it be that she is MSG intolerant? The pain would be more so after eating, not really a continual constant pain. I know someone who is mildly MSG intolerant and eating MSG heavy food will make them ill for a day.
"There have been numerous studies of allergies and/or sensitivities to MSG, attributed to the free glutamic acid component, which has been blamed for causing a wide variety of physical symptoms such as migraines, nausea, digestive upsets, bad dreams, disturbed sleep, drowsiness, heart palpitations, hair loss, asthma, anaphylactic shock, rapidly increasing diabetes, and many other complaints. "
http://en.wikipedia.org/wiki/Monosodium_glutamate
http://www.msgfacts.com/facts/msgfacts.html
"There have been numerous studies of allergies and/or sensitivities to MSG, attributed to the free glutamic acid component, which has been blamed for causing a wide variety of physical symptoms such as migraines, nausea, digestive upsets, bad dreams, disturbed sleep, drowsiness, heart palpitations, hair loss, asthma, anaphylactic shock, rapidly increasing diabetes, and many other complaints. "
http://en.wikipedia.org/wiki/Monosodium_glutamate
http://www.msgfacts.com/facts/msgfacts.html
Reply 8
A few possibilities
More likely:
Somatisation syndrome
IBS (lack of response to "IBS medications" does not mean much
Hypochondriasis
Less likely:
Porphyria
Lead poisoning
Abdominal migraine
Mesenteric ischaemia
Further worthwhile investigations:
Blood film (look for basophilic stippling )
Serum lead and Zinc protoporphyrin
Serum Amylase and lipase
Serum TTG, antigliadin antibody and endomysial antibody ( to exclude gluten enteropathy )
Stool reducing substances
Urine porphyrins
Helical abdominal CT (abd ultrasound tends to miss intra-abominal lymphadenopathy and pancreatic pathology )
More likely:
Somatisation syndrome
IBS (lack of response to "IBS medications" does not mean much
Hypochondriasis
Less likely:
Porphyria
Lead poisoning
Abdominal migraine
Mesenteric ischaemia
Further worthwhile investigations:
Blood film (look for basophilic stippling )
Serum lead and Zinc protoporphyrin
Serum Amylase and lipase
Serum TTG, antigliadin antibody and endomysial antibody ( to exclude gluten enteropathy )
Stool reducing substances
Urine porphyrins
Helical abdominal CT (abd ultrasound tends to miss intra-abominal lymphadenopathy and pancreatic pathology )
Reply 9
i was thinking perhaps msg intolerent as well, as msg is in practically everything except what says "msg free"
but its likely shes already been tested for this
ibs is another possibilty.
and perhaps she has more than one thing?
but its likely shes already been tested for this
ibs is another possibilty.
and perhaps she has more than one thing?
I get exactly the same thing, and the doctor arrived at the same conclusion basically- that it was either IBS or excess acid. I know how unpleasant it is- I just started my GCSE mocks today and right after my first exam it started, which made it really hard to concentrate for the rest of the day.
I'm just as stumped as you and your girlfriend, but what I would say is that the lack of medical results and the fact that nothing seems to be categorically wrong would seem to suggest it could be more psychological than anything else. I know the pain for me is usually worst at the beginning of the week- mainly Mondays and Tuesdays being the wost days. That suggests that unless I'm doing something exactly the same every week without knowing it; it's not necessarily a physical thing causing it.
I think all she can do is look very carefully at when the pain comes- perhaps by making a diary, and making sure to note what she's eaten; what activities she's done; how she's feeling mentally; and also what time the pain has come. Other than that, keep going with the meds (I can't swallow tablets; so I really don't know how effective they are) and also try heat packs or a hot water bottle when the stomach aches come.
I hope she feels a little bit better, or she finds a reason for it- it's really not a nice thing.
But it's great that you're supporting her- and I'm sure she'll really appreciate it.
I'm just as stumped as you and your girlfriend, but what I would say is that the lack of medical results and the fact that nothing seems to be categorically wrong would seem to suggest it could be more psychological than anything else. I know the pain for me is usually worst at the beginning of the week- mainly Mondays and Tuesdays being the wost days. That suggests that unless I'm doing something exactly the same every week without knowing it; it's not necessarily a physical thing causing it.
I think all she can do is look very carefully at when the pain comes- perhaps by making a diary, and making sure to note what she's eaten; what activities she's done; how she's feeling mentally; and also what time the pain has come. Other than that, keep going with the meds (I can't swallow tablets; so I really don't know how effective they are) and also try heat packs or a hot water bottle when the stomach aches come.
I hope she feels a little bit better, or she finds a reason for it- it's really not a nice thing.
But it's great that you're supporting her- and I'm sure she'll really appreciate it. 
My mum has a similar problem - and like your gf, has had tests, endoscopies etc with no answers/diagnosis. The only thing she gets relief from is a drug called Ranitidine - so unless your gf has already tried this, it may be worth asking her GP about it.
I hope she gets sorted soon.
xxxx
I hope she gets sorted soon.
xxxx
Reply 13
Laura Lou
My mum has a similar problem - and like your gf, has had tests, endoscopies etc with no answers/diagnosis. The only thing she gets relief from is a drug called Ranitidine
Ranitidine is a really old drug. It is a H2 receptor blocker and has long since been superseded by the Proton Pump Inhibitors (losec, somac, pariet, nexium etc )
However, I agree that she should try one of these.
But it is probably somatisation syndrome or IBS.
ie: psychological.
She does sound a bit off.
fundamentally
Ranitidine is a really old drug. It is a H2 receptor blocker and has long since been superseded by the Proton Pump Inhibitors (losec, somac, pariet, nexium etc )
However, I agree that she should try one of these.
But it is probably somatisation syndrome or IBS.
ie: psychological.
She does sound a bit off.
However, I agree that she should try one of these.
But it is probably somatisation syndrome or IBS.
ie: psychological.
She does sound a bit off.
Maybe it is old - but it's the only thing that's helped my mum.
Reply 15
Jamie
appendicitis? how in gods name does it sound like that.? constant sharp pain in the LEFT upper quadrant for seven months. I mean how does one arrive at appendicitis from that?
I'm stumped. I think anyone who claims to be anything other than stumped is silly. Because everything i would jump at - principally oesophagitis and peptic ulcer disease have been investigated. I'll assume there are no bowel symptoms (bar nausea) ruling out IBS somewhat (IBS isn't really a diagnosis so much as excluding everything else).
it could be really bad tietze's syndrome. it could be referred pain from the breast. but I'm sure both of these will have been fully investigated. the other alternative is one of the hundreds of weird and wacky syndromes which 1 in a 100 million has. who knows.
sorry I (and no one else) can't help.
I'm stumped. I think anyone who claims to be anything other than stumped is silly. Because everything i would jump at - principally oesophagitis and peptic ulcer disease have been investigated. I'll assume there are no bowel symptoms (bar nausea) ruling out IBS somewhat (IBS isn't really a diagnosis so much as excluding everything else).
it could be really bad tietze's syndrome. it could be referred pain from the breast. but I'm sure both of these will have been fully investigated. the other alternative is one of the hundreds of weird and wacky syndromes which 1 in a 100 million has. who knows.
sorry I (and no one else) can't help.
My fault. I read it as Right hand side.
Reply 16
Why
My fault. I read it as Right hand side.
Yeah sure....
And how is right UPPER quadrant pain going to be appendicitis ?
When did the appendix become retro-hepatic ?
Go study some anatomy.
Reply 17
fundamentally
Yeah sure....
And how is right UPPER quadrant pain going to be appendicitis ?
When did the appendix become retro-hepatic ?
Go study some anatomy.
And how is right UPPER quadrant pain going to be appendicitis ?
When did the appendix become retro-hepatic ?
Go study some anatomy.
The upper right quadrant consists of the costal region, idiot. This person mentioned BELOW the ribcage which is the LOWER right quadrant.
Reply 18
Why
The upper right quadrant consists of the costal region, idiot. This person mentioned BELOW the ribcage which is the LOWER right quadrant.
LOL !
You are so clueless.
The right upper quadrant of the abdomen is in the subcostal region.
The appendix is near the right iliac fossa.
Remember McBurney's point ?
Reply 19
Talya
I think we need Dr. House.
I concurr
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