upper left quadrant abdominal pain

[Jeannie912]

For the past 15 months Ive had off and on pain in my upper left quadrant of my abdomen. 2 months ago the pain started getting more frequent and worse. Also, with strenuous activity, the pain radiates from that one spot and goes across my left side to my kidney area. I went to the doctor a month ago with the pain (naprosyn had subsided the pain some) and he diagnosed me with IBS. (I have also been experiencing bowel problems for some time). He also had done a urinalysis and found very little blood in my urine indicating a possible kidney stone. The doctor recommended a colonoscopy for my abdominal pain and a CT for the kidney stone. I decided against the CT and went with drinking more water and THAT pain went away (unless again, I do something strenuous). I went with the colonoscopy and they found nothing but sent a sample to test for colitis and/or diverticulosis. Now they want to do a upper GI scope. Am I wasting my money and time for guesses? I'm so tired of this pain. The pain is still off and on but more frequent and more painful when it does come along. Sometimes it subsides with bowel movement, not always. Any advice?

[Dr. Safaa Mahmoud]

Hello,

Pain in left upper abdomen may occur due to gastroesohageal, colon, pancrease, spleen and renal problems like:

- GERD that result in acid reflux from the stomach into the oesophagus causing irritation and inflammation of the lower oesophagus. Certain positions may increase the pain.
- Gastritis due to H pylori or Drug induced (NSAID) or gastric ulcer. The pain is temporary relieved by simple foods and antacids.

- spleenomegally causes also left sided abdominal pain that may increase with movement.

- Renal colic is a common cause of abdominal pain and is usually due to renal stone.

- Pancreatitis can also cause left sided abdominal pain and GIT troubles (especially with fatty meals). Serum amylase and alkaline phophatase are usually high.

- IBS may also cause left sides abdominal pain with bloated abdomen and either diarrhoea or constipation or an alternation between both of them. Stress increases the frequency and the severity of symptoms in almost all cases. The diagnosis is made by exclusion of all other causes.

CBC, stool analysis, urine analysis and serum amylase are helpful to start with.
Investigations include upper endoscopy with some specific tests for H. pylori, lower endoscopy and CT scan.

You have blood in urine and left sides abdominal pain, so renal colic is to be excluded first. You mentioned also that there was a history of GIT problems so exclusion of gastrooesophageal causes is essential too.

CT-scan could be helpful to exclude renal, spleen as well as pancreatic problems. It can also see lesions in the colon and the stomach. It may also show unexpected vertebral problems that may induce a muscle spasm presenting with left sided pain that increase with certain movements.

If CT Scan showed no abnormalities, endoscopic evaluation would be the next step especially if blood in stools is found.

IBS would be diagnosed by exclusion.

Only by complete history, physical examination and investigations, the correct diagnosis can be reached. I would advise you to follow up with your doctor.
Hope you find this information useful.
Please keep us updated.
Best regards.