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Forum Name: Gastroenterology Topics

Question: strange upper left abdomen issue


 onetwothreefour - Wed Dec 27, 2006 10:40 am

hi, im an 18 year old female and for the past three months or so i have had a strange burning/slight swelling of the upper left abdomen...it seems like it's on top of my last two or three ribs. it hurts mostly after i eat dinner, for about four or five hours after, especially if i eat an especially big meal or drink a lot of coffee. it is more annoying than painful, but it seems like even when my stomach is empty (for example when i wake up in the morning) that this area of my ribs is slightly more fleshy (i guess that would be the right word) than the ribs on the right side of my body. touching it doesnt hurt, so i have been trying to feel it and doesnt seem to be lumpy or anything. i saw a doctor about the upper left abdominal pain, told her everything ive said here and after examining the rib she told me to take two zantac/day in order to relax the stomach acids because she thought the only thing that could cause this sort of pain was heartburn or an ulcer, and that the swelling was a result of this. the pain seemed to go away after two weeks so i stopped the zantac, i didnt really notice the rib area swelling at any point during that time, but now both symptoms are back so im wondering if this is something more than just persistent heartburn? im not having any other symptoms at all - everything else is normal, so i don't think its anything really serious... i know this is sort of confusing/obsolete but i would appreciate any ideas.
 Dr. Safaa Mahmoud - Wed Dec 27, 2006 7:07 pm

User avatar Hello,

The history you have given suggests that the pain is of a peptic origin. This include gastritis, esophagiis and H. pylori infections.

At this age, usually a trial of therapy with anti acids, histamine H2 blockers is indicated before further investigations are done to confirm the diagnosis.

A 4-6 weeks trial is usually satisfactory, if poor response then more investigations are done to find out the causes like:
GI radiological series to diagnose reflux disease and others.
Endoscopy and biposies to chech for H. pylori and resistent ulcers, etc. that include

If the results are:
- Resistent ulcer then Proton pump inhibitors are prescribed
- H. Pylori specific oral therapy is given that include anti-acid, antibiotics, and flagyl.
-GERD prokinetic drugs and antiacids are prescribed.

The swelling could be due to distension.
Direct clinical examination is essential.

Investigations include:
CBC
Abdominal US
Upper Endoscopy.

Changes in your dietary habits may help.
Certain foods are known to aggravate the condition, and you better avoid them. These include chocolate, beverages containing caffeine, alcohol, fatty and fried foods, garlic and onions, spicy and tomato containing foods. In addition smoking and stress should be avoided.

Follow up with your doctor is essential.
Best regards.

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