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Forum Name: Gastroenterology Topics

Question: Lower left side (flank) back pain every 5-7 days


 tallycal - Tue Sep 20, 2005 1:53 pm

I am a 22-year-old male, 6 foot 2 inches, 128 pounds (have been this weight since the age of 17). In June of 2001, I started experiencing pain in my lower left back (off to the left side). The pain is best described as a pain very similar to a stomach ache (cramping, not pulsating, dull yet intense pain unwavering in intensity). Each pain episode lasts 12-18 hours. The pain disappears at hour 12-18 only if I lie on my side with my knees bent, such that my left hip bears the weight. If so, I experience a gurgling noise (which sounds like stomach rumbling), except the sound originates from the lower left back/side, along with a spasmic/quick pulsating sensation. 15 seconds of this and the pain is completely gone, with no remaining symptoms whatsoever.

The pain occurs every 5-7 days, but it has not been continuous since 2001. I experienced the pain every 5-7 days in June of 2001, May-June of 2002, March-July of 2004, and July 2005-present. Within these periods, I haven’t gone over seven days without a pain episode, but the pain episode never occurs if it has been less than five days from the previous episode. Additionally, outside of the above-mentioned periods (e.g. between July of 2004 and July of 2005), I did not experience even one episode of pain.

An interesting occurrence marked the end of the March-July of 2004 pain sequence. I was traveling and thus unable to lie on my left side as I usually do to mitigate the pain. The pain increased to a nearly unbearable intensity (I had to try hard not to vomit). Then, I felt an extremely hot sensation on my lower left back/side, along with a clearly audible liquidy/gurgling sound. This lasted 15 seconds, and then the pain was completely gone (down instantly from the unbearable intensity). That was the last pain episode for an entire year, until July 2005.

Habits: the pain episodes were most intense during the 2004 sequence. Each pain episode was usually so intense that I couldn’t ingest foods or liquids. Any attempts lead to vomiting.

In July 2004, I introduced certain benchmarks in my diet. I increased my daily water intake to 8-10 glasses a day. I ingest multiple servings of high-fiber vegetables every day. I cut out all curries, fermented sauces, rice, and pastas. I take 400 IU of Vitamin E every evening. This was concurrent with the end of the pain episode. However, the 2005 pain episode now occurs even in light of following these dietary habits. Yet, I find that wavering from these habits (e.g. drinking less water or eating fewer vegetables) leads to more intense pain episodes than otherwise.

My normal bowel patterns are two large movements every morning, one when I wake up and one right after breakfast. Throughout this current 2005 pain episode, I have maintained unbroken regularity. I observe nothing unusual about my stools and am able to have bowel movements even during the pain episodes.

During the pain, I do sometimes (but not always) notice a foul taste and smell emanating from my mouth that otherwise is never present.

In terms of exercise, I have attempted swimming four times a day. This has not interrupted the episodic pain, nor has it reduced the intensity of the pain. Additionally, swimming during the pain episode has no effect on the pain.

I do not drink alcohol whatsoever, nor do I smoke. My beverage intake consists solely of water, except for a glass of cranberry juice every evening and a glass of orange juice every morning.

I eat three full meals a day. My normal breakfast consists of either a boiled egg or omelette, two pieces of toast (either honey wheat or sun dried tomato), grapes, and orange juice. Lunch usually comprises a salad an entrée (one of chicken with bell peppers, chicken with asparagus, or salmon) and a side of vegetables. Dinner will either be chicken marinated in olive oil, or beef, with stir fried vegetables cooked in olive oil with a dash of soy sauce, or lima beans. A cup of yogurt usually serves as a bedtime snack.

Certain tests have already been performed:
CT scan of kidney: showed a slightly enlarged left kidney (have had this since birth), but no blockage whatsoever in flow was detected. I find that my urination patterns are no different during the pain episodes than otherwise. As mentioned previously, drinking LESS water seems to lead to a subsequently more intense pain episode than drinking more.

MRI of spine – no compressed nerves or other abnormalities in spine condition.

Blood work – no elevated white blood cell count.

Vital signs – no fever during pain episodes.
 Dr. Safaa Mahmoud - Sat Aug 05, 2006 9:29 pm

User avatar Hello,

Your symptoms sound to be due to GI problem rather than a urinary one. However, no replacement to a direct clinical examination.

In general pain felt in the left side of the abdomen as you mentioned can be due to many causes including:

- Renal problems :the pain is felt like colic radiate to the groin and usually associated with urinary symptoms. CT, US and urine analysis are the commonly requested investigations.
- Colitis, due to infectious or inflammatory disease and vascular problems, there is always other GI symptoms like diarrhea, bloating, etc A lower endoscopy can help in establishing the diagnosis in addition to stool analysis.
- Excess gas and distension
- Indigestion

All the investigations you have done showed no abnormalities, if all needed investigations rule out the possible causing medical problems, IBS is to be considered.

Hope you find this information useful. Follow up with your doctor is essential. Only by complete history and physical examination, the correct diagnosis can be reached.

Best regards.

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