Sunday, September 16, 2012

Abdominal Pain? Back Pain?

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Gender: Female
How tall are you (feet and inches)?: 5'6"
What is your weight in pounds?: 171
How old are you?: 65
How long has this been going on?: More than a year


Describe associated symptoms not listed above: Quite a few years ago I began to have a slight twinge in the area of my solar plexis.  Went through all kinds of tests by a gastroenterologist and finally it was chalked up to IBF.  It has gotten progressively worse but the next time I went back he came up come up with the same diagnosis because he couldn't find anything else.  But that was still quite a few years ago.  Now it's really pronounced and the twinge radiates down my legs and I can feel it in my ankles.  Some sort of nerve thing????  It happens at night in bed mostly.  Any idea what this might be?

Please include tests and relevant studies here. Endoscopy, colonoscopy, MRI (or catscan) of my abdomen.  Again all quite a few years ago.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Used to have chronic fatigue - but it has been under control for quite awhile.

Complete hysterectomy, hip replacement, carpel tunnel, many trigger fingers, orthoscopic knee ( 2 surgeries), stent for May Thurner syndrome in iliac vein.

Check all conditions present in your immediate family... : Stroke

Please list any medication allergies that you have : : MRI Contrast - hives

Please list any medications you are currently taking (and dosage if known) :: levothyroxine .088 mg 1/daily
imitrex 5mg as needed for migraine

When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible
 
I'd like to know what this is since it's getting progressively more intense.  Or what type of physician I should see and what to tell them.  When I try to describe it no one seems to have any idea what it might be and tests don't find anything.  But the feeling is like the fright/flight internal shock.
May we send you a satisfaction survey after your question is answered? It takes a minut to fill out.: Yes

2 comments:

space doc said...

Dear Abdominal/back pain:

You mentioned a diagnosis of IBF--I assume you meant IBS (Irritable bowel syndrome)?--however this is usually associated with lower abdominal pain and either diarrhea or constipation which you didn't mention having.

Worsening pain in the "solar plexus" should definitely be checked out again.

An ulcer (either stomach or duodenal) can give you this kind of pain--not uncommonly worse at night. Getting a test for Helicobacter pylori (H. pylori) which is a bacterium associated with ulcers would be helpful. A repeat endoscopy might be needed since it's been a few years since that was done.

Problems with the pancreas can also give you similar symptons. Blood tests for amylase and/or lipase could signal inflammation of the pancreas.

Gall stones can also give you these symptons. An ultrasound of the upper abdomen could look at both the gall bladder and the pancreas.

The "twinge" going down the legs may be unrelated to the abdominal pain. With your hip replacement and knee problems it sounds like you may have a significant amount of arthritis. An arthritic condition called spinal stenosis can give you leg symptoms. Also sciatic nerve irritation can give you leg pain (more usually in just one leg or the other not both).

When the abdominal symptoms occur without any findings on testing it is often classified as functional dyspepsia. This often responds to proton pump inhibitors such as omeprazole--Yor doctor may have already tried this.

For any gastro-intestinal problems cigarette smoking tends to be a major contributor so it would be quite helpful to eliminate the cigarettes.

In summary, I think it would be definitely a good idea to get back in touch with a gastro-enterologist--he may need to repeat some or all of your tests, but you should stress that the symptoms have gotten worse. The leg symptoms may require some spinal x-rays or a visit to an orthopedist.

Good Luck! Would love to hear how this all turns out.

Space Doc

MDSTAT_ER_DOC_1 said...

I agree with my esteemed colleague above. It might also be beneficial to you not only to get back with a gastroenterologist, but to discuss with your doctor the possibility that the pain and sensation in your legs might be from a low back problem such as a herniated disc. A good exam can give a good clue as to this possibility. An MRI of your lumbar spine would be the test to confirm this .

Thanks for your question!