Upper abdominal pains around rib cage

Posted by stevetwarner @stevetwarner, Dec 8, 2020

Looking for some help hopefully. About 1.5 years ago noticed a pain in my left rib cage right on the bone. Could feel palpable pain when pressing on a certain area. Had X-ray and all looked normal. Later I noticed this painful spot would flair up when swallowing certain foods. This has been the most interesting, perplexing symptom! When I eat certain foods, mostly fruits and veggies, some spices (soy sauce, etc) and other highly "concentrated" foods I get an immediate sharp pain in that area that then fades away. Bland foods, rice, butter, meats, etc do not cause this?!? It feels neurological, like a nerve firing exactly upon the swallowing function. This has developed into abdominal/flank pain that flares up around both sides, primarily felt around the rib cages but also sometimes in the center. I went through a battery of additional tests over the next six months, abdominal ultrasound, abdominal CT scan, Gallbladder scans, blood, urine, Lipase test, MRI's of Thoracic and Cervical spine. Pretty much ALL came back normal, including images of spleen, liver, pancreas, kidneys,etc... except for some pretty bad spinal stenosis in my cervical spine. I worry most about Pancreas issues of course, as those are so serious, but I've never had anything close to the kind of pain that patients describe with Pancreatitis - plus both the ultrasound and abdominal CT scan showed normal pancreas - and Lipase test was only 33U/L. I do feel like I get some irritation from eating, although I've limited my diet now to a pretty bland assortment, plus no fruit and more limited veggies, lots of rice, butter, meats and that seems to help. I'll still eat the occasional salad even though it causes the pain to fire on the left rib cage. The eating part is what keeps me thinking its a digestive issue, but then some days I think it's got to be neurological. I am very active, cycling, running and after a hard run recently I noticed I was hurting. So, not even sure if I should be here in the Digestive forums! I've put off following up on much of this with Covid and just live with it, so its been about a year since I've had any tests, but have my annual physical with my Doc in January and we will start the ball rolling again. Anyway just wondering if this makes any sense to anyone who's had a similar experience?!? Thanks!

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@stevetwarner

Hi Teresa (@hopeful33250) - thanks for the reply. Sorry I did forget to mention, I've had both an upper GI and Colonoscopy within the last year and both looked clean. Very minor gastritis noted on the GI but they did not seem concerned. Yes its been frustrating to say the least - especially since everything has tested normal. I don't run a ton but have decided to back off on that to see what happens. It's also winter in Michigan so biking will have to take a break too. I did see a neurologist (spine surgeon) after the Cervical MRI and he was concerned about the stenosis though it was unrelated to any of the symptoms. His concern was about long term effects of balance issues, impact activities, etc. and of course wanted to schedule surgery - you know how that goes - I said no thanks for now! Eventually would like to speak with a neuro that really understands the nerves that innervate the organs/digestive system and the vagus nerve which as I understand it feeds a lot of that. Yes I will keep an eye on this post and give try to give updates. After my physical will probably start researching a visit with Mayo, Cleveland Clinic, etc to see if this can be figured out.

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@stevetwarner - Hi, I think we’re probably related from the description of your background, symptoms, and interests! I share some of the same GI and spinal issues you describe, along with a rare, incurable and progressive lung disease diagnosed 4 years ago when I was 54. Keep us posted on your findings and journey. 🙏

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Good afternoon Steve, I know this may be a long shot given its been 2 years since your original post, but I was curious if you were able to get a diagnosis as I am currently, and for some time now have been, experiencing the same symptoms almost to the t?

No one has been able to provide a diagnosis and like you I have had cts upper lower endos mri’s and my labs are all in the normal ranges.

Thanks in advance

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@aprilg95

Good afternoon Steve, I know this may be a long shot given its been 2 years since your original post, but I was curious if you were able to get a diagnosis as I am currently, and for some time now have been, experiencing the same symptoms almost to the t?

No one has been able to provide a diagnosis and like you I have had cts upper lower endos mri’s and my labs are all in the normal ranges.

Thanks in advance

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I’m not Steve, but I to am having the same issues. If you find out anything. Please share.

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I’m having this same problem only on my right side more. Both ribs hurt terribly. Have had the same test done. Nothing. Please let me know of any answer. Had COVID in 2020

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Hi Steven
In reviewing all your pain, discomfort and type of tests you have taken, have you event been diagnosed with MALS? Median Accurate Ligament Syntrom.
A year and a half ago, I started with pain in my sternum, my flank area, abdomen, and rib cage area. I have had every Gastro test imaginable. 2 endoscopies, esphageal manometry test, CTA abdomen, pancreas liver, gallbladder and many more. The HIDA test showed my Gallbladder only functioning 20%. My gallbladder was taken out. I had a nuclear stress test and nothing showed. Then I found a Facebook Page called MALS PALS and got educated on the possibility of that might be what I had. MALS is a very rare disease effecting 2%of 100,000 people. I then researched a Dr in my area who sent me for a few more tests and confirmed thats what I had. My was actually nMALS relating to the bundle of nerves twisting around the celiac artery and median accurate ligament. This is a very serious compression of the Celiac Artery not to mention the very long recovery.
I'm not saying you have those but you might look into it. I have lost 40 lbs because I couldn't eat anything without having 4 hours of pain. No matter how small a meal or even water effected me.
Good Luck! I hope you find some answers soon.

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thanks I will look into that

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