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!

Hello @stevetwarner and welcome to Mayo Clinic Connect!

I am sorry to hear about this irritating pain that comes and goes. When you have a chronic problem it is always good to get a diagnosis and an appropriate treatment plan. When neither is available it becomes frustrating, doesn't it?

Here on Connect, we are not medical professionals, just patients like yourself, who share our considerable health experiences with others in order to offer support and encouragement. With that said, It appears as if you have had extensive testing and lab work which is great. You have ruled out a lot of serious problems but I can understand your concern over not having an answer to your chronic pain.

Just a few suggestions, you mentioned some of the GI tests you have done but you did not mention having an upper endoscopy. That is where you are anesthetized and a tube (with a camera) goes down your esophagus and looks at the stomach and small intestine to see if there are any ulcers, gastritis, or esophagitis. Has this been done? If not, this might be a good test to ask for.

You also mentioned spinal stenosis and swallowing problems. I'm going to invite @jenniferhunter to respond to this discussion as she may have some ideas. She has had extensive spinal problems resulting from injuries and also had surgeries.

Also, I'm wondering if you have seen a neurologist? I mention this because it might be possible that the stenosis could be causing this pain as well as swallowing problems. I'm also wondering, given the spinal stenosis, if you have tried cutting back on some of the physical activity. Perhaps trying a couple of weeks of lower impact exercise and see if that results in a lower pain level. As I'm not a medical professional these are just some suggestions that come to mind.

Chronic pain, without a diagnosis, can be a puzzling situation and it takes a lot of work on the part of the patient to find a doctor who can put all of the puzzle pieces together. It often takes a lot of research and first as well as second (or even third) medical opinions to get a good answer.

I'd like to know how you are doing. Will you post again?

REPLY

Hello Steve, I've been almost through the same thing. I ended by seeing a GI who told me I had IBS (Irritable Bowel Syndrome) and prescribed Gantaon and Duspatalin. Things improved but the problem didn't disappear. I also got sever constipation and had my gallbladder removed almost 3 months ago. I hope this helps.

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@hopeful33250

Hello @stevetwarner and welcome to Mayo Clinic Connect!

I am sorry to hear about this irritating pain that comes and goes. When you have a chronic problem it is always good to get a diagnosis and an appropriate treatment plan. When neither is available it becomes frustrating, doesn't it?

Here on Connect, we are not medical professionals, just patients like yourself, who share our considerable health experiences with others in order to offer support and encouragement. With that said, It appears as if you have had extensive testing and lab work which is great. You have ruled out a lot of serious problems but I can understand your concern over not having an answer to your chronic pain.

Just a few suggestions, you mentioned some of the GI tests you have done but you did not mention having an upper endoscopy. That is where you are anesthetized and a tube (with a camera) goes down your esophagus and looks at the stomach and small intestine to see if there are any ulcers, gastritis, or esophagitis. Has this been done? If not, this might be a good test to ask for.

You also mentioned spinal stenosis and swallowing problems. I'm going to invite @jenniferhunter to respond to this discussion as she may have some ideas. She has had extensive spinal problems resulting from injuries and also had surgeries.

Also, I'm wondering if you have seen a neurologist? I mention this because it might be possible that the stenosis could be causing this pain as well as swallowing problems. I'm also wondering, given the spinal stenosis, if you have tried cutting back on some of the physical activity. Perhaps trying a couple of weeks of lower impact exercise and see if that results in a lower pain level. As I'm not a medical professional these are just some suggestions that come to mind.

Chronic pain, without a diagnosis, can be a puzzling situation and it takes a lot of work on the part of the patient to find a doctor who can put all of the puzzle pieces together. It often takes a lot of research and first as well as second (or even third) medical opinions to get a good answer.

I'd like to know how you are doing. Will you post again?

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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 All of this sounds good. I hope you are able to see a good specialist soon. Both Cleveland Clinic and Mayo would be good places to go.

As I live in Michigan as well, I'm wondering if you have been to the University of Michigan health system?

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@hopeful33250

@stevetwarner All of this sounds good. I hope you are able to see a good specialist soon. Both Cleveland Clinic and Mayo would be good places to go.

As I live in Michigan as well, I'm wondering if you have been to the University of Michigan health system?

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Haven't but yes they are on my list as well. Maybe an easier place to start as its closer. Thanks!

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@stevetwarner

Haven't but yes they are on my list as well. Maybe an easier place to start as its closer. Thanks!

Jump to this post

@stevetwarner I would strongly suggest you look into the Mayo Clinic. I also live in Michigan and have been bounced around since 2016 trying to get a diagnosis for a gastrointestinal issue. I went to Mayo in July and got an answer to that and some other problems in other areas. It is worth the effort to go and get some answers.

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@suzanne2

@stevetwarner I would strongly suggest you look into the Mayo Clinic. I also live in Michigan and have been bounced around since 2016 trying to get a diagnosis for a gastrointestinal issue. I went to Mayo in July and got an answer to that and some other problems in other areas. It is worth the effort to go and get some answers.

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@suzanne2 Thank you for that good word of recommendation! Yes, many people who have been seen at other good hospitals have found Mayo Clinic to be the premier center for finding a hard-to-diagnose problem!

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@suzanne2

@stevetwarner I would strongly suggest you look into the Mayo Clinic. I also live in Michigan and have been bounced around since 2016 trying to get a diagnosis for a gastrointestinal issue. I went to Mayo in July and got an answer to that and some other problems in other areas. It is worth the effort to go and get some answers.

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Hi @suzanne2, thanks for the reply. I looked at your profile and see you are from Richland. I'm from Vicksburg so I guess we are "neighbors"! I was a completely healthy guy until a year and a half ago – not A SINGLE serious issue in my medical records other than some higher cholesterol numbers. You are probably familiar with the term Oxalates if you've been dealing with digestive pains but this all started with me during a time where I was eating TONS of high oxalate foods, spinach smoothies, etc. I dropped my cholesterol numbers down significantly during that span which was the positive but then starting having all these abdominal problems. The timing may have been purely coincidental but I still have that back in my mind. I have a great primary doc at Bronson who I've been seeing for over 20 years but we just haven't been able to nail this down so yes, seriously considering going to one of these specialty centers. Thanks!

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@stevetwarner I self referred myself to Mayo! That is how desperate I was!

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Suzanne2, I did the same thing. Called Mayo in tears to get help. Boy, did that operator help me out! Mayo got rid of misdiagnoses! Made new, correct diagnoses and treatment that has and is really helpiing. I'm heading now to gasto in a week for endoscopy, whatever. I have pretty serious esophogeal reflux, very careful what I put in my stomach and been dealing with it for many years. Now, it's a bit worse, having some pain/ache/spasms in my diaphragm, so think it's time to get on top of this. I really suggest you think of getting yourself to Mayo, as they've solved so many issues for me that so many other docs weren't interested in solving or couldn't. Mayo has made my life so much better. I think your Mayo…I'm in Florida….is considered tops in gastro stuff….I know they are in neuro. Wish you the best in your journey. Keep it up, but get to the place that will really find the answers. Don't give up. Blessings.

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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.

Jump to this post

@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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