Left side abdominal pain at night for years

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Hoping someone might have some new ideas. I am a 31 year old female. I have had stomach pain the left side of my abdomen for 4+ years now. It is just under the bottom of the left ribcage and radiates to my back.

99% of the time this pain occurs at night and it is currently happening almost nightly. It started several years ago as maybe once a month but has definitely progressed in the past couple years and is more frequent and more painful. Pain ranges from moderate to severe and can last for hours.

When the pain comes I experience nausea, occasional vomiting (but most often dry heaving), occasional bloating, and sometimes chest pain on the left side. Eating and drinking definitely seems to make the pain worse. Daily, I experience early satiety (but with no weight loss) extreme fatigue and weakness.

I have have been seeing a gastroenterologist and have had the following tests performed: 2x endoscopy, colonoscopy, 2x barium swallow series of x rays, normal x rays, ultrasound, blood work/urine tests, HIDA scan. The ultrasound did show gallstones, but since the pain is always on the left they don't think it is related and won't perform surgery.

I am at my wits end. I am getting 2-3 hours of sleep at night on average and then still getting up every day to go to work. I am in so much pain every night and I fear I may have to quit my job because I feel so weak and exhausted all the time. My relationships are suffering and I am depressed because I don't feel like anyone understands what I am going through.

Has anyone experienced anything similar that can offer possible insight? I am at a loss and desperately need relief!

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  • Posted

    Which country do you live in?

    Have you thought about a CT with contrast? Also maybe seeing another specialist, possibly an upper GI surgeon?

    Ask for all the copies of your scans and maybe get another radiologist to view them. I think a second opinion is really important. There is a possibility you could be having referred pain from the gallstones.

    Are you taking any medication for your stomach?

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    • Posted

      Hi. I am in Canada. I have asked for a CT scan and MRI, but was told it wouldn't show anything that wouldn't have already shown up on one of the other tests. I will try asking again at my next appointment.

      I saw two surgeons regarding my gallbladder and both refused to take it out. We did talk about the possibility that the pain was linked to the gallbladder in some way (backwards pain receptors for example) but they felt it was so unlikely that they didn't really entertain the idea.

      I asked my GP to set me up for a second opinion awhile ago, but it hasn't happened yet. I think she is hesitant because it is insulting to the specialist I am seeing already. I will try that again too and will try to get copies of my scans as well.

      As for medication, stomach wise I am only on Prevacid for acid reflux. I have taken buscopan, dicetel, and amitriptyline in the past with no result. I did go to a pain clinic, but all they would give me was a cream that was supposed to numb the area. Because the pain is deeper that didn't help either.

      Thank you for your response!

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    • Posted

      It worries me that a doctor would get insulted if you ask for a second opinion, that is usually not a good sign. Some radiologists over call and some miss little things.

      Regarding a CT scan, it may be more accurate if you are overweight. Also the scans you may have had already might not have been that clear. If you are having as many problems as you seem to be just keep bugging them until they give in! There is a possibility it could be an issue with your pancreas.

      As for medication, the best acid reflux tablet in my opinion is esomeprazole which is commonly under the brand name nexium. I used to be on the same tablet you, lanzoprazole and I found it not to work at all. Also the best antispasmodic tablets in my opinion are alverine. I take double action chalk tablets which brand name is advertised on this website a lot! In the UK we have a tablet called deflatine but I am not sure if you get it in Canada, it helps with that gnawing central pain and bloating, it is another chalk tablet but specifically for bloating so you may have something similar where you are if that brand isn't sold there.

      In the mean time avoid alcohol, cigarettes and spicy food, if you don't already. Also fatty foods and sugar can upset my stomach.

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  • Posted

    Have you tried a food diary since the pain gets worse after eating and drinking? The intestines are on the left side, so it sounds like you may have some sort of intestinal irritation.. Did your endoscopy show anything? Was gastritis or h pylori mentioned? Pain under the ribcage is a gastritis symptom.

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    • Posted

      Hello!

      I did keep a food diary for a bit but was unable to pick out the possible culprit. It seems to come on regardless of the type of food, and ingesting anything (even water) makes the pain worse.

      I was tested for h pylori because they originally thought it was an ulcer but that was ruled out.

      One of the barium swallows showed duodenitis, but we booked an endoscopy to look at it further and the inflammation was gone. Gastritis has never been mentioned, but that is something I will follow up on.

      As for the intestines, she did originally think it might be ibs related, but after trying several treatments for ibs symptoms (buscopan, dicetel, and there is another that escapes me at the moment) I think she may have ruled that out as the main culprit. During the endoscopies and colonoscopy biopsies were taken and all came back clear.

      Thank you for your response!

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    • Posted

      Do you have trouble with bowel movements? Some people with IBS have pain predominant IBS which means pain is their main symptom but their bowel habit change is a less prominent feature. Pain tends to start on the left side with IBS and shifts about, particularly to the back. Ribcage pain can also occur with IBS. Pain can occur just about anywhere with this condition. No test or scan picks it up and some people find no treatment really helps. IBS is very hard to diagnose and some people can take years to get it identified. I would look into the Low Fodmap Diet and ask for a different antispasmodic. You may need to try several. I was tried on Mebeverine which made me worse so this confused my doctors and steered them away from an IBS diagnosis for three and a half months. I did in fact have IBS and only one of my doctors recognised it. For me, Buscopan really helped but everyone's IBS and response to treatment is different. All my scans were inconclusive .

      It is possible to have duodentis and IBS at the same time. Just because IBS was ruled out as the main culprit doesn't mean that you don't have IBS. It could mean that duodentis is your main problem along with IBS as a secondary condition. Some people with IBS show low level inflammation in their intestinal tract.

      It may also be that the duodenitis healed up by the time you had your endoscopy but reappeared afterwards. This seems a likely scenario since that was the only thing that showed up. The Barium swallow and the other tests you had are highly accurate. I would see a different gastroenterologist and ask for another endoscopy/barium swallow to see if the duodentis has come back. Investigate gastritis too.

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  • Posted

    Sometimes something as simple as simethicone anti-gas tablets can outwit all your tests. You have tried everything else. It is available over the counter and inexpensive.

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  • Posted

    Look up diverticulitis often called left sided appendicitis though your scans should have indicated it.

    Diverticula are small bulges or pockets that can develop in the lining of the intestine as you get older. Most people with diverticula don't get any symptoms and only know they have them after having a scan for another reason.

    When diverticula cause symptoms, such as pain in the lower tummy, it's called diverticular disease. If the diverticula become inflamed or infected, causing more severe symptoms, it's called diverticulitis.

    When I first had a barium enema X-Ray I was told that I had some pocketing. Next time severe pocketing and finally widespread pocketing. That time they said the X-Ray was rather fuzzy as many pockets still had hard poo in them that the laxative had not cleared out.

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