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Suffering form upper left abdominal pain below ribs. What test should be done?

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Practicing since : 1962
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I am suffering form upper left abdominal pain just below my ribs, recently it is radiating to my left Hypochondriac region and left arm. I recently undergone Ultrasound and my pancreas and spleen are adviced to me as normal. Pain comes and goes, severity is increasing recently. Please advice me what tests should I undergo to diagnose. I had endoscopy done 2 years before for GERD and was normal.I stopped PPI’s after endoscopy.Is ultrasound effective in recognising pancreatic cancer .Please advice me of the tests that I should request a doctor.I had ultrasound of upper abdomen(Liver,gallbladder ,kidneys and pancreas ) .will this be enough for renal coli( if I have one).I have pain in left abdomen radiating to my shoulder sometimes.
Posted Wed, 28 Nov 2012 in Digestion and Bowels
Answered by Dr. Charles S Narasi 1 hour later
Hello, XXXXXXX ,
Left sided upper abdominal pain can be related to problems
with the large intestine or the colon , the part that is close
to the spleen called the "Splenic Flexure". Since this is a bend,
sometimes intestinal gas gets trapped there and cause intense
pain, but is usually relieved by passing gas.
I am glad that you had endoscopy and it was normal.
I know you are concerned about pancreatic cancer.
If any member of your family had this or other types of
cancer, you should undergo further testing. Ultrasound
of the pancreas is not very reliable because pancreas is
kind of hidden between organs. The best initial test
would be a CT-scan of the abdomen at a reputable center.
If this shows any questionable spots, then you may need
ERCP (Endoscopic retrograde cholangio pancreatagraphy)
and biopsy or brushings to look for cancer cells.
Left sided kidney stone can give left loin pain radiating
toward the testicle and you may see blood in the urine.
Gallbladder stones cause pain under the right rib cage,
and usually you have fever, chills, nausea, vomiting etc.
Unexplained weight loss, lack of appetite, low blood count
are all warning signs, if you have them
Hope this helps you.
Wish you well.
Above answer was peer-reviewed by
Follow-up: Suffering form upper left abdominal pain below ribs. What test should be done? 6 hours later
Thank you Dr XXXXXXX
I do not have any family member with pancreatic cancer. I do have some weight loss but not any of the other symptoms.i live in Australia and I can request for a CT scan , Apart from CTscan do you suggest any other diagnostic approach to avoid radiation . I also have this anxiety that stopping PPI's might have caused an ulcer in my stomach. Does ulcer also give similar symptoms that I suggested.if I order CT does it also diagnose ulcers in stomach.Thanks for advising about splenic flexure. I do not have any loin,testicle or right abdomen pain. My left side stomach along with pain also makes lot of growling noise at night.
Answered by Dr. Charles S Narasi 19 minutes later
Hello, XXXXXXX ,
You should not be concerned about the amount
of radiation that you are exposed to during a CT-scan.
It is much safer than having multiple chest x-rays.
Glad that there is no family history of pancreatic cancer.
As for ulcer in the stomach, duodenal ulcer will give pain, usually
relieved by food or antacids or PPIs. You did say you had
endoscopy before and everything was normal. The CT-scan does
not show the ulcer. Upper G.I.series (Barium X-ray) may show
the ulcer, although missed sometimes. Endoscopy would be the
best way to find out about ulcers. If you have not been tested
for H.pylori , I recommend that you have that done. There is a
stool antigen test that can detect H.pylori. If positive, you need
a combination of three drugs for 10-14 days to treat the bug.
I hope this answers your concerns.
Wish you well.
Above answer was peer-reviewed by
Follow-up: Suffering form upper left abdominal pain below ribs. What test should be done? 2 hours later
Thanks for you reply. I had endoscopy done 2 years ago is it possible for developing ulcer now as I have stopped PPI's after that endoscopy which I am under for long time.I will also request for upper GI CT scan.Does CT check my spleen as well. If I have to do both ( endoscopy and CT) which order is the best.Should I go for endoscopy or endoscopic ultrasound or barium.Please advice the order if I have to go for all .
Answered by Dr. Charles S Narasi 15 hours later
Hello, XXXXXXX ,
Yes, it is possible to have developed an ulcer eventhough
you had negative endoscopy 2 years ago.
CT-scan of the abdomen will show spleeen,liver,kidneys,
and also pancreas. It also shows if you have enlarged
Get the scan (CT) first and later you can get X-ray studies
of the stomach.
Wish you well.
Above answer was peer-reviewed by
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