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What Causes Abdominal Pain,inflamation Under Rib Cage,pressure Below Diaphragm And Reccuring Heat In Face?

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Posted on Mon, 13 Jan 2014
Question: Hi - I have had abdominal pain/discomfort for the last few months. Sometimes it's better and sometimes it's worse. Some specific symptoms are that there is a general gnawing soreness that comes and goes - it seems to be worse when it's been a while since I have eaten. After I eat I tend to feel a pressure - like a centre of inflammation just under the right rib cage. At other times I will feel significant pressure behind or just below my diaphragm and it will climb up into my lower chest at times. All of these symptoms are experienced daily. I also feel a recurring heat in my face and a little colder than usual at times. And I also feel a little out of sorts. I have had an ultrasound which has only shown some small gallbladder polyps and a milk of calcium cyst in my kidney. I have had a CT scan which was suboptimal because of feces and gas (they didn't tell me not to eat). The only thing the CT scan found in the abdomen was several mesenteric lymphadenopathies - including measuring 8x10mm. I gastroscopy and colonoscopy without biopsy didn't reveal anything.
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Answered by Dr. Dr. Klerida Shehu (47 minutes later)
Brief Answer: Please follow the suggestions below.... Detailed Answer: Hi XXXXXXX I have read your medical history carefully and understood your concerns. The symptoms you are experiencing might be related to gastric or digestive problems. I'd advise to take simethicone and omeprazole for bloating and pain. You are saying to have had a suboptimal Ct-Scan because of feces and gas. Could you please send in the results of your tests? That could help me assist you further! Meanwhile, I'd suggest to repeat the Ct-Scan and to do MRI of the abdomen to better evaluate its condition. The polyps seen in your gallbladder together with mesenteric lymphadenopathies are also better evaluated by MRI. Looking forward to kindly have the requested test results! Dr.Klerida
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Dr. Klerida Shehu (40 minutes later)
Everything was unremarkable for the CT except the following: "Multiple mesenteric lymphadenopathies are seen. These are non-specific for size criteria. The largest measures 8 x 10mm along the ileocecal branches of the SMA and SMV." I might add one other thing - a couple of weeks ago - the blood work showed that my lipase level was slightly elevated above normal range. If you would like the complete reports attached I can do this - I just don't where or how to attach them. I would rather not start medicating until I know exactly what is going on. My worst fear is that the lymphadenopathies could be indicative of lymphoma. I just uploaded the reports. Please let me know what you think. I am especially concerned about the lympadenopathies. Thanks. I'm remembering a few other things - as I experience them too. I have intermittent discomfort in the back too - feels like it right on the other side of the pressure in the front. I also had headaches which have decreased in pain over the last couple of weeks though. This is notable because I never ever got headaches. THe headaches are more on the right side over the eye primarily if that is of any help.
doctor
Answered by Dr. Dr. Klerida Shehu (20 hours later)
Brief Answer: Please follow the suggestions below..... Detailed Answer: Hi XXXXXXX Thank you for sending in the test results and more of your medical data. With regards to your headache, to my opinion, it is not related to lymph-nodes. It is more related to muscle or stress or work overload. The hyper-reactive lymph-nodes could be related to re-activation of any nearby infection including TBC, sarcoidosis, etc. If this is your case, I'd suggest to schedule another Ct-Scan after 6 months (but this time with empty bowels) to evaluate better the state of lymph-nodes. All the best! Dr.Klerida
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Dr. Klerida Shehu

Gastroenterologist

Practicing since :2006

Answered : 2266 Questions

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What Causes Abdominal Pain,inflamation Under Rib Cage,pressure Below Diaphragm And Reccuring Heat In Face?

Brief Answer: Please follow the suggestions below.... Detailed Answer: Hi XXXXXXX I have read your medical history carefully and understood your concerns. The symptoms you are experiencing might be related to gastric or digestive problems. I'd advise to take simethicone and omeprazole for bloating and pain. You are saying to have had a suboptimal Ct-Scan because of feces and gas. Could you please send in the results of your tests? That could help me assist you further! Meanwhile, I'd suggest to repeat the Ct-Scan and to do MRI of the abdomen to better evaluate its condition. The polyps seen in your gallbladder together with mesenteric lymphadenopathies are also better evaluated by MRI. Looking forward to kindly have the requested test results! Dr.Klerida