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Chronic mid-back pain and abdominal pain. Test showed low blood pressure. What is going on?

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General & Family Physician
Practicing since : 2010
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Chronic mid-back pain bilaterally. Burning and sharp in nature. It never lets up. Also chronic abdominal pain. Some epigastric and Rt sided beneath the ribs. Lost 66 pounds in 2 months from the pain and nausea. HIDA scan & ultrasound was negative. Blood pressure and heart rate are both low. I used to have hypertension for 20+ years. Used to take 2 BP meds an now take NONE. No meds at all. I feel weak, light headed, sometimes confused fatigued and like passing out much of the time. Also I feel out of breath or like I will stop breathing. Yes, I know thats odd. NON-SMOKER. Also, Was diagnosed with Hashimoto's thryoiditis 6 years ago. Had to stop taking Armour Thyroid as even 15- 30 mg made me anxious et jittery. Foul (chemical) smelling stools for months. Soft stoolsand medium brown in color. Not constipated. Been to several MD's/DO's here and nobody has a clue. Most blood tests are 'normal' they say. Had several flat plates of abdomen and a couple of the back region. Shows nothing. Wanting an MRI. Been VERY sick and in constant pain for 7 months. Been taking probiotics, mastic gum and l-glutamine (all good for the stomach/intestines) and not consuming any sugar, no alcohol, no tobacco, no soda pop, no junk food. Nothing high fat, or processed much. Need relief soon!

Any thoughts as to what is going on?
Posted Fri, 2 Nov 2012 in Back Pain
Answered by Dr. Kulbir Singh 2 hours later
Hello and thanks for posting the query
I have read your query in detail. It seems that your problem is related to Digestive system and Heart related issue.

Confused status, fatigue, muscle weakness and weight loss can be related to bradycardia? I want to know some more detail like:
1. Your normal heart rate at rest in day time and during exercise or workout?
2. What is average Blood Pressure reading during day?
3. Have you undergone Holter study (24 hours EKG recorder)?
4. What is the report of Stress test if done, have you achieved the required heart rate?

As per back pain is concern it may be due to PIVD (Prolapsed Inter-vertebral Disc). You have to go for MRI scan to rule out this. Pain and numbness or burning sensation can radiate to both limbs in this disease.

Rest of the problem like nausea, foul smelling stool is related to Digestive system diseases like inflammation or infection of the track, GERD and Liver disorders. You needs to be investigated and treated for that.

Hope you answer the queries as early as possible, so that I can help you and give you a right advise.
Best Wishes
Dr. Kulbir Singh
Above answer was peer-reviewed by
Follow-up: Chronic mid-back pain and abdominal pain. Test showed low blood pressure. What is going on? 13 hours later
Normal heart rate (resting) prior to being sick for 7 months was in the 80's. Over the past few months resting goes as low as 44! Average resting HR now is low 60's.
Average blood pressure resting is 108/60's - 116/77. BP has been as low as 90/50's.
Heart rate with exertion can go to 80's maybe 90 but returns to 60's quickly. That has not been what was 'my normal' for many years.

They have not done 24hr holter monitor. Lexa Scan was considered normal. I achieved the required heart rate during the study.

The abdominal pain, back pain and breathing issues where I feel like its difficult to take a XXXXXXX breath, and feeling SOB or 'out of breath' has all been happening for many months. The breathing issue has been the past three months. The abdominal and back pain X 7 mos.

I do not have GERD. Liver enzymes were elevated some time ago when they had me taking many medications for years. But currently I'm not taking any meds. I'm still not sure if I have gallbladder problems. I saw a surgeon. He was unsure since HIDA scan and ultrasound were negative, but I have three family members who also had negative tests but had theirs removed and seem to be doing better.

I have been seeing a chiropractor for 2 months. Not much relief. He does adjustments, E-stim, and accupuncture. It helps for a day or so, but doesn't ever completely get rid of the pain.

Let me know if you have any other questions/concerns. Thank you.
Answered by Dr. Kulbir Singh 2 hours later
Hello XXXXXXX and thanks again for the query
It seems totally a heart related issue. You have to immediately go for 24 hr holter study which records your exact maximum and minimum heart rate and any significant pause between two beats. Heart rate 44 per minute is a matter of concern. It needs an urgent treatment. Heart rate below 50 can cause breathing problem, weakness, fatigue, pain and even faint attacks.

Feel free to consult your cardiologist and go for the study and accordingly treatment can be planned. Your doctor may advise you Permanent Pacemaker Implantation (PPI) or prescribe you specific medication depending on the holter examination report.

As your Lexiscan stress test is negative, there are very less chances of having Coronary heart disease. So the problem you are facing can be due to weakness of the heart muscle. A pacemaker implantation can take care of that.

Gall bladder issue can be settle down later, as heart is a very important organ and cannot be ignored. If your heart is OK, rest of the thing can be made OK later on.

Hope you got answer to all your queries. Keep me informing about your health. Write back you have any further queries.
Best Wishes
Dr. Kulbir Singh
Above answer was peer-reviewed by
Follow-up: Chronic mid-back pain and abdominal pain. Test showed low blood pressure. What is going on? 12 minutes later

I've seen three cardiologists. One I used to see every year for follow up since he's the one who had me on BP meds. I saw him less than a month ago. He just does not feel this is heart related. He can't offer any explanation of what's going on but said he doesn't feel its my heart after reviewing the Echo, lab work and Lexa scan. Also why he doesn't want to order a holter monitor.

My chronic, severe back and abdominal pain are of great concern to me. I get no relief and I dont want to take pain meds. They only mask symptoms and do nothing for cure. Plus there is great risk of kidney/liver damage especially since I had elevated liver enzymes from all the meds doctors had me on for a couple of years. I take nothing now and I prefer to take nothing or would rather take nutritional supplements, vitamins, minerals etc. Like CoQ10, fish oil, D3 and things like that.

Since I have been sick and in chronic pain with autoimmune issues/Fibromyalgia I know there is stress in my body. I think there is something going on with my adrenal glands. Not saying it is Addison's disease, but I have all except one or two of the classical symptoms. Adrenal fatigue to say the very least, if not more.

My pain is very close to my kidney region. The adrenals are right on top so it would make sense putting the pieces of the puzzle together. Wouldn't you agree about something happening with the adrenals? With all the pain/pressure happening constantly, it makes me question if there is a tumor or something growing. Its always a possibility. All the more reason I need an MRI.
Answered by Dr. Kulbir Singh 2 hours later
Hello XXXXXXX and thanks for posting follow up query
If you and your doctor think that your heart has no problem than why you are getting bradycardia and shortness of breath? As you’re all other reports are within normal limit. You have to prove it by holter examination. Consult your doctor again and discuss it and get to a decision.

As per your adrenal disorder is concern, Low blood pressure and heart rate can be present in it but associated with low sodium and high potassium level. I don't think you have it. But to give a relaxation to you mind do you CT scan or MRI abdomen and rule out this.

As I have earlier said that your pain might be due to PIVD so when you are doing MRI abdomen, has a look at lumbosacral region.

My final advice to you is that keep your mind relax and do not diagnoses number of diseases in it. Let your treating doctor do the thing. Stress and anxiety itself gives you a feeling a pain.

Hope you understand and follow the instruction of your treating doctor. Have a appointment with your orthopaedics for back and abdominal pain.
Best Wishes and have a healthy life.
Dr. Kulbir Singh
Above answer was peer-reviewed by
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