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Is It Possible That Stomach Or Colon Would Cause Pain On The Left Deep Under The Rib?

Posted on Wed, 26 Mar 2014

Question: Is it possible that stomach or colon would cause pain on the left deep under the rib? With sometimes pain in the same area in the back? Or is this more likely pancreas? I have pain in the left most often superficial but high under the rib. And sometimes pain more toward the center under the sternum. Have a history of GERD and years (4) ago had a bout of gastritis and duodenal ulcer but I don't remember it feel like this. Afraid it is pancreatic cancer .

Answered by Dr. Grzegorz Stanko (1 hour later)

Brief Answer: Detailed below. Detailed Answer: Hello! Thank you for the query. Upper left abdomen is where large intestine and kidney are located. Stomach and pancreas is more in the center and right side. Some heart problems can also cause upper left abdominal pain. The most probable reason of your symptoms are kidney stones or infection. Upper left abdominal pain which radiates to the back is quite characteristic for this condition. You may also have frequent urinating, burning while urinating, lower abdominal pain. Large intestine usually does not give a pain which radiates to the back. However in some cases of diverticulitis similar symptoms can appear (diverticulitis usually affects sigmoid colon what gives lower left abdominal pain). Pancreas cancer in first stages does not give any symptoms at all. First symptom is usually jaundice. As you have had abdominal CT, pancreas cancer is rather ruled out with this test. Heart ischemic disease or heart arrhythmia can also give upper left abdominal pain along with chest pain, burning. The pain usually radiates to the left arm or jaw. GERD and ulcers history can have some impact to your abdominal pain which can coexist with mentioned above issues. Here is what I suggest you to do: - have urine analysis and abdominal ultrasound (in CT stones can be invisible) - if you have had chronic constipation, any blood or mucus in stool, weight loss, low hemoglobin level, colonoscopy should be done - have gastroscopy to see if there is no ulcers in stomach and duodenum - have heart ECG and consult cardiologist Hope this will help. Feel free to ask further questions. Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (1 hour later)

Thank you for your quick response to my question. I have been u DDR the care of a cardiologist for years now for tx of the palpitations. My last nuclear stress test was done in August and was normal. My last ECG was a few weeks ago and showed no change from previous ECGs. I have been having general abdomi all pain for a while now but this specific pain is the one that is concerning to me. It is kind of sharp as if someone is poking me. The exact location would be just slightly left of the middle if you drew a line between my sternum and lateral left side. Sometimes I have pain that goes to below the sternum as well. So, with the negative CT I can assume no pancreatic cancer? I was hoping that was the case. I have an appointment with the GI specialist next week as my sister just had a malignancy removed from her colon. I did two of the Walgreens FOBT tests that came back negative and last week I did a fecal immunoassay blood occult test with the lab and that came back negative. I am hoping this is a good sign because I am afraid of what may be found with colonoscopy. The closer this appointment gets the more afraid I become. Does it mean anything that sometimes I don't have the pain at all? Also I had complete blood work done which except for a slightly low potassium level was normal. Also normal blood sugars. She did CBC and chem 8. Also had ua done recently. Assuming normal because I was not told otherwise but did not specifically ask.

Answered by Dr. Grzegorz Stanko (17 minutes later)

Brief Answer: . Detailed Answer: Yes, pancreas cancer is ruled out with CT. You should forget about this cancer. Colon cancer in the family is a risk factor if your sister was younger than 50 when it was diagnosed. You should have colonoscopy 10 years earlier than your sister diagnose age. Regular FOBT test should be done 3 times. Before this test, you should not eat meat for 3 days. Immunoassay FOBT is a better one and allows to assume that you are free of blood in the stool. But there is always a possibility of some small lesion in large intestine (polyps) which needs to be removed. So colonoscopy seems advisable. If its about your abdominal pain, as all other things seems to be rule out, gastroscopy is a next step to see stomach condition. Intermittent pain does not indicate anything significant. Every person has abdominal pain from time to time and usually it does not point to a cancer. In conclusion, please do not worry about cancer. Pancreas cancer is very rare and as you have CT seems hardly possible at your case. Colon cancer grows about 10 years and abdominal pain is not specific symptoms. Before the pain usually blood in stool, weakness, bloating, constipation appear. As you havent mentioned any of these symptoms, your FOBTs are negative, the risk of colon cancer is also very low. So please treat colonoscopy as a precaution. Hope this will help. Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (12 minutes later)

Thank you so much! My sister is only 18 months older than me (I'm 43) so getting checked ten years earlier is not an option. I did the first walgreens test in December. I bought two kits and tested five consecutive BMs over a thre or foud day period. The next Walgreens tests was probably late Jamuary and the lab tesy was last week so I am trying to take comfort in the fact that they were all negative. I do not ever have blood in stools or constipation. Actually quite the opposite. Loose stools and IBS type symptoms but no diagnosis of IBS. I will try not to worry before my appointment next week. Should I get both colonoscopy and endoscopy? That seems awfully invasive. Which is important? Are there other options for either one?

Answered by Dr. Grzegorz Stanko (18 minutes later)

Brief Answer: . Detailed Answer: Gastroscopy should be done as you have had ulcers before. And you have upper abdominal pain. So sounds like you wont avoid it. During this test samples will be collected if ulcers or inflammation will be present. This is very important as in rare cases what acts like an ulcer can be something worse. Colonoscopy is also important for you. You may have virtual colonoscopy instead of it. It is not invasive but polypd can not be removed with it. Please discuss it with GI doctor. Regards.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar