What causes abdominal pain?
MRI of the thoracic spine
Thanks for your query.
Noted and re-read the history.
The pain is at a fixed area it seems.
It is increased after weight lifting.
All the investigations done till now related to this problem are negative.
Sphincter of Oddi dysfunction will always be picked up by the tests. So no question about this unless the investigations are abnormal. So out of question.
Pancreatitis will never be increased by weight lifting.
Gastrtis pain is typically burning sensation and increases with stress. It is usually increased on food.
As you have done all relevant tests and are negative, I would advise for a few more tests which may help ::
*MRI of the whole spine particular attention to the thoracic vertebral area. Disc and such problems causing compression can mimic the symptoms you have and your saying that the pain increases on weight lifting leads more to this diagnosis.
* Angiography of the abdominal aorta and the arteries supplying the GI system to see for stenosis/ blockage.
Let this be diagnosed or be ruled out.
Consultation of the Neurologist or Neurosurgeon can help in this regards, better to have a second opinion.
Yes, indeed !
Yes, very true !
Sphincter of Oddi manometry can be done and involves passing a catheter into the bile and/or pancreatic duct during ERCP ( Endoscopic Retrograde Cholangiopancreatography ) to measure the pressure of the biliary and/or pancreatic sphincter. It is considered the gold standard diagnostic test for Sphincter of Oddi Dysfunction.
Go for ERCP
Thanks for your feedback and an understanding you have.
Since the MRI and all other investigations are within normal range, this can be a type III SOD- Sphincter of Oddi Dysfunction.
The medical management is by giving anti-spasmodic medicines only,
ERCP can be employed for diagnostic (including manometry if available )as well as therapeutic. You have to discuss this with your Gastroenterologist.
Since the MRCP and other investigations are negative, ERCP can help in diagnosis > the direct visualization of the Sphincter is possible, also to see if there is scarring / edema and fibrosis of it. A small cut in the sphincter called sphincterotomy may hep as a treatment too.
Medical treatment is to take the anti-spsmodic tablets.
The causes of SOD are not really understood. There can be a fibrosis over this sphincter mechanism, or the sphincter has become less pliable.
Weight lifting or exercises can not cause this.
Follow-up ultrasonography & Upper GI Endoscopy
Yes, surely your concerns are noteworthy.
As a rule, no simple cysts of the size of 1 cm in any part of the body cause pain. They can cause pain only if complicated by sudden increase in size, infection or bleeding (and twisting in case of ovarian simple cysts).This may be the reason your Doctors are not feeling these simple cysts to be a cause of pain.
Mild pancreatitis will definitely cause pain, but still it will be characteristic of a pancreatic pain only. Severe, in the mid-upper abdomen or back, starts or increases after few hours of food, not immediately on food.
Pancreatic enzyme supplements, when taken with the food can lessen or relieve pain ( one diagnostic and therapeutic simple test).
These can be easily followed-up regularly on a simple ultrasonography- we have to just see the size and contents.
Let us suppose, this is causing pain, it will be felt in the center of abdomen or in the back, exactly where they are situated.
The pain can be due to gastritis, comes on eating or drinking almost immediately, not relieved easily, increases with stress or certain foods and beverages, can appear to be gas pain in upper back as you have rightly explained.
Tingling in hands and feet, and mild weight loss can be due to chronicity of the problem. Gas pain in the upper upper back can be due to gastro-esophagitis as it is enhanced by eating and drinking.
There has to be an evidence-based investigation to prove pancreatitis. You may also go for upper GI Endoscopy.
I hope this helps you further to understand the problem.
stress > gastritis
Sorry for the late ( you know how is the Surgeon's life).
You had USG, Endo, Ba and all came to normal except for GASTRITIS.
The main reason of gastritis is always the stress and the symptoms related to the ones you have explained.
You have a pain mainly before breakfast and then goes away.It is never severe.
EUS is a very good investigation in the hands of an expert. and will help us to rule out any problem and the condition of the 2 simple cysts that were detected. Please get these too done if you have the facility.
Tingling is mostly due to stress, and is usually non-specific.
MRI, MRCP, CT, USG, Clinical Judgement of so many Doctors, blood tests can not miss even mild pancreatitis. I hope your blood sugar levels are also normal.
Stress is the mother of many many diseases = (dis-ease). It has to be under control at any time at any cost, I would say. You live only once, then why to have anything which causes stress? Go out , change the atmosphere, habits, hobbies, lifestyle- Say NO- a strict no to anything which you know increases your stress.
Is there any history of pancreas related disease or disorder or deaths in your near and dear ones?
I again hope this helps you a lot.
Therapeutic dose of Vitamin A and D.
Nice to know your glucose is normal, the question was pertaining to pancreatitis. Normal glucose again supports against pancreatitis.
Yes, a proper supplement of Vitamin D and A helps healing the mucosal lining of the stomach (gastritis). Take the therapeutic dose in consultation with your Doctor.
Thanks for your feedback again.
It is very true that the pancreatic pain is always referred to the part of the back where it is situated, not in the upper back.
Upper back pains are usually due to stress and muscle spasm ( I do not mean to connect to your case).
RUQ Pain :: Just a thought. Please do a simple test at home. Palpate and put a pressure on the lower ribs. See whether it elicits the similar pain. If yes , this can be a case of costo-chondritis. It can have varied associated symptoms , least understood and easily missed by many. ( you had noted that the pain increases on lifting weight and may be exercises ans such activities which expands the chest more than normal and also increases with stress)
Vitamin D deficiency is not well documented to be connected to pancreatic problems.
If there was an acute pancratitis, then only chronic will develop.
By definition: Chronic is where there is permanent damage. And is easily picked by any imaging tests.
Costo-chondritis to be thought of
Thanks for your feedback.
Costo-chondritis is more probable, the nerves pass from the under-border of the ribs , thereby whenever there is inflammation of this area, the nerves might be transmitting the pain to the area where you feel it.
Costo-chondritis: the exact reason is not known, it does increase with stress. Tapering doses of steroids like Deflazacort is the best diagnostic and therapeutic trial. This means if the pain goes away, this is diagnostic of costo-chondritis and therapeutic as you get a relief. We Do advise additional anti-inflammatory medicines, Doxycyclin and multivitamins, application of local rubrafacient liniments ( which make the area warm and increase blood circulation, reduces the pain and improves the healing)
You may please discuss with your Doctor and take a course if you believe.
It is good that you do not have diabetes. Deflazacort can be safely given.
Well the anxiety would obviously not go till you get relief ( and get a diagnosis ).
Relax: it helps in early recovery.
The User accepted the expert's answer
Get personalised answers from verified doctor in minutes across 80+ specialties
- What causes backache with abdominal pain
- What causes lower abdominal pain
- What can cause abdominal pains
- What causes abdominal pain with diarrhea
- What causes abdominal pain and sickness
- What causes abdominal pain and constipation
- What is causing abdominal pain and ibs
- What is the cause and treatment for abdominal pain
- What causes severe abdominal pain
- What causes diarrheavomiting with abdominal pain