Pain under lower LEFT ribcage, worsens with body movement

Chest and lungs
1

Chronic pain, LEFT UPPER abdomen and chest, already for 5 months.

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- Dull pain, sometimes also feeling like bubbles, mostly under lower left ribcage. Worsens with body movement like moving fast around the house (but not with shaking of for example going on a car). 

- Sometimes also at heart level, rarely radiating towards armpit. Occasional back pain, also in left side. No pain in right side, be abdomen or chest.

- Pain started 5 months ago. One lung infection 4 months ago (pain disappeared temporarily with antibiotics). Periodic constipation and occasional nausea and heartburn

- Besides body movement, pain also worsens after fatty meals and stress.

- Doctor first suspected as pericartitis or pleurisy, then costochondritis, now suspected to be IBS)

- Blood tests all normal (blood count, thyroid, liver)

- Negative celiac, negative H. pylori, no blood in stool). 

- Normal ECG, normal Abdominal ultrasound, no Colonoscopy yet.

- Abnormal tests: slightly elevated IgA (but only barely above upper limit); weak positive calprotectin stool test (intestine inflammation)

- I have mody diabetes (mild), controlled by diet, ans periodontal disease. Age 36, male

- My suspected diagnosis: mild diverticolitis, pleurisy, fibromyalgia, B12 deficiency, Chronic pancreatitis, Costochondritis

 

Has anyone experienced something similar? Upper left chest/abdomen pain that worsens with simple body movement?

2

Wondering if you have a disperse vascular disease. Microvascular dysfunction can cause havoc with referred angina from heart and also possible issues with good modality in intestines... (vessels ARE everywhere if micro vessels are dysfunctional then they don't feed areas well)

Just a thought. May be worth looking into but as it's a less understood area? Typically all boxes must be ticked off first. 

Autoimmune issues may also drive this type of non obstructive heart/vascular disease. They are unsure of exact cause. 

Best of luck-

Annette 

3

Many thanks for your suggestion.

What are symptoms, method of diagnosis and treatment? Do you know people that had it?

My pain seems not worsened by exercise itself but by body movement.

4

I don’t know if you have what I suggest. Here my info-

I do live with this dysfunction. It mostly affects my heart. The only gold standard testing is done in two possible ways to ‘catch’ what may be happening in our microvasculature.

- invasive;  provocative catheterization done only by those cardiologists who do many of these. So typically at centers of excellence.... IE Specific teaching hospitals and Mayo Clinic locations. 

-non-invasive; cMRI also provocative (means it is an agent that creates heart to exert or beat faster) then a rescue agent is added and they measure perfusion or flow. In this, a blushing is seen in imaging but again... MUST be those used to diagnosing this as others may miss it.

This dysfunction is thought to be driven by a lack of natural nitric oxide production. I needed donor nitro and had trouble getting a doc to try this. Once I finally found one who agreed I was presenting with this? We tried nitro tabs and it began lessening. Which also of course suggests what is wrong by what helps! I started to understand what was driving this and began better care. Keep in mind, I was completely fit. Great blood work. I ran 5k every other day. Attended stress by meditation.... and believe me they dismissed me for a long time because I looked so good. But I knew something was wrong and listened to my body. I was getting steadily worse, until I finally found (had to drive 5 hours and get out of town as my primary suggested- and I don’t live in the back woods by the way) a doctor who thinks outside of all those checked off boxes to see what was most likely happening. Sometimes these things they aren’t used to looking for, especially of they literally can’t see it in typical testing, are very real and need management. You must find someone who keeps expanding the scope of diagnosis. Where do you live? I may be able to suggest a doctor or facility.

This is non-obstructive heart or vascular disease. It is fast on the rise and there are many in a private group I moderate who are younger and were otherwise fit. Although I was 40 when it began, I was still considered too young for heart disease by docs. So no wonder you are dismissed. Also this is a 60% female disease and 40% male... some wrongly also dismiss males because too many have labeled this as a woman’s disease which it is not. More likely... but as percentages show? Not overwhelmingly female.

Typically, the symptoms are brought on by extra exertion, but often after you stop moving. I am concerned as your description of where you feel discomfort I sounds a lot like me... and all being left side... bottom line is almost every patient must go through the million dollar work up to be sure you don’t have what is typically the case. Then they can finally discern what less understood things might be occurring. Sadly this wastes time and money but it is the system we live with in health care. Although I see a big difference in clinical,awareness for this in the past 7 years? There are still far too many dismissed. It’s not as rare as they initially thought and also not as benign! Keep fighting to be heard and read a bit on Coronary Microvascular Dysfunction ...

there is a public page on Facebook if you search

Coronary Microvascular Disease- Non-Obstructive CAD and you may find some links to your presentation.

sorry this was a book... lol. Keep,listening to your gut on this. I know it can be frustrating but it is YOUR life.❤️

 

5

​Update. Recently the pain moved further along armpit into the left arm and made it numb for a few days. After a GP appointment, it was clear that the cause seems more neurological (something akin to Fibro or MS, B12 deficiency or something neurological, - could be even something like Lyme´s).

I was experiencing also muscle twitches, which seem to be the hallmark of something neurological or a nutrient deficiency (or Lyme - which I still await testing). 

Another possibility is something vascular, like your suggestion of microvascular disease, but the GP does not think so. 

What I find it interesting, is that the low level of chronic pain only worsens upon body movements, so that leads me to suspect of a vascular cause.

The gut symptons have mostly disappeared upon totally removing gluten and dairy from my diet and increasingly significantly omega3 consumption (like fish) and some meat too.

6

After 15 months i finally got a diagnosis!!!
The journey went like this:

  • Aug 2017, pain in upper left abdomen starts, initially some chest pain too. A week later, chronic constipation starts for a few months. ECG shows normal heart function
  • Sep2017, got pneumonia. Doctor suspected lung pleurisy. Symptoms disappeared for a month. Between guts and lungs, both me and doctors are left confused!
  • Nov 2017: return of constant pain under lower left ribs, now with GERD and food intolerances. I do many tests, mostly blood. Mild iron deficiency. No celiac. No H. pylori. Small raise in calprotectin. Abdomen ultrasound negative. Relief that pancreas, spleen and aneurysm, are not the cause of pain. Three doctors says its IBS, despite the unusual local persistent pain (not typical of IBS).
  • Jan 2018. Fasciculations started in the area of pain. I feel worried. Doctor wonders Crohns (but i have constipation rather than bloody diarrhoea). Other options considered were lyme disease (negative test) and multiple sclerosis.
  • Apr 2018. Slight swollen in same site of pain. This is unusual and I am worried about what is causing it. But all doctors and a gastroenterologist dismiss that as IBS and colon spasms. I do not believe them. I do a MRI for that part of abdomen, everything is fine. Frustated by not finding the root of the pain and swollen, I did also a chest x ray: also nothing usual.
  • May 2018. At this time, I suspect the culprit may be the stomach or colon (as others exams ruled out other organs in that area of the pain). I asked many of these doctors if it could be a hernia, all said no.
  • Jun 2018 I managed to get a gastro referred me into the waiting list for a colonoscopy and gastroendoscopy. He said probably IBS and the swelling is caused by air.
  • Nov 2018: colonoscopy shows that colon is fine. Endoscopy reveals a paraesophageal hernia!