Pain Below Ribcage On Left Side--spleen Problem?

[haybilly]

Hello all,

I have been experiencing a dull, but annoying, pain in the region just below my ribs on my left side [ about 3-4 inches, or 100 to 120 mm, above belly button] for about 3 to 4 weeks--initially I thought it was a muscle strain caused by lifting, twisting etc.. incorrectly but after it continued for several days and now weeks I can rule that out.

Having googled my fingers off I am now sure I have Celiacs disease, Swollen Spleen problems, small intestine and colon cancer, Crohns disease and any number of other life threatening illnesses---

I am away from home [ C.M.] and in a town with no English speaking doctors but on my return to civilisation I shall away to hospital for a zillion tests--but, in the meantime does anyone out there in TV land have any other ideas of unpleasant illnesses that I can worry about please????

[PeaceBlondie]

Hay, Billy,

Sorry to hear it. Our medical moderators are probably both off duty now, so take any advice with a grain of salt and an aspirin. Good luck

[Sheryl]

Actually I'm still here thru tomorrow but thanks for keeping on eye out PB.

Haybilly, what you describe is almost certainly nothing at all to do with your spleen nor is likely to be any of the other nasties you mention.

Assuming you do not also have fever or diarrhea, soft tissue injury (to muscle or ligament) or gastric or duodenal inflammation/ulcer are the most likely.

I would start by checking for the latter, because if that is what it is it will respond well to a nightly dose of omeprezole (20 mg) or ranitidine (300 mg to start with, can reduce to 150 later), both readily available over the counter in any pharmac, even in the boondocks (altho they may not recognize these generic names, so just ask for ya beurt tong and read the label yourslef). Should see the difference within 2-3 days at most. Google the contraindications and side effects first, as should be done before taking any medication. If it works you will need to continue it for at least 4 weeks and should either be tested or empirically treated for h. pylori infection.

A soft tissue injury will not be affected by these meds altho it will get temporary relief from anti-inflammatory drugs (ibuprofen, ponstan, even aspirin etc). However those same drugs would make gastric or duodenal inflammation worse.. So before risking that see if the above mentioned provide relief.

By all means if it persists, get a proper exam upon your return to civilization, but from what you describe it is unlikley to be anything immediately life-threatening. Initial test you would want in additiona to manual exam would be complete blood count, test for occult blood in the stool and test for h. pylori.

P.S. If you do have gastric or duodenal ulcer or inflammation, both alcohol and cigarettes should be avoided and go easy on the caffeine. If you can't totally avoid alcohol keep it to a minimum and always with food.

[haybilly]

Actually I'm still here thru tomorrow but thanks for keeping on eye out PB.

Haybilly, what you describe is almost certainly nothing at all to do with your spleen nor is likely to be any of the other nasties you mention.

Assuming you do not also have fever or diarrhea, soft tissue injury (to muscle or ligament) or gastric or duodenal inflammation/ulcer are the most likely.

I would start by checking for the latter, because if that is what it is it will respond well to a nightly dose of omeprezole (20 mg) or ranitidine (300 mg to start with, can reduce to 150 later), both readily available over the counter in any pharmac, even in the boondocks (altho they may not recognize these generic names, so just ask for ya beurt tong and read the label yourslef). Should see the difference within 2-3 days at most. Google the contraindications and side effects first, as should be done before taking any medication. If it works you will need to continue it for at least 4 weeks and should either be tested or empirically treated for h. pylori infection.

A soft tissue injury will not be affected by these meds altho it will get temporary relief from anti-inflammatory drugs (ibuprofen, ponstan, even aspirin etc). However those same drugs would make gastric or duodenal inflammation worse.. So before risking that see if the above mentioned provide relief.

By all means if it persists, get a proper exam upon your return to civilization, but from what you describe it is unlikley to be anything immediately life-threatening. Initial test you would want in additiona to manual exam would be complete blood count, test for occult blood in the stool and test for h. pylori.

P.S. If you do have gastric or duodenal ulcer or inflammation, both alcohol and cigarettes should be avoided and go easy on the caffeine. If you can't totally avoid alcohol keep it to a minimum and always with food.

Thanks for your reply, Sheryl [ I was hoping that you or GunnyD were about]--I also received a PM from another TV member who suggested exactly the same as you--i.e. an H Pylori infection [ probably dirty fingers preparing my 'somtam' if indeed that's what it is]--and I have already paid a visit to a local pharmacy and bought a couple packets of Omeprazole Miracid and am going to give this a try before anything else--I'm back in Chiang Mai after the New Year and will get blood tests done then--incidentally, I have read online that sometimes Omeprazole is combined with antibiotics--would you suggest this also, or is the Omeprazole sufficient on it's own??

Whilst I am not yet feeling any improvement, obviously as it's early days, but I certainly feel better hearing from you that it's 'unlikely' to be life-threatening--one of the problems with googling symptoms is that I usually find out I have everything known to man and should really be writing my will not surfing the net!!

P.S.--kick a man when he's down, eh--avoid alchohol, cigs and coffee--aaarrrggghhh!!

[Sheryl]

Thanks for your reply, Sheryl [ I was hoping that you or GunnyD were about]--I also received a PM from another TV member who suggested exactly the same as you--i.e. an H Pylori infection [ probably dirty fingers preparing my 'somtam' if indeed that's what it is]--and I have already paid a visit to a local pharmacy and bought a couple packets of Omeprazole Miracid and am going to give this a try before anything else--I'm back in Chiang Mai after the New Year and will get blood tests done then--incidentally, I have read online that sometimes Omeprazole is combined with antibiotics--would you suggest this also, or is the Omeprazole sufficient on it's own??

Whilst I am not yet feeling any improvement, obviously as it's early days, but I certainly feel better hearing from you that it's 'unlikely' to be life-threatening--one of the problems with googling symptoms is that I usually find out I have everything known to man and should really be writing my will not surfing the net!!

P.S.--kick a man when he's down, eh--avoid alchohol, cigs and coffee--aaarrrggghhh!!

The Omeprazole alone will reduce acidity causing a reduction in pain if the cource is, as suspected, inflammation (with or without ulceration) of the stomach or duodenum. So it will work for practical diagnostic purposes and also give you relief if we're right as to what it is.

Where it is used in combination with antibiotics is for the eradication of H. pylori which is frequently the underlying ciase of these problems. For that, it needs a 2 or 3 week course of omeprazole plus at least 2 different antibiotics. one of which is usually either flagyl or fasigyn (tinidazole) which can be unpleasant to take and will definitely require you not to drink ( !).

There are 2 schools of thought on this. One is to treat for heliobacter only if tests confirm its presence, the other is to treat empirically in cases where the person is known to have been exposed to food and drink of questionable hygienic preparation and/or living in an area where this is very widspread. (Basically all of us here in LOS. ). A variant on this last would be to treat empirically but only of the problem recurs or doesn't seem to respond to treatment with omeprazole alone. Unless there is some other obvious risk factor like having taken aspirin or NSAIDs, the odds are that in favor of being positive for h.pylori, and the noninvasive tests (i.e. blood tests as opposed to oness that require a tube down your node into your stomach) vary in their reliability.

I certainly wouldn't try to self-treat for heliobacter now while you are out in the boondocks as the treatment may make you feel worse intially. And if the Omeprazole doesn't bring any relief at all then odds are the pain has a different cause altogether and other possibilites should be considered.

So I suggest you stick to the Omez for now. If it brings partial or complete relief continue with it and then once you are back to civilization you can consider either empirical treatment for h. pylori (realizing that it will entail at least 2 weeks no booze and maybe some quesiness or nausea) or getting tested for it (which will cost time and money, might give a false negative and if positive, still require the no booze queezy 2 week bit) as you prefer.

Blood count, simple physical exam and stool test for occult blood good idea in either case unless you had a physical check up recently.

BTW, acohol and cigarettes really do do bad things to your gastric mucosa, and caffeine (esp coffee and colas) isn't too kind either. If you can't abstain at least cut back and mitigate the harm by taking food with it. Do not take any alcohol or black coffee on an empty stomach unless you want that ache to become a serious pain or worse....

[girlx]

at least 2 different antibiotics. one of which is usually either flagyl or fasigyn (tinidazole) which can be unpleasant to take and will definitely require you not to drink ( dry.gif !).

i took tinidazole in south america and had a full on, day and a half panic attack. learned later that that was because the drug affects the lithium levels in your brain. one of the worst days of my life. i would use it as a last resort.

funnily enough, i have had a sharp pain right under my left rib cage as well, for a few days now. thanks for all the advice.

[khundon]

Thanks for your reply, Sheryl [ I was hoping that you or GunnyD were about]--I also received a PM from another TV member who suggested exactly the same as you--i.e. an H Pylori infection [ probably dirty fingers preparing my 'somtam' if indeed that's what it is]--and I have already paid a visit to a local pharmacy and bought a couple packets of Omeprazole Miracid and am going to give this a try before anything else--I'm back in Chiang Mai after the New Year and will get blood tests done then--incidentally, I have read online that sometimes Omeprazole is combined with antibiotics--would you suggest this also, or is the Omeprazole sufficient on it's own??

Whilst I am not yet feeling any improvement, obviously as it's early days, but I certainly feel better hearing from you that it's 'unlikely' to be life-threatening--one of the problems with googling symptoms is that I usually find out I have everything known to man and should really be writing my will not surfing the net!!

P.S.--kick a man when he's down, eh--avoid alchohol, cigs and coffee--aaarrrggghhh!!

The Omeprazole alone will reduce acidity causing a reduction in pain if the cource is, as suspected, inflammation (with or without ulceration) of the stomach or duodenum. So it will work for practical diagnostic purposes and also give you relief if we're right as to what it is.

Where it is used in combination with antibiotics is for the eradication of H. pylori which is frequently the underlying ciase of these problems. For that, it needs a 2 or 3 week course of omeprazole plus at least 2 different antibiotics. one of which is usually either flagyl or fasigyn (tinidazole) which can be unpleasant to take and will definitely require you not to drink ( !).

There are 2 schools of thought on this. One is to treat for heliobacter only if tests confirm its presence, the other is to treat empirically in cases where the person is known to have been exposed to food and drink of questionable hygienic preparation and/or living in an area where this is very widspread. (Basically all of us here in LOS. ). A variant on this last would be to treat empirically but only of the problem recurs or doesn't seem to respond to treatment with omeprazole alone. Unless there is some other obvious risk factor like having taken aspirin or NSAIDs, the odds are that in favor of being positive for h.pylori, and the noninvasive tests (i.e. blood tests as opposed to oness that require a tube down your node into your stomach) vary in their reliability.

I certainly wouldn't try to self-treat for heliobacter now while you are out in the boondocks as the treatment may make you feel worse intially. And if the Omeprazole doesn't bring any relief at all then odds are the pain has a different cause altogether and other possibilites should be considered.

So I suggest you stick to the Omez for now. If it brings partial or complete relief continue with it and then once you are back to civilization you can consider either empirical treatment for h. pylori (realizing that it will entail at least 2 weeks no booze and maybe some quesiness or nausea) or getting tested for it (which will cost time and money, might give a false negative and if positive, still require the no booze queezy 2 week bit) as you prefer.

Blood count, simple physical exam and stool test for occult blood good idea in either case unless you had a physical check up recently.

BTW, acohol and cigarettes really do do bad things to your gastric mucosa, and caffeine (esp coffee and colas) isn't too kind either. If you can't abstain at least cut back and mitigate the harm by taking food with it. Do not take any alcohol or black coffee on an empty stomach unless you want that ache to become a serious pain or worse....

What FANTASTIC advice, I wish I had know about this site when I was in LOS.

I ate a hot dog in a Jet service station (I know stupid thing to do) and suffered similar pains etc including constant runs and vomating for almost 8 months.

I took many many courses of over the counter Antibiotics, which seemed to cure it but then it would come back with a vengance.

Finally went to hospital and they tested my liquid stools and told me, due to the over use of antibiotics I had only minute amounts of "good bacteria" in my gut.

I was already on Lansoprazole plus many other meds (dicky heart) so the doctor put me on high dose of Lactil Forte ( I think that was how it was spelt) bacterial tablets and I was right as rain in just over 1 week.

I paid 900Bht for 12 tabs, later found that they only cost 100Bht for box of 40 but hey ho!

Luck was on my side as prolonged "runs" could have had serious effect on my heart. I did however miss the coffee, beer etc.

I agree with OP, Google is great for most things but not if you are in the middle of nowhere and scared sh**less.

Wish you all the best and a Happy New year Haybilly

[haybilly]

Thanks for your reply, Sheryl [ I was hoping that you or GunnyD were about]--I also received a PM from another TV member who suggested exactly the same as you--i.e. an H Pylori infection [ probably dirty fingers preparing my 'somtam' if indeed that's what it is]--and I have already paid a visit to a local pharmacy and bought a couple packets of Omeprazole Miracid and am going to give this a try before anything else--I'm back in Chiang Mai after the New Year and will get blood tests done then--incidentally, I have read online that sometimes Omeprazole is combined with antibiotics--would you suggest this also, or is the Omeprazole sufficient on it's own??

Whilst I am not yet feeling any improvement, obviously as it's early days, but I certainly feel better hearing from you that it's 'unlikely' to be life-threatening--one of the problems with googling symptoms is that I usually find out I have everything known to man and should really be writing my will not surfing the net!!

P.S.--kick a man when he's down, eh--avoid alchohol, cigs and coffee--aaarrrggghhh!!

The Omeprazole alone will reduce acidity causing a reduction in pain if the cource is, as suspected, inflammation (with or without ulceration) of the stomach or duodenum. So it will work for practical diagnostic purposes and also give you relief if we're right as to what it is.

Where it is used in combination with antibiotics is for the eradication of H. pylori which is frequently the underlying ciase of these problems. For that, it needs a 2 or 3 week course of omeprazole plus at least 2 different antibiotics. one of which is usually either flagyl or fasigyn (tinidazole) which can be unpleasant to take and will definitely require you not to drink ( !).

There are 2 schools of thought on this. One is to treat for heliobacter only if tests confirm its presence, the other is to treat empirically in cases where the person is known to have been exposed to food and drink of questionable hygienic preparation and/or living in an area where this is very widspread. (Basically all of us here in LOS. ). A variant on this last would be to treat empirically but only of the problem recurs or doesn't seem to respond to treatment with omeprazole alone. Unless there is some other obvious risk factor like having taken aspirin or NSAIDs, the odds are that in favor of being positive for h.pylori, and the noninvasive tests (i.e. blood tests as opposed to oness that require a tube down your node into your stomach) vary in their reliability.

I certainly wouldn't try to self-treat for heliobacter now while you are out in the boondocks as the treatment may make you feel worse intially. And if the Omeprazole doesn't bring any relief at all then odds are the pain has a different cause altogether and other possibilites should be considered.

So I suggest you stick to the Omez for now. If it brings partial or complete relief continue with it and then once you are back to civilization you can consider either empirical treatment for h. pylori (realizing that it will entail at least 2 weeks no booze and maybe some quesiness or nausea) or getting tested for it (which will cost time and money, might give a false negative and if positive, still require the no booze queezy 2 week bit) as you prefer.

Blood count, simple physical exam and stool test for occult blood good idea in either case unless you had a physical check up recently.

BTW, acohol and cigarettes really do do bad things to your gastric mucosa, and caffeine (esp coffee and colas) isn't too kind either. If you can't abstain at least cut back and mitigate the harm by taking food with it. Do not take any alcohol or black coffee on an empty stomach unless you want that ache to become a serious pain or worse....

Once again, thanks for your excellent advice--I shall do as you say and try to cut down on the 'weed,whites and wine' or whatever--I have actually taken Metronidazole or Flagyl before, about 30 years ago in India following months of stomach problems which were finally diagnosed as Amoebic Dysentery and I can still remember how unpleasant it was to take the course--finally fixed the dysentery but the combination of the stomach problems and the cure meant that my guts were messed up for months if not years--and from the sound of GirlX's reaction to the other option, Tinedazole, I will resisit this one also if possible.

Anyway thanks to Sheryl, T_Dog [ who PM'ed me] PB and you other folks who have all helped--Have a really Happy and hopefully Healthy New Year

[T_Dog]

Glad to see we are still here and kicking! Happy New Year to all!

With H Pylori, there are numerous remedies that are suggested, and you can find SOME of those at

http://www.helico.com/treat_therapy.html which also has a lot of background on this bacteria. I responded to the double remedy of amoxycillin and omeprazole. As always, good to get a professional opinion.