Subject: Re: chronic left flank/upperleft quadrant pain
Forum: The Gastroenterology and Liver Diseases Forum

Topic Area: Gastroenterology - General

I have lupus and am on Prednisone, Relafen, Plaquenil, Hydrochlorothyazide, K-Dur, Pepsid AC. calcium and premphase. Have had 2 C-sections, 2 incisional hernia repairs, 1 surgery to remove scar tissue and a gall bladder removal.I've been having pain that seems to begin on the left side toward the back. (Just below my bra line.) It radiates to the left front. I have mentioned this to my Dr. (Rheumatologist) several times. She doesn't address it. I went to a G.P. last winter and she scheduled an abdominal ultrasound. The day of my appointment there was a snow storm & I had to cancel. On my next visit to my Rheum. she said, "An ultrasound won't show anything, anyway." I guess I don't want to have the ultrasound and be told.."I told you so." This pain seems to be mostly in the evenings. It seems to be related to eating, although I haven't been able to pinpoint any certain foods that trigger it and I sometimes wake up with it in the mornings. Although it worsens after I eat. Twice it has esculated to the point that I have vowed to call the Dr. the next day or the next Monday. Both times, after the pain becomes so much worse...it stops. Then I am fine for about a week or so then it starts again. It gradually increases in intensity & frequency. When it gets real bad I can releive the pain by getting on my knees in front of the couch & laying over onto the couch. I once had an abcess in my abdomen that acted similar to this. I had had a incisional hernia repair with a mesh screen. My body apparently rejected the screen. In surgery to remove scar tissue (shich the Dr. believed to be the source of my pain) they found a "ball" of tissue that was abcessed. No screen was found. This surgery was before my dx of Lupus. I asked my Rheum if she thought there was a posibility of chronic pancreatitis. She said not unless I was an alchoholic. Since then I have found literature that states that lupus can attack the pancreas. I am at my wits end. I am too embarrassed to go back to my G.P. After I didn't rechedule my abdominal ultrasound because of what my Rheum said. Would an ultrasound show an abcess, pancreatitis, ulcer? UA, WBC & BUN are all normal. Any ideas?
Thank you!
Rita

Dear Rita,
It is difficult to know the cause of your pain, given the complexity of your medical history. In view of the chronicity and disability associated with your pain, it wouold seem appropriate to look for possible treatable causes. If the workup is negative(i.e. no cause is found), then this unfortunate but you would not have to think that you are missing a possibly treatable cause for your symptoms.

An ultrasound test can be a good test to diagnose problems of kidneys, pancreas, gall bladder and liver. If you had pancreatitis, the ultrasound MIGHT (but not necessarily) be abnormal. LUPUS can cause pancreatitis.

This information is presented for educational purposes only. Ask specific questions to your personal physician.

HFHS-Gastro-MD-RF
*keywords: abdominal pain, lupus, pancreatitis, ultrasound
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