Pain Under Left Side of Rib Cage (Page 6)

Hi, I too have had pain on my left side. It spasms when I bend down. I am not sure what is it, but it is also swollen. I will be seeing my doctor this monday and hopefully they will not find anything bad. I will keep you all informed.

Hi there. That one individual who posted about splenic flexure disorder---was really on target (at least for me personally). People should try a colonoscopy/sigmoidoscopy or barium enema test as a first step. The splenic flexure disorder (would define those who feel the symptoms of pain on their left side under the rib and tenderness in the abdomen.) google splenic flexure disorder for yourself to see if it may match your symptoms. Other symptoms dealing with diarrhea with passage of blood or mucous in the stool could be "ulcerative colitis"--confined to the distal colon and rectum. Also the pain that people are experiencing could be due to a large bowel obstruction (cecal volvulus)--constipation and cramping are some of the symptoms involved with it.

Symptoms of splenic flexure disorder (or colon splenic flexure distention) are (1.) rapid heart rate (2.) abdominal pain (3.) tenderness or a palpable mass

tests that are done to see if one has splenic flexure disorder are
(1.) abdominal x-ray (2.) barium enema (3.) abdominal ct scan and (4.) abdominal mri. A colonoscopy wouldn't hurt either.

I had one of the original postings in this chain. After getting caught up on the latest postings here, particularly that of whirlygirly, it really seems like my symptoms could very well be due to splenic flexure syndrome. Particularly in light of the relatively recent heart manifestations I have been experiencing - specifically rapid heart beats and palpitations in conjunction with the upper left abdominal discomfort, increased stress and even, in some cases, exercise. I have seen a cardiologist, and my heart is fine -- so these seemingly heart related symptoms must be due to sfs, right? It would be nice to get a confirming diagnosis from my gi doc, but no such luck yet. And what can be done to eliminate, or at least minimize, the symptoms? Exercise used to help, but now I feel stressed about the heart-like symptoms when I exercise, so I am not sure what to do.

Hey dougfish. I am going to be investigating into the splenic flexure distention myself--to see if that is what is causing my pain. I have pain under my left rib too--and sometimes stabbing pain in the abdomen (middle to left side)--which sometimes worsens after eating. I had blood tests/endoscopy--which seemed normal/minor gerd but nothing too serious--haven't had a colonoscopy in 8 years and have had serious cramping/and constipation in that same area (under the rib)=lower left quadrant of the abdominal region. Haven't had any tests done for my abdomen/or colon in a long while. Like you dougfish--i have serious heart palpitations too--my heart beats so fast for no reason that the inside of my palms sweat and I sometimes feel lightheaded from it. I too thought it was my heart so I had a chest x-ray and everything was okay as far as the results go. Since my pain only radiates under the left rib--and middle abdomen/lower left abdomen--and sometimes in the chest cavity/sternum--i'm really thinking spleen/colon/abdomen here.

I understand everyone's frustrations here and I am glad there is a forum to look for answers to these problems. I have had the pain in the chest on and off for 2 and 1/2 years (worse after eating/or lying down at night)/sometimes accompanied by fast heart palpitations, constant pain under the left ribs for the same amount of time--as well as the abdominal pain--the cramps/and constipation under the left rib--lower left side of abdomen has only been occurring since the end of november of 2005 -recent. During that time--i feel such pressure like something is blocked on the left side--which is causing me such severe cramping.

I am going to my physician next thursday to seek out options/tests and ask questions about the splenic flexure distention and if the colonoscopy can detect the splenic flexure distention or if I will need additional abdominal x-rays/ct scans and such to detect it.

To dougfish, did you have a colonoscopy at all during the time you were having all of these pains--if so, did they find anything. Just wondering--because I am trying to use this forum as a way to rule out tests that don't need to be done if it didn't help anyone on here--with these same problems. Thanks.

Hey there. Have you had any tests done on the abdomen at all like x-ray, ultrasound, or mri? If so, did they find anything? Thanks. Sorry, I reread my earlier post--read you didn't have pain under the ribs just the abdomen/fast heartbeat. Sorry. Still wanted to know if you had a colonoscopy though---because the colon--is part of the intestine--the intestine along with the colon is part of the digestive chain and the abdomen is centered somewhere around all of it. Thanks.

Alternative names
colon splenic flexure distention
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definition


distention of the colon''s splenic flexure is an enlargement of the splenic flexure beyond what is normal.
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causes, incidence, and risk factors


distention is usually caused by infection (tuberculosis, amebiasis), inflammation (ulcerative colitis, crohn''s disease), twisting of the colon (torsion, volvulus) or obstruction (cancer). If the colon does not contract properly, the splenic flexure can become distended.


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symptoms


symptoms of fever, rapid heart rate, abdominal pain and tenderness, and a palpable mass are caused when the splenic flexure becomes ballooned.


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signs and tests


splenic flexure distention may be identified by the following studies:

abdominal x-ray
barium enema
abdominal ct scan
abdominal mri

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treatment


treatment involves decompressing the colon and treating the underlying cause of distention. This may be done with a rectal tube for decompression, or a colonoscopy to remove excess air in the colon. Occasionally, surgery may be performed to remove an obstruction or to prevent perforation.


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expectations (prognosis)


prognosis is generally good if an underlying cause of distention can be identified and treated.


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complications


complications are primarily perforation (hole in the colon) and infection.


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calling your health care provider


if symptoms of abdominal pain, abdominal distention, or fever occur, call your provider.


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prevention


there are no methods of preventing splenic flexure distention.

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•••

What is the anatomy of the colon?

The colon extends from the end of the small intestine to the anus looking somewhat like a large question mark placed over the belly. The first part is the cecum to which the small intestine and the appendix are attached. It is usually found in the right lower abdomen. The ascending colon goes upward from the cecum to the right upper abdomen. The colon turn underneath the liver at the hepatic flexure and extends across the belly as the transverse colon. It then turns downward at the splenic flexure to the descending colon. This extends to the sigmoid colon in the right lower abdomen. The lowest 5 inches (8cm) or so is the rectum which continues to the anal opening. The terms colon or colorectal refer to the entire colon including the rectum. For technical reasons the rectum is considered separately for treatment.


1.2 what does the colon do?

The colon's primary function is to reabsorb water from the digested food that enters from the small intestine. It also holds solid waste until it is convenient to eliminate.

Chest pain

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excerpts from living longer with heart disease: the noninvasive approach that can save your life health information press, los angeles, ca copyright by howard h. Wayne, m.D., m.S., f.A.C.C., f.A.C.P

living longer with heart disease: the noninvasive approach that can save your life can be ordered directly from health information press by calling 1-800-med shop (1-800-633-7467)



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diseases and conditions that may cause chest pain
a large number of conditions other than obstructive coronary artery disease may cause chest pain. The source may be from other structures and organs within the chest, the chest wall itself, the spinal column, or the abdomen. Some diseases will indirectly cause coronary artery disease, that has been present in silent form for many years, to become symptomatic. In such cases, treatment should be directed at the primary cause rather than the fact that coincidental coronary artery disease is causing chest pain. The following is a list of some of the more common causes of chest pain. It is by no means a complete list.



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vascular causes of chest pain

hypertension
(high blood pressure) as a cause of chest pain in both men and women is listed first because it is the single most common cause of chest pain, including coronary artery disease itself. In other words, more people suffer from chest pain due to high blood pressure than those who have chest pain because of obstructive coronary artery disease. Considering the fact that 64 million people in this country have hypertension, and approximately 75% of them are either unaware of its presence, or are not adequately treated, it is not hard to understand why so many individuals with high blood pressure are having chest pain.
Although it is a long known fact that hypertension can cause chest pain, it is not a commonly known fact. Indeed, most doctors including cardiologists seem to be completely unaware of it. Complicating this lack of awareness on the part of doctors is the fact that hypertension may exist for years with both patient and doctor being unaware of its presence. This is because typically such patients will have a rise in their blood pressure only during periods of stress or extraordinary physical activity. At rest, or in the absence of stress, their blood pressure is normal. Thus, their blood pressure is apt to be normal during a routine office examination in which blood pressure is typically taken while the patient is at rest. Eventually the blood pressure of such patients will become elevated even at rest, but not until there has been extensive damage to the kidneys, heart, vascular system and brain. This is why hypertension has been called the "silent killer."

the mechanism of an elevated blood pressure causing chest pain is similar to the changes that occur when a blood pressure cuff around the arm is inflated. The pressure within the cuff is transmitted to the arm itself, and directly to the brachial artery within the arm. When the pressure within the cuff becomes greater than the pressure within the artery, the artery will collapse and blood flow will stop. In the case of the heart, when the blood pressure is elevated, that pressure is transmitted back to the cavity of the left ventricle. The increase in pressure is transferred to the heart muscle itself. When the transmitted pressure within the heart wall is great enough, it will cause the small coronary arteries within the muscle, that are branches and smaller in diameter than the surface coronary arteries, to collapse. Therefore, blood flow within the muscle will be reduced or cease altogether, and chest pain will result.

It should be apparent that if an individual is having chest pain, and a resting blood pressure is normal, and that patient is made to undergo angiograms, coincidental coronary artery disease may well be found. The cardiologist is likely to conclude that it is the coronary artery disease that is responsible for the patient's symptoms. In such a situation, the patient should purchase a blood pressure cuff, and take his own blood pressure during episodes of his chest pain. If he finds his blood pressure is elevated, then he should insist that his blood pressure be brought down to normal with medications. Obviously, if medication causes his blood pressure to return to normal, and his chest pain disappears, then he doesn't need angioplasty or coronary artery bypass surgery. Finally, it would make sense to investigate the cause of your chest pain before undergoing angiograms. See additional causes below.



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esophageal causes of chest pain

gerd
or gastroesophageal reflux disease is causes by failure of the sphincter at the lower end of the esophagus to close properly. As a result, there is often regurgitation of gastric acid from the stomach into the lower esophagus producing spasm and inflammation of the lining that may produce chest pain that is very similar to angina pectoris, including the fact that it may be precipitated by exertion, and relieved by sublingual nitroglycerine. In fact, esophageal disorders often coexist with coronary artery disease. Chest pain from esophageal disorders is usually precipitated by eating of food, or by lying down after eating, and it can be relieved by antacids and milk. Often it is accompanied by heartburn and difficulty swallowing (dysphagia). Unlike angina pectoris, which typically radiates across the upper and mid chest, esophageal pain tends to be located at the lower end of the sternum (breastbone) and radiates to the epigastrium. Certain kinds of food more characteristically produce esophageal pain. These include alcohol, spicy food, mexican food, and coffee. Unlike angina, which tends to last less than 5-10 minutes, esophageal pain may last for hours and fluctuate in intensity. Gerd can be effectively treated with proton pump inhibitors such as prilosec.

Hiatal hernia.
A hiatal hernia, also called a diaphragmatic hernia, is an abnormally large opening in the diaphragm where the esophagus connects to the stomach. As a result, the upper end of the stomach may herniate into the chest cavity. This is not likely to occur while someone is sitting or standing. Consequently, chest pain, when it appears, does so only when the subject is either lying down or leaning forward after a heavy meal. The chest pain that develops is a constricting or burning discomfort that appears in the mid and left chest regions, and may last for 30 minutes or longer. On occasion it may radiate to the left arm. It may be temporarily relieved by belching or assumption of the upright position. Sublingual nitroglycerine does not relieve the pain.


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chest pain from other areas within the chest

lungs:
a variety of disorders involving the lung may be associated with chest pain. Pneumonia is one of the most common, particularly when it involves the lining of the surface of the lung known as the pleura. Inflammation of the pleura is called pleurisy. Pleuritic pain tend to be sharp, and of brief duration when it is present. Typically it may come and go over a period of hours, and tends to occur only during inspiration. When associated with pneumonia, it is usually accompanied by a cough and fever. It also may be a symptom of a pulmonary embolism (see below), the site of metastasis of a malignant tumor, or a sign of one of the autoimmune diseases such as lupus erythematosus. Although pleurisy tends to be localized to a relatively small area of the chest, at times, with the more infectious type, the chest pain may be generalized and cause shortness of breath.

Pulmonary embolism:
another major cause of chest pain is a pulmonary embolism. An embolism is a mobile blood clot that usually occurs after a surgical procedure, particularly if the patient has been lying immobile in bed for several days. Immobility and the stress of surgery are associated with stasis of blood in the lower extremities and pelvis. This encourages the formation of blood clots in these areas. An injury to the lower extremities also may result in the formation of a clot, days or even weeks later. Whatever the origin, portions of the clot may break off and migrate to the lungs. This is most likely to occur when attempts are made to ambulate a patient in the post-operative period. Usually such a clot lodges in the small blood vessels in the lung. If the clot is a large one, it may be associated with coughing up of blood, shortness of breath, pain intensified by deep breathing, and even sudden death. The pain associated with a pulmonary embolism may be indistinguishable from both cardiac ischemia and the pain of an acute heart attack. Chest pain may be the first clue that a clot is present in the legs or thighs. In general, prolonged bed rest for any reason encourages the formation of blood clots in the lower half of the body followed by a pulmonary embolus. Usually the diagnosis of an embolism can be made by chest x-ray, however, special tests and procedures may be required in more obscure cases.

Pneumothorax:
a pneumothorax is an important cause of chest pain. It occurs when air perforates the outer surface of the lung forcing ambient air into the chest cavity. When this happens, the victim suffers chest pain followed by collapse of the perforated lung and shortness of breath. Usually the pain is in the lateral chest rather than the center of the chest, and it may be aggravated by breathing. The diagnosis of pneumothorax can readily be made with a chest x-ray. It also may be identified on physical examination, if the doctor takes the trouble to listen to both lungs.

Mediastinal emphysema
refers to the presence of air in the central portion of the chest cavity that contains the heart. Because the air may create pressure and stretching of the structures and nerves within the mediastinum, severe chest pain may result. In addition, because the stretched nerves involve the same nerve roots as the nerves coming from the heart, it may be very similar to cardiac pain. Usually the pain is more superficial and tends to be modified by respiration and body position. This disorder can be diagnosed by a chest x-ray.

Pulmonary hypertension
is a rare cause of chest pain. As you might infer, this is an elevation of the pressure in the pulmonary arteries. The pulmonary artery is the artery that exits from the right ventricle. Before it enters the lungs and branches into tiny blood vessels, it contains unoxygenated, venous blood. A number of diseases may cause the pressure in the pulmonary artery to become elevated including various forms of congenital heart disease, mitral stenosis (obstruction of the mitral valve), chronic lung disease, and primary pulmonary hypertension. Although primary pulmonary hypertension is an extremely rare disease, it has recently been found to be a side effect of certain medications used for weight loss. The chest pain associated with pulmonary hypertension occurs with exertion and is relieved by rest, and may be indistinguishable from the chest pain associated with cardiac ischemia. Indeed, it is thought that the pain seen in this condition is due to ischemia of the right ventricle. Except for chronic lung disease, the various conditions giving rise to pulmonary hypertension occur in a much younger group of people, and the chest pain that develops does not respond to the usual cardiac medications. The diagnosis of all these disorders can be made from a careful physical examination, chest x-ray, and even the electrocardiogram.

Aortic valve disease:
the aortic valve is the exit valve of the heart and all blood must leave the heart through this opening. Immediately after the aorta exits from the heart, the coronary arteries arise and supply the heart muscle with blood. If the aortic valve is diseased and obstructed, the blood flow exiting from the heart eventually will be reduced, even though the pressure within the left ventricular chamber becomes markedly elevated. At the same time, the pressure within the aorta beyond the valve will be reduced, and the amount it is reduced depends upon how obstructed the aortic valve becomes. If pre-existing coronary artery disease is present, a previously insignificant degree of narrowing in a coronary artery may now become very significant. The result will be a reduction in blood flow and chest pain. Usually, if significant aortic stenosis is present, the murmur associated with it is readily heard. Unfortunately, the modern cardiologist has become so technology oriented that frequently he does not even bother to listen to a patient's heart with a low technology instrument such as the stethoscope. Even if he does so conscientiously, the blood flow through the valve may be so reduced that no murmur can be heard.

Mitral valve prolapse
has been claimed to cause chest pain. There is no anatomical reason why mitral valve prolapse should cause chest pain. Because both this disorder and recurring chest patient pain are so common, mitral valve prolapse is often discovered coincidentally in the evaluation of a patient with chest pain symptoms. Also, mitral valve prolapse may accompany obstructive coronary artery disease; however it is the coronary artery disease that produces the chest pain and not the mitral valve prolapse.

Pericarditis:
this is due to an inflammation of the membrane surrounding the heart called the pericardium, and is accompanied by unique changes in the electrocardiogram. Viral and bacterial infections may sometimes involve the pericardium and will produce chest pain very similar to that seen with cardiac pain. The pain of pericarditis, however, is aggravated by deep breathing and influenced by changes in body position. It may cease when the breath is held or if the victim leans forward. Pericarditis is not a common disorder. Because of its similarity to cardiac pain, and the unique changes seen on the electrocardiogram, it easily can be mistaken for an impending heart attack. If coincidental coronary artery disease is found on an angiogram, and if the doctor seeing the patient is an aggressive cardiologist, potentially dangerous coronary artery bypass surgery may be performed that not only is unnecessary, but possibly harmful to the patient.

Dissecting aneurysm of the aorta
is enlargement and separation of the wall of the aorta, the main artery exiting from the heart. When present, it may cause chest pain and be mistaken for an acute heart attack. When chest pain is present, it usually is severe, may involve the back and even the abdomen, and is a medical emergency. If the artery ruptures through the weakened portion of the aortic wall, death is immediate. Milder forms of dissection may be confused with a heart attack but can usually be diagnosed by a simple chest x-ray. However, if an x-ray is not taken, and the patient is made to undergo angiograms, there will be prolonged delay during which the aneurysm may rupture.

Syphilis:
while syphilis is rarely seen today, it occasionally does occur, particularly in individuals who spent their earlier years in undeveloped countries where this disease is still prevalent. The lesions of syphilis have a predilection for the ostia of the coronary arteries; that is, where the coronary arteries exit from the aorta just above the aortic valves. By causing marked narrowing of the ostia, blood flow is markedly reduced in the coronary arteries. This will cause chest pain that is identical to that caused by obstructive coronary artery disease. Surgical intervention as well as antibiotic treatment of the syphilis are the recommended forms of therapy.

Premature beats
may be accompanied by a sharp, stabbing pain over the heart area, and occasionally may be associated with a fleeting choking sensation. Usually such symptoms occur at rest and decrease during physical activity, but may reoccur when activity ceases.


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chest wall pain

cervical disk:
a cervical disk may irritate the nerve roots going to the chest wall and produce chronic chest pain that is aggravated by walking and certain body positions. The pain tends to be more superficial than that seen with obstructive coronary artery disease and is more likely to be present at rest.

Thoracic outlet syndrome:
the nerves and blood vessels that enter the arm often have to go through a bottleneck of muscles. If a blood vessel or a nerve is kinked by a muscle or a rib, arm and chest pain may develop that is associated with walking. Since exertional chest pain is a hallmark of coronary artery disease, it is easy to see why confusion may arise. The pain is induced by swinging of the arms, and can be reproduced by elevating the arm and rotating it.

Tietze's syndrome:
inflammation and swelling of the cartilage between the rib and breastbone (costochondral or chondrosternal joints is known as tietze's syndrome. Such chest pain tends to be superficial rather than deep, is aggravated by breathing, and is very tender if the area is pressed.

Tenderness of the muscles of the chest wall:
a variety of factors may be responsible for tenderness of chest wall muscles including injury from direct trauma (usually several days before the onset of pain), coughing, and weight lifting causing a pulled muscle. Usually the chest pain is localized to a small area, is brief while it lasts, is aggravated by chest wall movements, turning, twisting and deep breathing, and may last many hours.

Herpes zoster:
a severe skin rash that does not spread beyond the midline, may cause extreme chest pain in the pre-eruptive stage. Typically the skin is extremely sensitive over the involved area. Herpes may not be suspected until the skin eruption actually occurs.

Hyperventilation syndrome:
an extremely common cause of chest pain is the hyperventilation syndrome. Hyperventilation is simply over breathing as a result of anxiety or fear. It also has been called panic attacks. Typically the subject unconsciously starts to breath more rapidly and deeply when under stress. The over breathing is often interspersed with deep sighs. In its acute form it will quickly produce a variety of symptoms including lightheadedness, dizziness, a far away feeling, numbness, palpitations, blurred visions, flushing, and tingling of the hands and around the mouth. Sometimes the victim will even faint. In its milder form, the subject may be constantly over breathing throughout the day. In so doing there is increased use of the chest muscles. If there is enough overuse of these muscles, they will become painful producing chest pain. Usually the victim is not consciously aware that he is over breathing, but rather feels short of breath. When this is associated with pounding of one's heart, dizziness, blurred vision and the other symptoms of hyperventilation, it is not hard to understand the panic that may accompany this disorder. Because the symptoms are due to over breathing and blowing off of carbon dioxide from the lungs, the chest pain and shortness of breath do not occur during exertion but rather at rest. Indeed, physical exertion, which will produce carbon dioxide, makes the victim feel better.

Primary muscle pain:
this includes some poorly understood disorders that have been called fibrositis, fibromyalgia, myalgia and neuralgia. The pain of these disorders tend to be chronic and ill-defined by the patient, are usually not related to exertion, and are confined to localized areas of the chest in locations that are different than what is seen with cardiac pain. The patient is usually more concerned about the significance of the symptoms, and whether it is a sign of heart disease rather than the intensity of the pain.

Cancer
may originate or spread to any structure in the chest including the heart and cause chest pain. Such pain tends to be continuous and not related to physical exertion. The diagnosis often may be made by a chest x-ray. Cancer also may spread to the spine and vertebrae with irritation of the nerve roots that go to the chest. Such pain may be quite severe and will not respond to the usual cardiac medications.


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Gas in the digestive tract
what is gas in the digestive tract?
Gas in the digestive tract is created from:

swallowing air.
The breakdown of certain foods by the bacteria that are present in the colon.
Everyone has gas. It may be uncomfortable and embarrassing, but it is not life-threatening. Gas is eliminated by burping or passing it through the rectum. Most people produce about 1 to 3 pints of gas a day and pass gas about 14 times a day.

Most gas is made up of odorless vapors - carbon dioxide, oxygen, nitrogen, hydrogen, and (sometimes) methane. Gases that contain sulfur often produce the unpleasant odor of flatulence.

What causes gas in the digestive tract?
Gas in the digestive tract comes from two sources:

aerophagia (air swallowing) - usually caused by eating or drinking rapidly, as well as by chewing gum, smoking, or wearing loose dentures.
Belching is the way most swallowed air leaves the stomach. The remaining gas is partially absorbed into the small intestine and a small amount goes into the large intestine and is released through the rectum.

Breakdown of certain undigested foods by harmless bacteria naturally present in the large intestine (colon)

some carbohydrates (sugar, starches, and fiber) are not digested or absorbed in the small intestine because of a shortage or absence of certain enzymes. The undigested or unabsorbed food then passes into the large intestine, where harmless and normal bacteria break down the food. This process produces hydrogen, carbon dioxide, and, in about one-third of all people, methane gases, which are released through the rectum.
Foods that commonly cause gas:
according to the national institute of diabetes and digestive and kidney diseases (niddk), most foods that contain carbohydrates can cause gas, and fats and proteins cause little gas. Foods that cause gas include the following:
raffinose - a complex sugar found in beans, cabbage, brussels sprouts, broccoli, asparagus, other vegetables, and whole grains.
Lactose - a natural sugar found in milk and milk products, such as cheese and ice cream, and in processed foods, such as bread, cereal, and salad dressing.
Fructose - a sugar found in onions, artichokes, pears, and wheat, and is also used as a sweetener in some soft drinks and fruit drinks.
Sorbitol - a sugar found naturally in fruits, including apples, pears, peaches, and prunes, and is also used as an artificial sweetener in many dietetic foods and sugar-free candies and gums.
Starches - most starches, including potatoes, corn, noodles, and wheat produce gas as they are broken down in the large intestine. (rice is the only starch that does not cause gas.)
soluble fiber - fiber that dissolves easily in water and takes on a soft, gel-like texture in the intestines; is found in oat bran, beans, peas, and most fruits.
Insoluble fiber - fiber, such as that found in wheat bran and some vegetables, which passes essentially unchanged through the intestines and produces little gas.


What are the symptoms of gas?
Chronic symptoms caused by too much gas or by a serious disease are rare. The following are the most common symptoms of gas. However, each individual may experience symptoms differently. Symptoms may include:

belching
belching during or after meals is normal, but people who belch frequently may be swallowing too much air and releasing it before the air enters the stomach.
Chronic belching may also indicate an upper gi disorder, such as peptic ulcer disease, gastroesophageal reflux disease (gerd), or gastritis.

According to the national institute of diabetes and digestive and kidney diseases, rare, chronic gas syndromes associated with belching include the following:

meganblase syndrome
meganblase syndrome causes chronic belching. It is characterized by severe air swallowing and an enlarged bubble of gas in the stomach following heavy meals. Fullness and shortness of breath caused by this disorder may mimic a heart attack.
Gas-bloat syndrome
gas-bloat syndrome may occur after surgery to correct gerd. The surgery creates a one-way valve between the esophagus and stomach that allows food and gas to enter the stomach.
Flatulence
passing gas through the rectum is called flatulence. Passing gas 14 to 23 times a day is considered normal.
Abdominal bloating
bloating is usually the result of an intestinal motility disorder, such as irritable bowel syndrome (ibs). Motility disorders are characterized by abnormal movements and contractions of intestinal muscles. These disorders may give a false sensation of bloating because of an increased sensitivity to gas.
Splenic-flexure syndrome is a chronic disorder that may be caused by gas trapped at bends (flexures) in the colon.
Crohn's disease, colon cancer, or any disease that causes intestinal obstruction, may also cause abdominal bloating.
Internal hernias or adhesions (scar tissue) from surgery may cause bloating or pain.
Fatty foods can delay stomach emptying and cause bloating and discomfort, but not necessarily too much gas.
Abdominal pain and discomfort
gas in the intestine causes pain for some people. When it collects on the left side of the colon, the pain can be confused with heart disease. When it collects on the right side of the colon, the pain may feel like the pain associated with gallstones or appendicitis.
The symptoms of gas may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is gas in the digestive tract diagnosed?
Symptoms of gas may be caused by a serious disorder, which should be determined. In addition to a complete medical history and physical examination, your physician may suggest the following activities to assist in the diagnosis:

food diary
you may be asked to keep a diary of foods and beverages consumed for a specific time period, and/or to count the number of times you pass gas during the day.
Colonoscopy
for people 50 years of age and older, and for those with a family history, the possibility of colorectal cancer is considered. Colonoscopy is a procedure that allows the physician to view the entire length of the large intestine, and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the physician to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.

Click image to enlarge

sigmoidoscopy
a sigmoidoscopy is a diagnostic procedure that allows the physician to examine the inside of a portion of the large intestine, and is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube, called a sigmoidoscope, is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier.
Upper gi (gastrointestinal) series (also called barium swallow.)
for chronic belching, your physician will look for signs or causes of excessive air swallowing and may request an upper gi series. An upper gi series is a diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.
Treatment for gas in the digestive tract:
specific treatment for gas in the digestive tract will be determined by your physician based on:

your age, overall health, and medical history
extent of the condition
your tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
your opinion or preference
preventing gas in the digestive tract:
the most common ways to reduce the discomfort of gas include the following:

changes in the diet
medications
reducing the amount of air swallowed
click here to view the
online resources of digestive disorders

© copyright 2006 harvard vanguard medical associates

Symptoms of splenic flexure syndrome


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left upper abdominal pain is the most common symptom. The pain may be relieved by passing stool or gas. Occasionally, eating may aggravate the pain. The pain may only last minutes, but when it recurs it does so many times for weeks or months on end. Diarrhea, constipation and changes in the size and shape of the stool may occur.

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overview and causes of splenic flexure syndrome - click here


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symptoms of splenic flexure syndrome and other
diseases that share similar medical symptoms

body area abdomen
general symptom abdominal pain - left upper - localized
symptoms

left upper abdominal pain
bowel movement relieves pain
passing gas relieves pain
pencil or ribbon shaped stools
diarrhea
constipation
episodes last weeks/months
dietary bran decreases symptoms


view related diseases


body area abdomen
general symptom localized abdominal pain(left upper)
symptoms

left upper abdominal pain
pain relieved by passage of gas or stool
pencil or ribbon shaped stools
diarrhea
constipation
episodes may occur in clusters for weeks or months
use of dietary bran may decrease symptoms


view related diseases

Transient ischemic colitis in young adults
american family physician, sept 15, 1997 by astrid m. Newell, james j. Deckert

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Ischemic colitis is usually encountered in elderly persons and often occurs without a clear precipitating cause. The severity may range from mild, with reversible mucosal changes (transient nongangrenous colitis), to severe, with transmural infarction and gangrene.[1,2] while colonic ischemia is not as common in adults under age 60, it is being recognized more frequently in this population.[2] some younger patients affected with this condition have underlying vascular disorders or a hypercoagulable state, such as a deficiency of protein c, protein s or antithrombin iii. However, many others are relatively healthy. In this younger population, nongangrenous ischemic colitis can be transient and benign. It is likely that primary care physicians will encounter ischemic colitis in their practices. The following three cases from our practice are illustrative.

Illustrative cases

case 1

a previously healthy 36-year-old man presented to the emergency department with a one-day history of crampy lower abdominal pain, tenesmus and bloody diarrhea without associated fever or vomiting. He had no previous history of bowel problems or recent exposures. The family history was negative. The only medication. That the patient was taking was tramadol for a shoulder injury. He did not smoke, but he did chew tobacco.

Physical examination revealed significant left lower quadrant tenderness without peritoneal signs. The patient's white blood cell count was 18,000 per [mm.Sup.3] (18.0 x [10.Sup.9] per l). Other laboratory results were unremarkable. The patient was admitted to the hospital and given intravenous fluids. Colonoscopy demonstrated severe ischemic colitis involving the left portion of the colon. The patient improved quickly and was discharged within 48 hours.

Case 2

a 48-year-old woman presented with a four-day history of nausea, vomiting and diffuse abdominal cramping followed by bloody diarrhea. The patient was afebrile and had no recent exposures, travel, antibiotic use or previous history of bowel problems. The patient was taking timolol drops for glaucoma, skeletal muscle relaxants (some compound) and fluoxetine. She had undergone a hysterectomy without an oophorectomy, and she had never received estrogen therapy. She had a family history of colon cancer. She smoked one pack of cigarettes per day.

Physical examination revealed diffuse mild abdominal tenderness without peritoneal signs. Rectal examination demonstrated dark red guaiac-positive stool. The patient's white blood cell count was 14,900 per [mm.Sup.3] (14.9 x [10.Sup.9] per l). Colonoscopy was performed the following day and revealed a 20-cm segment at the splenic flexure consistent with ischemic colitis. The patient recovered without further intervention.

Case 3

a previously healthy 42-year-old woman presented with a one-day history of low-grade temperature, nausea, vomiting, lower abdominal cramping, and watery, then bloody diarrhea. She had no recent exposures, travel or antibiotic usage. She had a history of irritable bowel syndrome and a family history of colon cancer. She was a nonsmoker and had been taking conjugated estrogen (premarin) since her hysterectomy for fibroid tumors several years previously.

Physical examination revealed left lower quadrant tenderness without peritoneal signs. The patient's white blood cell count was 16,800 per [mm.Sup.3] (16.8 x [10.Sup.9] per l). Results of other laboratory tests, including a hematocrit, were unremarkable. She was admitted for intravenous hydration. Colonoscopy revealed patchy regions of inflammation in the transverse to left portion of the colon. Pathologic changes noted on biopsy were consistent with ischemic colitis. Estrogen therapy was discontinued. The patient recovered over a four-day period and was doing well at one month follow-up.

Background and terminology

until the 1950s, the only recognized manifestation of colonic ischemia was catastrophic bowel injury and gangrene. In 1963, the first cases of noncatastrophic, reversible colonic injury due to transient ischemia were described.[3] in 1966, the term "ischemic colitis" was introduced to include a spectrum of injury patterns seen with colonic ischemia, ranging from transient mucosal changes to ischemic stricture formation to transmural infarction and gangrene.[1] currently, the term ischemic colitis is used to refer to any disorder involving colonic ischemia. In its severe form, ischemic colitis is a serious, life-threatening condition; when associated with shock, it is generally fatal.

In contrast, the term "transient ischemic colitis" is used to refer to a small subset of patients with colonic ischemia who typically have a benign, transient course. At the outset, it is not possible to predict which patients have transient ischemic colitis and which have a more severe form. Thus, transient ischemic colitis is a diagnosis made in retrospect, only after following the evaluation and clinical course of a patient over time. Estimates are that up to one half of cases of ischemic colitis are transient in nature.[4] at this time, the incidence of ischemic colitis is unknown mainly because patients with milder disease may not seek care, symptoms may resolve before studies are performed, or the condition may be misdiagnosed.[4]

etiology

colonic ischemia results from a sudden, usually temporary, reduction in splanchnic blood flow. The extent of damage to the colon is related to a number of factors, including the duration of the decrease in blood flow, the amount of vasculature involved, the presence of adequate collateral circulation and the presence of an underlying condition.[5,6] occasionally, a clear precipitating cause of reduced blood flow may be present, such as surgery involving the aorta,[7] or hypovolemic shock[5,8] (table 1). Long-distance running, in which blood flow is preferentially diverted away from the colon,[9] and especially cocaine use, with its intense vasoconstrictive properties,[10] have also been associated with colonic ischemia. Many cases;however, occur spontaneously in the absence of an obvious precipitating event.

Table 1
etiology of ischemic colitis

atherosclerotic vascular disease
vascular thrombus (e.G., aortic surgery)
intestinal vasospasm (e.G., cocaine use)
coagulopathy (e.G., deficiency of protein c,
protein s, antithrombin iii)
obstructive colonic lesions (e.G., cancer)
hypovolemic shock
vasculitis
idiopathic
[figure 1 illustration omitted]

differential diagnosis

in younger adults with symptoms consistent with ischemic colitis, the most common alternative diagnoses are acute infectious enteritis, pseudomembranous colitis and inflammatory bowel disease. Other less likely possibilities include diverticulitis or bleeding diverticulosis, colon cancer, bowel strangulation and arteriovascular malformations (table 2). Acute mesenteric ischemia should also be considered, especially in seriously ill or toxic-appearing patients. This condition represents ongoing mesenteric

I just went to the doctor on thursday for previous problems (abdominal discomfort/pain under the left ribs) and my doctor ordered me up and abdominal ct scan which he says checks so many organs in the lower region (and is a very good/effective diagnostic tool) to check for any problems at all (pelvic, abdominal, kidney, spleen, pancreas, bowel, intestines, adrenal glands,--so forth). I recommend that if anyone has had some of the similar symtpoms that I have been feeling to mention it to your doctor (abdominal ct scan)/ another thing I asked of my doctor was a proteinuria urine test (that tests for the amount/levels of protein in the urine). He also gave me the 24 hour urine test which I will be doing after I have the abdominal ct scan. I went over to the kidney problems forum on this site and had read some of the posts that described some of the same symptoms (mimic) as the ones over on the site (pain under the left rib)--for example. I had an endoscopy--everything was fine for me--so I know my pain has nothing to do with indigestion problems. The one pain that sticks out the most for me is the pain under my left rib (it is sharp and sometimes hurts even more after eating).

I also had a urine test done at my doctors office and my test had some blood in it--so he put me on the antibiotic cipro--which i'm taking twice a day. I'm going to try to get my abdominal ct scan done next week and will keep everyone informed of the results. I know everyone on this site has different symptoms (or some symptoms that are similar but have different reactions with each)--but from my doctors description of what the abdominal ct scan covers, it seems thorough enough to hopefully identify this problem without anything being bad. The scan covers everything imaginable in the lower region. I mean, the stomach is one organ but stomach pain can revolve around many organs that may not have anything to do with the stomach at all--but this scan will show every organ near and around the stomach, ribs--in detail. Just throwing it out there. Thanks

Hey.

Im 16 years old. And ive been having a sharp pain under my breast on the left side, everytime I lay down. Its been happening a lot lately..And I really..Really want to know what it is. Im becoming scared, and I want to know what it is right away.

I dont really have time to go to the doctors because I have school and work.

When I try and breath, a sharp pain goes threw my left side under my breast.

Im not sure if a rib is broken..Or something.


Please email me if you know anything about this...



thanks...

My brethren!

Damn, i've been feeling mostly miserable for almost a year and a half now, and i've done countless google searches, and this is the first time i've come across something that really described what i'm feeling and going through. Granted...Some of you aren't particularly close to me on this, in terms of symptoms, but there's like 20 of you who are spot on.

What I feel most of the time, I would basically describe as a balloon in my back on my left side. I breathe in, and everything feels great on the right, but on the left it feels like i'm pushing up against something. Usually, the worse I feel, the more gas I have, and it feels like pressure will just keep building and building, until I burp, and then i'll feel a little better for five seconds, after which the whole cycle will start again. I also occasionally feel some pressure and tingling in my chest.

At times I try to explain this to people, and the way they look at me and respond, I feel like i'm losing my mind. Other times I feel so crappy and miserable that I know there's no way i'm losing my mind, and that there just has to be something wrong with me. Anyway, it's nice to finally see that there a bunch of people who are going through the same thing...It's validation, in a way. I'm not a psychopath.

I've decided to become more proactive about my health. In part, this is because I feel like my future on the line. I'm 24 years old. Sometimes the thought of living another 50-60 years feeling like this makes me pretty depressed and frustrated. I just started medical school this year, and in another 18 months or so, i'm going to be on the wards, having to work long, tiriing shifts, and i'm really not sure how i'm going to be able to deal with it all, when more often than not I feel too crappy to even want to talk to anyone. I can push myself to do just about anything, but i'm worried that I will be miserable, and therefore the worst doctor on the planet. My future seemed much brighter 18 months ago. Now it just seems like...Bleh.

Anyway, I went to the doctor today, and in about 10 days i'm going to get a whole battery of tests done, which, if this board is any indication, will all come back normal. We'll see.

But the one common thread here among just about everybody is stress. I've never thought of myself as a real stressful person, at least not before all this pain and discomfort started. Now I stress non-stop. Every breath reminds me that I don't feel well, and I wonder why. Talk about distracting. But before all this, I wouldn't have said I was stressed. But maybe I was just fooling myself. Maybe i've been bottling all this stuff up. I don't know, but I can't ignore the signs here. Everyone is talking about stress. So, starting right now, i'm setting myself on a path towards better living. I'm going to eat better, sleep more, try to have more fun, express myself more...I don't know...Whatever works...Try some yoga or something. Start exercising again. Because I have to do whatever I can possibly do to get myself right, otherwise i'm going to end up wasting my entire life. Give myself every chance to feel right again. I'll be sure to let you all know if any of this actually works. I'm guardedly optimistic.

Also, i've noticed that just about everyone on here has been suffering for 3 years or less. What's up with that? Do people stop caring after 3 years? Does this thing take care of itself eventually? Is there something in the water that's causing this; is it an altogether new phenomenon? Theories are welcome.

Well, that was quite a ramble. Good luck to everyone.

If anyone is still having these pains, please let me know. Just in the last month they have started and are now not going away at all, just subsiding a little. I have had all blood tests, mri, x-rays........Everything is normal. I have some other strange medical problems found in the mri, but doctors dont think they are any where severe enough to cause this pain. Please let me know if you found out anything.

I can't believe that I found a place where others describe many of the things I have been experiencing. I was searching for information on a spleen rupture that my brother just experienced and wondered if there was a connection.

I can remember when this started I was healthy, runner, cyclist and gym guy. Now, 12 year later i'm over weight, tired, in pain and filled with fear of possible cancer. I went to 3 doctors at kaiser who all dismissed me.

This pain started when I was working for my cosmo liscense and I thought it might have something to do with the toxic chemical brew or being on my feet with my arms in the air all day. I also thought maybe it was in some way parasite related. The pain in my side has been persistent for all this time, sometimes it radiates, gurgles, pin pricks, burns or is just a dull constent pain on the lower left underside of the rib cage. I did find some relief once when on a long trip in india, so stress may be a factor.

This pain eventually has manifested or could be related to other issues. I then begain to have left hip pain in joint, and pain in my left leg. My left big toe was often numb and now several of my toes feel numb and I can't stand to have bedding touch them at night; this has now spread to my other foot in the same place. I also get some pains in my chest from time to time and now have sleep apnea. Sleeping at night is a terrible struggle at times between my side pain, feet and the sleep apnea machine I sleep with.

Has anyone spent time looking at richarddd's response and found it useful? It seems to be the most specific medical sounding response i've read?

Thanks!

I have posted here before. I had a pain in my left rib cage or right at the base of the ribs. It causes tenderness in abdomen. I had it during oct-december. Saw many docs to find this unexplained condition. I ended up having 3 ct scans in that time. Visited a cardiologist (at request of my md)- had an endoscope by gi doc. All was fine. By xmas, I found a product called digestinol (healing by a derivitive of aloe vera). It was expensive. $175 for 180 tablets. Take 12 day. I dont know if that was a factor, but I started to fell much better..Pain gone. Not 100%, but pretty close. Eventually I ran out of digestinol and because I was feeling better, did not buy any more. Unfortuntately my rib pain is back, worse than before. Splenic flexure describes my problem perfectly. I do notice this time, the pain is much more severe when I bend over. Feels much better when lying on my back. Went back to my md last week, he said it was probably muscle spasms...What a joke. Told me to get a rib belt and wear. I got one, it seemed to help for a few days.

Most of our posts seem to prescribe the problems we are having, and are short on solutions. The one common thread is stress/anxiety. I have experienced both over the last 2 1/2 years. To deal with the anxiety I have am trying deep breathing techniques through the chinese methodology of qichong. Too early to tell results. I already have incorporated more fruits and vegetables in my diet and right now am doing a 3 day fruit/vegetable fast..That cant hurt. I also am trying a therapudic dose of probiotics (primal defense from gardenoflifeusa).

If anyone else as found success in dealing with splenic flexure, please post. Thanks

Where to start, I have the same syptoms, plus tenderness in the chest area, and heart burn, fatige, they have done an upper gi, heart mri's abominal mri's, and found nothing so they call it ibs. Im still pushing them to find out what it is, I just went in for 14 blood tests, apparently 1 came back possitive. I have anklongsing spondyitits, it is a form of arthtitis, though from what ive read it affect organs as well as a lot of other things, I think this may cover some of my syptoms, but not all im still looking, ive been suffering for over a year and I have started trying to diagnose my self. It seems that gerd or heartburn is a commen denominater. Has anyone else here had a test show possitive for something even if it seems unrelated to the symptom?

For anyone wanting more info on aklongsing spondyitits, you are in more pain in the am or at night and feel best when active. It has something to do with haveing a b27 gene and is related to crohns, ulcertive colonitis, psorisis sponyitis, it affects people in mid twentys to 40s mainly men.

Hi there. I have a question to the guy who posted from texas about digestinol. Can you buy digestinol at health food stores or only online? Is it fda regulated? The reason why I ask is that if these are natural supplements ( a lot of times these types of supplements are marketed but are not necessarily approved by our government--not that some of the drugs approved by our government doesn't pose risks and health concerns even regulated like vioxx) but i'm just wondering. I saw the site online for digestinol (florida based company) and I just want to make sure that its not some guys in a basement concocting pills just for profit and making it seem legit by putting up a webpage promoting it. Let me know if possible, if you read this and can provide useful information for digestinol---so I can make sure its legit and not going to have any harmful side effects in the process. Thanks.if you can provide the info there. I'm thinking of ordering some of it but I want to make sure that this company that is selling it is legal/legit--i'm sorry, but you know a lot of people sell things online---and it's hard to tell--especially with pills ( a little iffy) :) thanks.