Re: Take a Shot at a diagnosis
- From: "Paul T. Holland" <pholland@xxxxxxxxxxxxxxxx>
- Date: Sun, 03 Feb 2008 21:16:00 GMT
hey og
taking things out of order
"Patient has a history of pretty bad untreated GERD"
is this only in the past, or still the case today?
also: since gerd can be an expression of a couple diff. physiologic
triggering events - has it been determined just what your trigger is?
is 'your' gerd symptom esophageal/upper valve [cardiac sphincter], or
stomach/ pyloric sphincter???
that aside,
from your description, gall bladder, kidney stones, or pancreatic
inflammation are the most common culprits,
but you should also consider the less common: restricted blood flow to
the stomach wall or intestine as possibly being involved.
since you state that bowel motility can ramp up the sensation this
should be considered even if not a high probability.
each would require its own set of diag. tests to eliminate [no pun] or
confirm.
i'm ignoring viral pneumo since you didn't talk about any related
pulmonary signs
there is always the off chance of yea old fashioned ulcer - have the
standard blood tests pulled and or you might need to just go on the
anti-bio protocol for the bacteria - providing that the ulcer isn't from
gastric juices not being able to descend into the small intestine.
shot in the dark time: an history of shingles? it's been reported to
cause severe intestinal distress without showing exterior...
there is one thing: the 'small amount of blood' you mention - small
amounts of blood from the stomach [equal to 'spotting'] would most
likely be black by the time it is passed out in a bowel movement -
bright red blood is almost always from the lower large intestine or anal
area -
was there any 'straining' involved when you noticed the drops?
either way - if this spotting has happened on several successive days -
get it looked to...no fooling around.
OldGoat wrote:
.
OK, Here goes:
Abdominal pain, left side, not upper quad, not lower quad. More like right
around the area where the ribs end. Narcotics are ineffective, Tylenol a
slight relief and ibuprofen (eventually, after about 400mgs) seems to get it
under control. Not an intestinal block, as things keep sailing along. Pain
is worse when lying on the left side, a bit better when on the right side
and face up or down the pain is somewhere in between in intensity. Very
painful in the spot when swallowing, coughing etc. Patient has a history of
pretty bad untreated GERD. Most comfortable sleeping position is in a
recliner, surrounded by pillows to avoid laying on the side Bowel movement
are uncomfortable in the same area which have been noticed with a touch of
bright blood (not a lot nor dark)
Diverticulitis has been mentioned as has an ulcer since there seems to be
little there in that location other than the stomach (I was worried my liver
was going to explode at one point, but it's the wrong side and thumping the
appendix showed no tenderness). Pain is lessened by an empty bladder, but
plumbing and prostate seem to be in good shape. Full or empty bowel are
irrelevant.
Looking for best guess, no points deducted for being wrong, just take your
best crack at it. Interested in what your experience or gut (no pun
intended) may be telling you
Thanks for playing--og
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- From: OldGoat
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