Pressure and pain under left rib cage

by R
(CA, United States)

Country: United States
Age : 24 Years old, Upper left abdominal pain
Past surgeries: Tonsils removed when 10 years old
Otherwise healthy and active before all this started.
Family history of:
Lupus
Breast Cancer
High Blood Pressure

March 2010 - I started to feel nauseous at work; I left early and before I could get home I was so sick to my stomach I could hardly bear it. I spent the night extremely nauseous, making runs to the bathroom (diarrhea) frequently. This lasted for hours.

June 2010 - I started to feel pain in my stomach, especially after eating fatty or spicy foods or drinking alcohol. General feeling of being unwell. I went to the doctor and blood tests revealed incredibly low and unexplained iron level of 2, though I wasn't anemic. (Blood tests afterwards reveal a normal iron level though I haven't taken any supplements or increased it in my diet)

Pancreatitis

One night I made fettuccine alfredo and started to feel sick shortly after. A bit nauseous, sweaty. I went to sleep and woke up a couple hours later in the worst pain of my life. I sat on the toilet but never passed anything. I felt like I was having contractions that would last 5-10 seconds, and when they'd come they were so painful I'm surprised I didn't pass out. I kept getting in and out of the bathtub for about 4-5 hours before I went to the ER. They did not check my pancreatic enzymes (probably because of my age), but both my amylase and lipase were very slightly elevated (139/63) about a week later so my gastroenterologist assumes it was a bout of acute pancreatits.

July 2010 - Upper Scope and Colonoscopy results NORMAL.

July 2010 - December 2010 Ultrasounds, CT Scans, MRCP - everything came back normal. However I was so sick I was unable to eat and soon was underweight. It got bad enough that I was forgetting to eat altogether, my diet consisted of jello and small amounts of water on the days I remembered to eat. I was in and out of the emergency room, always told that my blood looked okay for the most part.

December 2010 - December 2010 - I had to quit my job, had to quit university and move back in with my mom. For the most part I'm better than I was. I've been very strict about my diet, no alcohol - taking every precaution as I've thought my pancreas was causing my problems. However, despite being able to eat solid food again, I'm still suffering from debilitating symptoms.

They did another upper GI endoscopy and said it looks like I have very mild gastritis. I've been on a PPI since June of 2010.

I've been in the hospital several more times during 2010, and after reviewing my blood tests I've noticed a pattern:
1. My indirect bilirubin is always elevated. (Direct/conjugated is normal)
2. My lipase is always elevated. (Amylase is normal)

Consistent Symptoms:

Pressure and pain under left rib cage
Shortness of breath (though I'm always told I'm getting enough oxygen)
I can't sleep on my left side. I feel I can't breathe well. I sleep sitting up or on my right side.
Relentless thirst and dehydration - I wake up feeling like I've slept in the Sahara
Stomach bloating (I can't wear jeans or anything at all restricting)
Gas (Belching) (Perhaps from gasping for air because of shortness of breath)
Fatigue and weakness
Anxiety
When I get hungry or thirsty I just feel so incredibly sick and abnormally irritable
Back hurts when standing or walking for more than an hour
Itchy thighs, especially the back

Recent Symptoms (the past 1 month):
Eczema type rash on my right knuckles (Never had eczema before - wasn't "butterfly" shaped)
Itchy, dry flaky irritable scalp
Episode of high blood pressure, heart palpitations, racing heartrate when I attempted to exercise. Went to the hospital and my heart was fine, said I was probably dehydrated.
Achy, heavy feeling in my chest (have had this off and on since I got sick last June)
When I take a deep breath in, I have sharp localized upper left abdominal pain.


A list of blood tests, by date, showing mostly abnormal results. My results are on the left, "normal range" in parentheses :
7-7-10
ALK PHOS - 28 (38-126) L
Calcium - 8.4 (8.7-10.2) L
Amylase - 139 (36-128) H
Lipase - 63 (22-51) H
A/G Ratio - 1.5 Normal
Total Bili - 1.3 Normalish
AST (15-43U/L) & ALT (5-54U/L) - Both 20 Normal

7-16-10
Lymph - 42 (15-41%) H
Basos - Normal
Mono - Normal
Amylase & Lipase - Normal
MPV - Normal
RBC - 4.73 Normal

7-18-10
Lymph% - 47 H (15-41%)
Atypical Lymph - Present (Negative) Abnormal
Total Bili - 0.9 Normal
RBC - 4.93 Normal
ALT - 15 Normal (5-54U/L)
AST - 20 Normal (15-43U/L)
Lipase - Normal

9-16-10
RBC - 4.97 Normal
Lymph% - 20 Normal
Baso% - 1 Normal
Amylase - 109 ?
Lipase - 67 (22-51) H
Urine PH - 7

10-3-10
ALB - 5.4 (3.2-4.7) H
AG Ratio - 2.0 (1.0-1.6) H
Total Bili - 3.2 (0.3-2.2) H
MPV - 11 (7.4-10.4) H
Basos - 2 (0-1%) H
Ketones - 15 (Negative) Abnormal
ALT - 14 Normal (5-54U/L)
AST - 22 Normal (15-43U/L)
ALK PHOS ALP - 45 Normal
Lymph - 29 Normal (15-41%)
RBC - 5.09 (Steadily increasing)
Lipase - 34 Normal
Urine PH - 5.5

10-10-10
A/G Ratio - 1.8 (1.0-1.6) H
ALK PHOS ALP - 37 (38-126) L
Urine or blood ph? PH - 7.5 (5-7) H
OCC. BLD - Large (Negative) Abnormal (On my period?)
Lipase - 66 (22-51) H
Urine PH - 7.5 (5-7) H
Total Bili - 1.1
ALT - 10 Normal (5-54U/L)
AST - 15 Normal (15-43U/L)
RBC - 4.81 Normal
MPV - 10.2 Normal (7.4-10.4)
Lymph - 40 Normal (15-41%)
Basos - 0 Normal
Mono - 8 Normal

10-23-10
BUN - 6 (8-22) L
Total Bili - 2.0 (0.3-1.3) H
Direct Bili - 0.2 Normal (0-0.2)
MPV - 11.2 (6.8-10) H
Lipase - 49 Normal (22-51)
ALP - 35 Normal (35-115)
RBC - 4.65 Normal (3.7-5.5)
Lymph% - 34.5 Normal (15-41%)
Hematocrit - 41.1 Normal (34-44)
Basos - Normal
ALT - 10 Normal (5-54U/L)
AST - 16 (15-43U/L)

1-12-11
Hematocrit - 44.5 (34-44) H
Total Bili - 1.8 (0-1.2) H
Iron Serum - 90 Normal
RBC - 5.07 Normal (3.7-5.5)
Basos - Normal
BUN - 12 Normal (8-22)
Lymph - 41 Normal (15-41%)
A/G Ratio - 2 Normal? (1.0-1.6) H on previous tests, however this test measures normal range as (1.1-2.5)
ALT - 10 Normal
AST - 12 Normal
Thyroxine - 7.1 Normal (Thyroid test)
Mononucleosis Test - Negative

1-15-11
Total Bili - 1.8 (0.2-1.0) H
AST - 12 (15-37) L
ALT - 25 (30-65) L
Protime - 12.3 (10-12) H
Mono% - 10.3 (0-10%) H
Urine PH - 8 (5-6) H
UR Amor Debris - 4+ (None) H
A/G Ratio - 1.5 Normal (1.0-1.6) H on previous tests, however other tests measure normal range as (1.1-2.5)
RBC - 4.92
Lymph% - 31.9 Normal
RBC - 4.92 Normal
Baso - Normal
BUN - 13 Normal (8-22) ( Increased by 1 since 1-12-10, Increased by 7 since 10-23-10)

8-2-11
Creatinine, Serum 1.02 (.57-1.00) H
Iron - Normal
H.Pylori - 1.00 (0-.79) H
Lipase - 86 (0-59) H
RBC - 4.91 Normal
Lymphs% - 29 Normal
Basos% - 1 Normal
BUN - 10 Normal
A/G Ratio - 2.1 Normal? (1.0-1.6) H on previous tests, however other tests measure normal range as (1.1-2.5)
ALT - 14 (15-37)
AST - 19 (30-65)
Urine PH - 7
Reticulocyte Count - 0.9 Normal (0.5-3.0)

9-2-11
Osmo, Calc - 272 (273-304) L
Total Bili - 1.5 (0.3-1.3) H
Lipase - 354 (65-230) H
Urine PH - 6
BUN - 12 Normal
A/G Ratio - 1.5
ALT - 31
AST - 16
ALK PHOS ALP - 52
RBC - 4.65
Lymph - Normal
Mono - Normal