Okay, here's the deal. Male, 38, 188 lbs, no history of contributing factors, no hospitilization of any kind, no present illness, overall good health. No family history of genetic predisoposition. NKDA and NAD. Non smoker. No alcohol to speak of. Caffeine, well yeah and sometimes plenty (monster drinks, coffee, starbucks, 5 hour energy). The caffeine does instigate some diarrhea sometimes but does not seem to be the cause of this problem, just doesn't help. Although it helps me get through work.
Complaint: Discomfort around stomach, abdominal bloating, some dyspepsia (mild to moderate w/o pain). Chronic.
Onset...rougly August '05 discomfort around stomach started.
Provocation/palliative...started feeling a queezy, spasm in LUQ just below ribs, lateral. Digital pressure on the site makes it "feel" better...looked like Napolean. Some twisting of upper torso made it more symptomatic.
Quality...I can't say it's "painful" just very uncomfortable. The twisting sensation almost feels like a spasm but it would have to be organ tissue not muscle since it doesn't have that type of feeling like a strong muscle spasm has...kind of a fasiculation. No fever, numbness, tingling or other sx.
Referral...Up until last December no referral and minor discomfort. It is now accompanied by GI bloating especially after meals, fatty or non fatty-big and small, my abdomen gets very hard. It's w/i 1 to 1 1/2 hrs so it's still in the small intestine. No burning sensation, no gerd, no pain in abdomen but a sensation of being swollen.
Site...Central abdomen and LUQ
Timing...Definitely now after meals. I can't say there's a lot of "gas" problems associated with the bloating b/c most times you know...there is no after effect of gas. It just feels bloated and hard as a rock in spite of whatever is eaten. I can't say it's worse with fatty foods. It's during the day when I notice it more. I don't automatically run to the bathroom when the gastro-colic reflex hits about 20 min post meal but I don't always have anything to ya know...do or doo.
Palpation over area does not have site tenderness. No tenderness over RUQ over Gallbladder. I don't feel an elarged liver, although with my weight status and other coronary factors (cholesterol, diet, inactivity) I probably DO have some fatty liver. I do not have any melena (although it obviously doesn't smell like a bed of roses), no floaties and it otherwise looks like, well, poo.
I have taken 2 whole blood H. Pylori finger stick tests. Both Negative. I have not had any objective tests otherwise although at onset I did see a D.O. who thought ulcer (Duh! but no pain, gerd, reflux...nada) and said "Mylanta"..I said...go back to school. CBC looked normal at that time, high cholesterol but that's it. I am going to get a spiral CT probably with contrast done here soon. I don't want to waste time with an ultrasound.
That's about it and I hope as clear as I can get. My self diagnosis: I have no freaking idea. It doesn't fit classic GERD, ULCER, Gallbladder disease, hernia, IBS, IBD, Colitis, Diverticulitis. I have no classic "pain" just really uncomfortable abdominal bloating with and without increased bowel gas. I don't have any burning sensations, just a sensation of being swollen and a queezy LUQ.
I am taking probiotics and maybe the severity is diminishing. I can't say for sure and I could be kidding myself. I know my abdominal fat has some effect on comfort so that may explain part of it if I lose 30 lbs but why the bowel distension? Why the bloating? Is this a cascade effect of gallstone obstruction and fatty bolus not being digested? Any gastroenterologists out there?
Best Guess? Fire away!
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