Having Horrible Abdominal, Epigastric Pain, Back And Neck Pain. Extreme Weakness And Numbness In Legs. Need Help?

Posted on Tue, 3 Sep 2013

Question: My quality of life is decreasing daily and no physicians seems to take my complaints seriously- horrible abdominal and epigastric pain and abdominal tensing when standing up but disappears when I lie down on my back. No N/V or bowel issues and I've been on PPI for a week with no improvement. When standing up I have to put my fist into my abdomen for any relief and pain meds or anti-anxiety meds do not help with this. Lying flat on my back or pushing on my abdomen is all that helps so you can imagine getting along in daily life is becoming hell and I'm an RN so basically I'm really in a pickle. The only other real outstanding issues are back and neck pain with right arm pain and occasionally extreme weakness and numbness in legs that requires me to sit immediately or I will fall down. I want my life back as this is becoming extremely disabling. Any help would be very much appreciated

Answered by Dr. Grzegorz Stanko (22 minutes later)

Brief Answer:
Abdominal hernia in the scar area.

Detailed Answer:
Hello!

Thank you for the query.

Before any diagnosis please try to answer this questions:
- what kind of surgeries and when have you had? Where are the scars located? How many entrances to the abdominal cavity?
- have you had any laboratory tests recently?
- were there abdominal ultrasound, CT or gastroscopy done?
- is there any lump in the pain area?

From your description you seem to suffer from abdominal hernia. When you stand up, the pressure in the abdominal cavity rises and pushes out intestines through the hernia opening. You should be able to provoke the pain when coughing.
Other common reason of epigastric pain which gives all tests negative is peptic ulcer. However the pain is associated with meals.

I`m looking forward to hearing from you.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (41 minutes later)

The only abdominal surgery I have had was a tubal ligation in 1992 with scar in the umbilicus. I don't notice any bulging in the abdomen but my belly really tenses to the point its hard to catch my breath. I actually cannot even push my belly outwards its tensed so much. I am a GI and PreOp nurse- had not even considered a hernia and i assumed being on a PPI for a week would have brought some relief. I will definately bring this to the attention of my surgeon (see him at work daily) and will ask him to check for the hernia. I had just always assumed that hernias always bulged outwards. As an added note relating to bowels- Havent reached the age where I'm obsessed with them yet, but they have decreased to around 1 a week BUT no abdominal distention- not eating much at all- 1 meal a day average....and drinking lots of fluids

Answered by Dr. Grzegorz Stanko (14 minutes later)

Brief Answer:
Abdominal ultrasound, blood work and gastroscopy.

Detailed Answer:
I suggest you to have an ultrasound of abdomen and abdominal wall done. Blood work (to see hemoglobin level) should be also done. Next should be gastroscopy. PPIs treatment without this test can delay stomach cancer diagnose (which should always be considered in case of epigastric pain). Also Helicobacter Pylori infection needs to be checked. If it is present, PPI treatment without an eradication is pointless.

Hope this will help. Feel free o ask further questions.
Regards.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar