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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35801
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have had a surging pain inside my left side over the last

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I have had a surging pain inside my left side over the last 2 years. What I mean by surging is that it starts like a slight burn in my side and then turns to a pain that is hard to believe.. I have a high tolerancy for pain and this is becoming unbearable.  It has lasted 5 hours on a trip to my mothers and when I took a half of a loratab it stopped. This morning it started while I was on an errand and before I got back home (30min) I was about to die.  It is really a bad burning, sensation, not cramping, nothing to touch and feel, Its so scary!  I have been given and inflamation pill and take that on the onset. Now it is getting to where that doesn't help. It starts usually in the morning and if it continues it is such a pain that I once went to the hospital. They sent me home with a pulled muscle. I have had xrays and I know I have a little curviture of the spine. I sometimes feel, because it is so deep and nowhere can I touch that pinpoints the pain, that is in my intestines somewhere. I do not get constipated. I have good metabolism. I go to the bathroom both ways normal.. sometimes with diarrea. I am going to tell my general doctor to refer me to an internal doctor. Then I will get a CT scan or MRI.. I just wish I knew what I was in for.

Greetings Lori.

If you do not have this surging pain / burning associated with the following symptoms;

urinary symptoms; burning, increased frequency
increased pain associated with the meals / specific food.

loss of appetite

change in bowel habits.

persistent or off and on diarrhea.

this is unlikely to be due to abdominal viscera and abdominal wall can be responsible for this pain. A chronic pain / burning with just occasional diarrhea (which is likely due to irritable bowel syndrome / IBS) and with a curvature of spine is most likely due to pinched nerves in the back. ACNES (abdominal cutaneous nerve entrapment syndrome) can be a possibility and the diagnosis can be confirmed by the subcutaneous infiltration of the local anesthetic like xylocaine. If the pain disappears completely, this substantiates the diagnosis. Abdominal wall pain can occur from nerve entrapment syndrome, irritation of intercostal nerve roots, anterior cutaneous nerve entrapment, rib-tip syndrome, myofascial pain and trigger points. Your doctor should consider these abdominal wall problems for your pain (especially in the absence of the visceral symptoms and medical imaging not revealing anything significant). I do agree, though, that a CT scan or MRI of the abdomen and spine would be the next step of evaluation. An ultrasound, HIDA scan (for gall bladder functions) blood tests for kidneys, pancreas and liver too would be recommended.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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Customer: replied 4 years ago.

I've had a complete physical and ask for all the tests to be done. I've had an xray to include my liver.. I have had an ultrasound, everything being normal. Can you tell me exactly to which kind of doctor I need my general doctor to refer me to?

Hello Lori,

The best specialist would be a gastroenterologist to rule out a visceral / abdominal issue. Once the gastroenterologist is able to rule out abdominal issue, the next step would be to consult a MD in physical medicine and rehabilitation (PMR). The PMR specialist is good to handle the spine, nerve, abdominal wall and related pain issues.

It is privilege assisting you.
Customer: replied 4 years ago.

Thank you so much!

You are very welcome.