Undiagnosed constant upper abdominal pain

by Beth

I've been suffering now for over 6 months with constant upper abdominal pain.

I had knee surgery the beginning of October and it started about 2 weeks after. So initially, my doctor thought it was due to the pain meds.

I've had a full work-up: endoscope, proton pump inhibitors, ultrasound and hydascan of gall bladder, bloodwork including celiac disease, pH and esophageal motility study, stomach emptying study and a colonoscopy. Everything has been normal.

I'm being sent on for a second opinion but am losing hope. My pain is centered right around and below my sternum. It is very sensitive to pressure. Bras or even a tight shirt causes a lot of discomfort. It hurts all the time, but can be worse different days and different times.

Sometimes it seems like certain foods bother me (sweets, pop, etc) but I haven't been able to really link it to anything in particular.

Anyone else experience these symptoms? Any ideas on what it might be?

Dear Beth,

The undiagnosed constant upper abdominal pain following surgery you describe sounds very much like a post operative costochondritis.

What is costochondritis? It is the inflammation of the ends of the ribs, where they join the sternum or breast plate. It is a common sequelea of inflammatory disorders like rheumatoid arthritis, ankylosing spondylitis, fibromyalgia and viral infections.

Costochondritis has also been reported to follow surgery, as in your case.

What makes this most likely is what you have described - post operative, pain worsened by pressure or even clothing like bras.

Could the pain last this long? Yes. Generally, costochondritis takes about 4 to 8 weeks to go away, but some in cases, it could last for several months.

The good news in your case is that other potential mimickers of this condition that could also have terrible consequences if not diagnosed have been excluded. While you await further assessment, efforts should be focused on alleviating the pain with simple pain killers combined with neurogenic modulatory agents.

There is no sure diagnostic work up for costochondritis, other than excluding other potentially dangerous causes of upper abdominal and chest pain.

Please discuss this possibility (of a diagnosis of costochondritis) with your healthcare provider, and during your second opinion visit and see what is thought.

Please see more information on costochondritis here.

We will be most pleased to hear back from you as you let us know how things went and wish you a vibrant recovery soon.


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