Left Upper Abdominal Discomfort: Causes and Solutions

Discomfort in the upper left abdomen?

Dr.
Lin: Hello, I would like to ask a few questions.
I previously underwent an upper gastrointestinal endoscopy at Taoyuan Hospital, and the physician who performed the procedure diagnosed me with gastroesophageal reflux disease (GERD).
After taking medication for two weeks, I began to feel a sensation of pressure or discomfort in my left upper abdomen, which is difficult to describe, as if something is there.
This sensation is more pronounced when I sit down.
On July 1, while playing basketball, I experienced pain in my left upper abdomen, but it subsided after resting.
During my follow-up appointment on July 3, I described this situation to the outpatient doctor, who said it was likely a gastric spasm.
I did some research online about the causes of gastric spasms, and I understand that intense physical activity may trigger them, possibly due to my eating around 3 PM and then exercising at 5 PM.
However, I still have the lingering sensation of pressure in my left upper abdomen.
Should I undergo any further examinations, or am I just being overly concerned? Additionally, how long should I expect to be on medication for gastroesophageal reflux? I've received varying answers from different doctors, with some suggesting two months and others four months.
I would like to hear your thoughts.
Thank you for taking the time to read this!

Kaso, 20~29 year old female. Ask Date: 2015/07/04

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, the endoscopic results for gastroesophageal reflux disease (GERD) are classified as follows: 1.
Non-erosive esophagitis 2.
Erosive esophagitis 3.
Severe Barrett's esophagus.
Currently, proton pump inhibitors (PPIs) are being used for treatment, which are effective for about four to eight weeks.
If symptoms persist after the initial treatment, further therapy may be considered.
Generally, the maximum duration covered by health insurance is four months.
For severe reflux and Barrett's esophagus, long-term treatment and follow-up are necessary, with insurance coverage extending up to one year.
The management of GERD relies not only on medication but also on lifestyle modifications to maintain treatment efficacy.
In cases of structural abnormalities where medications are ineffective and reflux symptoms recur, laparoscopic fundoplication may be considered as a surgical treatment.
Wishing you safety and health.
Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/07/04

More Info

Left upper abdominal discomfort can arise from various causes, and understanding these can help in managing the symptoms effectively. Based on the information provided, it seems that you have been diagnosed with gastroesophageal reflux disease (GERD) and have experienced symptoms such as a feeling of fullness or pressure in the left upper abdomen, which may be exacerbated by physical activity and possibly related to your eating habits.

Potential Causes of Left Upper Abdominal Discomfort
1. Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid flows back into the esophagus, leading to symptoms such as heartburn, regurgitation, and discomfort in the upper abdomen. The sensation of something being "stuck" or a feeling of fullness can be associated with GERD, especially after meals.

2. Gastric Spasms: As mentioned by your physician, gastric spasms can occur due to various factors, including stress, overeating, or vigorous physical activity shortly after eating. These spasms can lead to sharp pain or a cramping sensation in the abdomen.

3. Musculoskeletal Issues: Sometimes, pain in the left upper abdomen can be related to muscle strain or injury, especially if you have engaged in physical activities like playing sports. This could explain the pain you experienced while playing basketball.

4. Splenic Issues: The spleen is located in the left upper abdomen, and conditions such as splenomegaly (enlargement of the spleen) or splenic infarction can cause discomfort in this area. However, these conditions are less common and would typically present with additional symptoms.

5. Pancreatitis: Inflammation of the pancreas can cause pain in the upper abdomen, often radiating to the back. This is usually accompanied by other symptoms such as nausea and vomiting.

6. Gastric Ulcers: Ulcers can cause pain and discomfort in the upper abdomen, particularly after eating. They may also lead to a feeling of fullness.

Recommended Actions
Given your symptoms and previous diagnosis, here are some recommendations:
- Follow-Up with Your Physician: Since you have already undergone an endoscopy, it may be beneficial to discuss your ongoing symptoms with your gastroenterologist. They may recommend further tests, such as an abdominal ultrasound or a CT scan, to rule out any structural issues.

- Dietary Modifications: Avoiding large meals, spicy foods, caffeine, and alcohol can help manage GERD symptoms. Eating smaller, more frequent meals may also alleviate discomfort.

- Medication Adherence: Continue taking the prescribed medications for GERD as directed. The duration of treatment can vary based on individual responses, but many patients may require several months of therapy to manage symptoms effectively. It’s essential to discuss any concerns about medication duration with your healthcare provider.

- Lifestyle Changes: Incorporating stress-reduction techniques, such as yoga or meditation, and avoiding vigorous exercise immediately after meals can help reduce the frequency of gastric spasms.

- Monitoring Symptoms: Keep a diary of your symptoms, noting when they occur, their intensity, and any associated activities or foods. This information can be valuable for your healthcare provider in determining the next steps in your care.

Conclusion
In summary, left upper abdominal discomfort can stem from various causes, including GERD, gastric spasms, and musculoskeletal issues. It is crucial to maintain open communication with your healthcare provider regarding your symptoms and treatment plan. By making dietary and lifestyle adjustments and adhering to your medication regimen, you can better manage your symptoms and improve your quality of life. If symptoms persist or worsen, seeking further evaluation is essential to rule out any serious underlying conditions.

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