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the-good-doctor, Board Certified Physician
Category: Medical
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, I went to my GP (I'm in the UK) last October with a persistent

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I went to my GP (I'm in the UK) last October with a persistent sore throat and acid reflux and was prescribed Lanzoprazole and Gaviscon which settled everything down after a few months. At Xmas, I noticed my mouth and eyes were very dry particularly at night. I've also been rather constipated since around the same time. For the past 6 weeks, I've been having a pulling, scratching kind of pain under my left ribcage. I'm also feeling tired and not feeling rested after a night's sleep and my appetite isn't as good as usual.
I'm normal weight, aged 60, had IBS diagnosed many years ago but infrequent symptoms since I cut out cow's milk/cheese/butter.
I occasionally have fatty stools, normally if I eat something with cow's products in by mistake, or something high in fat. I have a small sliding hiatus hernia (diagnosed 2006).
My blood pressure is normal. I take HRT and Cynomel.
Could these symptoms be connected and do you have any thoughts about whether I should get myself tested - and for what?
Many thanks,

Hello. I'm Dr. Phil, licensed and practicing internist.

Excellent service is my goal.

Thanks for this question Jan

this sounds like an IBS flare in part.

Are these typical symptoms of your IBS?

the-good-doctor and 6 other Medical Specialists are ready to help you
Do you take any other meds?
are these symptoms typical of your IBS?
Customer: replied 5 years ago.

These symptoms aren't very similar to what I used to get, which was normally severe stomach cramping which went off after a couple of hours. Plus sometimes fatty stools too.

The scratchy, pulling sensation I have now is not the same at all.

these symptoms could be a change in your IBS. This can happen over time. Also some side effects from the meds you are taking
I would also get your thyroid tested
You are on cytomel so low thyroid can cause a lot of this
I would see your GP and get a thyroid test and exam of the belly
If the GP thinks it is necessary I would get an endoscopy to look into the stomach
Customer: replied 5 years ago.

When I googled 'pain under left ribcage' there was information about potential pancreatitis, spleen and gall bladder problems - are any of those likely to cause these symptoms, in your opinion?

No, not likely. An enlarged spleen is pretty rare
pancreatitis causes severe pain especially with eating.
gall bladder normally causes right upper quadrant pain with eating.
Customer: replied 5 years ago.

And what about pancreatic cancer or other cancers in those organs?

not likely
pancreatic cancer usually causes yellowing of the skin and a vague central belly pain
Customer: replied 5 years ago.

When you suggest an exam of the belly what would you expect the GP to be checking for?

I would be a thorough abdominal exam looking for masses, pain, bloating and other signs.
I would expect to see a diffuse non specific tenderness with IBS
Customer: replied 5 years ago.

OK thanks for your help.

I'll ask the GP to do that and also check the thyroid treatment is working adequately.

sounds like a plan. :)
let me know how it goes.
i will follow up with you in a few days
Customer: replied 5 years ago.

Thanks - it will probably be a week or so before I get to see the GP.

You're welcome :)
I appreciate the excellent rating.

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