Suggest Treatment For Intermittent Lower Back Pain

Posted on Thu, 8 Dec 2016

Question: I went to Kaiser-Permanente yesterday due to concerns about some symptoms. Intermittent pain in lower right back, ranging from sharp sudden pain to mild discomfort; onset was several weeks ago. Concurrently, I've also been experiencing a feeling of pressure in the upper right abdomen, just below and possibly slightly beneath the last rib. No nausea, no fever. I'm 58 years old, male, 174 lbs., 6'1". BP 136/75, resting heart rate 64 bpm. I drink 3-4 cups of coffee daily and consume 3-4 alcoholic drinks almost daily. I have consumed alcohol on an almost daily basis for almost 40 years. My current exercise consists of a daily bicycle commute of 15-20 minutes, twice daily, 4-5 days per week, at a sometimes brisk pace (enough to 'break a sweat' and elevate my heart rate). I was an avid recreational cyclist up until 8 years ago, and before that an amateur competitor. I work in a retail bicycle shop and so I'm on my feet most of the day, with many trips up and down a tall flight of stairs. I'm not currently taking any medications, prescription or OTC, although I've sometimes taken IBU 400-600 mg doses (not exceeding daily limits) for up to two weeks for back pain over the years. No known chronic conditions other than diverticulosis. Doctor at Kaiser prescribed CBC, urine analysis, a thorough ultra-sound and abdominal x-rays. I'm awaiting results of the blood work and other lab results. I'm hoping that imaging shows something treatable like a duct blockage or kidney stones or gallstones. I know I should just wait for the doctor's office to contact me, but I couldn't sleep and felt that I needed to do something, so I'm seeking a second opinion - yes, before I've even received the first opinion. I'm already thinking about who I know in the local medical community that I could ask for referrals to a good oncologist. I've known two people who both succumbed to pancreatic cancer. I was also previously affiliated with the Leukemia and Lymphoma Society, and met several cancer survivors in my role as a cycling coach. I'm hopeful, but trying to mentally prepare for the worst.

Answered by Dr. Dr. Happykumar Kagathara (1 hour later)

Brief Answer:
No need to worry. Sometimes worry is bigger symptom than primary symptom

Detailed Answer:
Hello,
1) I believe this might be sympathy counselling rather than disease-specific opinion. But i will try my best to provide you enough information
2) Your habit of coffee + alcohol make you prone for development of gastritis or GERD.
3) Alcohol consumption affect liver function therefore liver function test is essential for you to see primarily how your liver is functioning. USG abdomen will give idea about any structural abnormality in any abdominal organ including liver
4) Ibuprofen is also risk factor for development of gastritis.
5) Gastritis/ GERD can produce symptoms as suggested by you.
6) based on your life-style, habits, medication history i would suggest you to add upper GI endoscopy in your evaluation
7) Most of cancer produce symptoms. Only few cancers are asymptomatic initially and produce symptoms very late i.e. pancreatic cancer but it can be screened with specific blood test for specific tumor marker and based on that further evaluation can be done. Alcohol affect more on liver than pancreas and you do not have any other risk factor than alcohol for development of pancreatic cancer.

Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Prasad