Gastric Abdominal Gas and Pain in Chest, Hard Ball or Knot

KristalTT Asked :

Over the past few weeks, I have been feeling a pain on the front of my chest just at the bottom of the left side of my rib cage. It almost feels like a hard ball or knot which is like protruding into the top of my abdomen area. I can feel partly feel this ball at the top of my abdomen and if I dig my finger under the rib cage which is very painful.

It comes and goes but it causes a lot of pain, more in my chest than abdomen. Its sometimes a dull ache and at other times it feels like a tight pain. From what I read up, I thought it was a hiatus hernia and I went and saw my doctor and then a gastroenterologist. He was very thorough and did a whole lot of tests. Everything was in order, even my heart, and I was told that it was probably just a gas build up. I was given quite a few medicines including something for cramps.

I have been suffering with IBS (irritable bowel syndrome) for many years and while it sometimes troubles me for a few days or weeks, overall it is quite under control. I can take the episodes of constipation and flatulence but I never before experienced any bowel cramps in all this time.

Now I am a bit worried if my IBS is getting worse and if these hard balls are due to cramps and not just gas. Could it be a tumor that it is sometimes being pushed out when I have gas? If it is gas, should I be using medicines for cramps? Could this be the only bowel related cause of chest pain?

This question was posted under the Gastrointestinal, Gastric Chest Pain article.

Any response by the Health Hype team does not constitute a medical consultation and the advice should be viewed purely as a guide. Always consult with your doctor before making any changes to your current treatment program. The information provided in this article is not an authoritative resource on the subject matter and solely intends to guide the reader based on the questions asked and information provided.

Dr. Chris Answered :

This may possibly be splenic flexure syndrome where pockets of gas are trapped in the corner (‘bend’) of the large colon on the left side. Splenic flexure syndrome is not uncommon in IBS patients with increased intestinal gas. Since it is just gas, it will ‘come and go’ and treating any constipation, if present, will help release this gas as well.

The location of the splenic flexure is on the upper left side of the abdomen and just under the left rib cage. The rib cage is not the the border between the chest cavity and abdominal cavity. So some of the abdominal contents do lie behind the rib cage and will even rise up higher when you exhale. This is why chest pain can sometimes be the result of some disorder within the abdominal organs.

When the colon becomes inflated by a gas pocket (like a balloon), the wall of the colon becomes stretched and the muscles within the wall will then contract. The contracting intestinal wall muscle will narrow the lumen of the colon while the gas pocket is stretching it.These are two opposing forces and these muscles may go into spasm (cramp). Cramping can also play a part in further trapping these gas pockets. Pain is one of the consequences.

In terms of a tumor, only your gastroenterologist will be able to exclude this after the proper investigation. You should speak to him about your concerns and also ask him about dietary changes if he has not already advised you accordingly. In all likelihood from what you report, it is these gas pockets in the colon that is causing these ‘hard balls’ and not a tumor. However, it is always good to be vigilant. There are a number of gastrointestinal causes of chest pain but your doctor will confirm or exclude any differential diagnosis.

Refer to these articles on Causes of Bloating and Gas, Pain Under the Left Rib Cage, and Left Upper Quadrant (LUQ) Pain.

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