I have a health question. I have been experiencing upper left quadrant
abdominal discomfort manifested by visible spasms and a bulge
protruding under my left breast just below the rib cage. The bulge
only appeared once and when I pushed it in, it slipped back.
Subsequent examinations and tests have produced negative results. I
have had cats and mris all negative. The slightes physical or mental
stress (agitation) produces the spasms. I can only eat small portions
and usually feel slightly nauseous after any meal but tolerate liquids
without any problems. I have a feeling of pressure in the left upper
quadrant of my abdomen which intensifies when I do any kind of bending
or even sitting on a hard surface for any lengths of time. The only
way to get relieve is to lie down and or take a muscle relaxer such as
librax or xanax. Only on few occasions have I experienced sharp pains
mostly I have a feeling of bloating, pressure, contractions and like
something is pushing from the inside out. I have had an endoscopy and
colonoscopy with negative results. My doctors, surgeons are puzzled.
They mentioned possibility of a fatty tumor or an intermittent
spigelian hernia. They do not recommend surgery since the site of my
discomfort cannot be specified and we only have my description of
symptoms to go by. There is a spot on my abdomen in the general
location where I experience the spasms when the doctor pushed on it I
felt a sharp stabbing pain and felt nauseous afterwards. At this point
I don't know what to do anymore. I am a 53 year old female in good
health and within my weight limit. Just before I started having this
problem I started fainting and was diagnosed with syncope. I am not
taking any medications only xanax prn. Please help. I want to know
what's wrong and I would like to go back to work.

---

Request for Question Clarification by jbf777-ga on 15 Feb 2003 13:20 PST

Hello -
 
Firstly, I want to give my condolences to you for your situation. 
Chronic pain is not a fun thing to deal with.  If you accept what I
have to say as an answer,  I will post it as one.
 
Since the medical community seems baffled by this, you may need to
take a homeopathic approach to your situation.  This is advisable even
if you're seeking medical advice.
 
It seems to me that your body is protesting something.  Normally when
something like this "happens out of nowhere," there is typically a
reason, and an addressable one at that.  Your body is no different
from a car in terms of principle: it's an interconnected,
interdependent system.  Your car has a dashboard that gives you
readouts for various things that are happening with it.  For instance,
the "Lights" readout will flash if you need to change a light bulb, or
the "Check Oil" alert will flash.  Your body has signals as well.
 
For many years I suffered with horrible headaches.  Horrible.  They
would imprison me in sharp, chronic pain.  Headache medicine would be
the first thing I turned to.  But that never addressed the cause of my
headaches.  It wasn't until I started learning about the body's
response to toxins that I was truly freed from that hell.  The cause
of my headaches, which may very well be the cause of 95% of headaches
in America, was due to toxin build up from sluggish elimination. 
Quite simply, if I were to go eat a few pieces of pizza, wait a few
hours [with little physical activity], and then have a subb sandwich,
I would be in for a nice fat headache.  Everytime I had this sort of
back-to-back starchy/bready meal, this would happen.  Why?  Because
white flour-based breads and starches are fiberless foods that move
very slowly through the colon.  The body would send a "dashboard
alert" in the form of a headache to alert me that something wasn't
right.  Like having a potato stuck in the exhaust pipe of your car...
the elimination portion of my system would not move the food through
my intestines fast enough, and my body would "protest" this in the
form of a headache.  Not enough exercise, not enough fiber, not enough
water, and too much white flour [which, when mixed with water, is
glue].  It makes sense if you think of the body as an extremely
interconnected system.
 
A colleague of mine at work actually went to the hospital a few times
for his headaches.  He was never informed of this type of advice, and
he didn't know where to turn.  I told him about my approach, and how
my headaches are now gone.  He decided to take the same approach, and
his headaches are gone.
 
I got the understanding of this after watching a video series from a
homeopathic doctor talk about natural healing.  It changed the way I
look at health.
 
The surgeon general has said that over half of diseases in America are
caused by diet.  It may very well be a higher number.  Everything from
bone conditions, headaches, arthritis, cancers -- much of this is
caused by diet.  I know personally of a man who has healed himself
from arthritis by changing his diet.
 
What am I getting at?
 
I would venture to guess that, unless you've been externally injured,
either A) Your body is depleted of something vital that it needs, B)
It is responding to toxins of some sort or C) you have a chemistry
imbalance.
 
Firstly I would look at my diet.  Am I eating any junk food?  Coffee? 
Smoking?  Soda?  Diet soda?   What is my intake of white sugar?  Am I
eating foods with preservatives and synthetic additives?  Everything
from breads to toppings can have chemicals in this country.  Is MOST
of my diet raw fruits and vegetables?    Am I getting enough fiber? 
Minerals?  Vitamins?  There may very well be something in your diet
that your body is reacting to.  A combination of things, perhaps.  Or
it's not eliminating waste effectively.  Or you could be depleted of
essential vitamins, minerals, and nutrition on some level.
 
I would go on a juice fast for quite some time.  I would buy a juicer
and do nothing but juice raw fruits and vegetables, and completely
detoxify my entire body.  I would then introduce nothing but raw
fruits and vegetables into my diet.  I would ingest herbs that are
specifically indicated for this type of ailment, and apply related
topical solutions [if necessary].  Over time, the cells of the body
will regenerate and detoxify into healthy cells, and it's possible
your problem will subsist.
 
You said in your question that you are healthy.  It may be true to
some extent, but not healthy enough to not have this problem.  Healthy
is a relative term.
 
This road is not easy.  It requires sacrifice and determination. 
Thomas Edison once said, "The doctor of the future will give no
medicine, but rather interest their patients in the care of the human
frame through lifestyle and diet, and in the cause and prevention of
disease."  I think medicine will always be around, but his point is
quite poignant.
 
I would HIGHLY recommend you call the American Botanical Pharmacy and
Natural Healing Publications at 1-877-832-2463.  Richard Schulze is
the owner of the company, and puts out an 8-video series where he
teaches about natural healing -- including some of the things I
touched on above.  I am normally extremely skeptical about such
things, but it was this video series that tipped me off to the
approach I used for my headaches.  I would order that series from
them, and also get a catalog of products they sell.
 
I'm not a doctor, nor a nutritionist, and I do not know exactly what
it is that you have, nor do I guarantee any results of any kind; but I
hope this will point you in a new direction for answers.
 
jbf777-ga
GA Researcher

Hello, mouse50-ga

 As you know, Goolge Researchers are not doctors, with the exception
of one that we have here on staff!! I have referred you to one of his
forums in the information below.

 Since I am not a doctor, I can only refer you to information I have
found relating to abdominal spasms and possible causes. Even if I was
a doctor, I could not give you a diagnosis over the internet! As I am
sure you were not expecting a diagnosis from Google Answers, I hope
the following information will provide you with some avenues to
explore.

 You have obviously taken the first important steps in getting a
possible diagnosis from your doctor, including CAT scans, MRI's, a
colonoscopy and an endoscopy. As you've said, they showed up nothing.
My research shows your are not alone in getting a "non-diagnosis." As
you will see from the following information, there are thousands of
people suffering from gastrointestinal problems that cannot seem to
find a definitive diagnosis.

My first question, however, is whether you have visited a specialist
in Gastroenterology? If not, I would suggest going to the best
specialist you can find in your area. Also, did you tell your doctor
that you had experienced frequent fainting spells prior to the
abdominal spasms? It seems that could be a very important clue, when
both conditions are considered together.

I have tried to find all the pertinent information I can relating to
abdominal spasms, as well as information relating to the type of
hernia your doctor suggested,  primarily to give you some ideas to
consider.


An excerpt follows from the Organization for Community Networks
newsgroup on Digestive Problems
http://www.ofcn.org/cyber.serv/hwp/hwc/digestive/news/digest015.html
***********************************************************************

Could you tell me what a gastro-intestinal spasm (is)? 

Reply: 

The muscles of the gastro-intestinal tract are not under voluntary
control once food has been swallowed and up to the time stool is
expelled from the body. These types of muscles surround the inner
layers of the esophagus, stomach, small intestine, and large bowel;
they function to propel our food through the G.I. tract during which
time it is acted on by mechanical and chemical forces so that it can
be digested and absorbed into the body. These muscles, like other
muscles, can seize up in what would be a cramp in the muscles of your
arms or legs. This contraction is called spasm and can interfere with
the muscles doing their job of propelling material through the
digestive system. The spasm can cause pain or discomfort in the area
it occurs which may be felt in different ways (for example, chest pain
with esophageal spasms or abdominal cramps with spasm of the
intestines, small or large).

Bruce Sckolnick, M.D.


============================================================================


Hernias
*********

Spigelian hernia:

I searched for a description of this term, and came up with the
following description from
"SPIGELIAN HERNIA," by M.J. Rutten and G.J. Jager
http://www.rbrs.org/database/80-6/page310.html
*****************************************************

"Spigelian hernia or spontaneous ventrolateral hernia is an uncommonly
diagnosed hernia. Inferior to the umbilicus, there is a thinning of
the posterior rectus sheath and variable separation of the
musculo-aponeurotic bands of the transverse abdominal and internal
oblique muscles creating potential parallel slitlike defects. In 95%
the herniation protrudes through these defects. It always contains a
peritoneal sac, and rarely reaches a diameter of more than 2 to 3 cm.
Anteriorly the hernia is usually covered by the aponeurosis of the
external oblique muscle. In less than 5% the hernial sac also
penetrates the latter aponeurosis and will be located subcutaneously.
Spigelian hernia generally occurs during midlife. The incidence is not
known. Both sexes are equally affected. These hernias are difficult to
diagnose clinically. However, cross-sectional imaging techniques
(ultrasonography and CT) will easily detect a Spigelian hernia and
differentiate it from other abdominal wall masses, such as tumors,
abscesses, lipomas, sebaceous cysts and spontaneous hematomas."

( I noticed that in the above description,  these hernias are often
located below the umbilicus, or navel!) You say your bulge is below
the left rib!

However, the following article reveals that such hernia's can show up
higher on the abdomen:

"A case of a Spigelian hernia at an unusually high anatomical
location," by .M. REHMAN*, C.S. SEOW# and P.J. O’DWYER *Department of
Radiology and University Department of Surgery, Western Infirmary,
Glasgow, UK
http://www.rcsed.ac.uk/journal/vol45_3/4530015.htm 

I tried to find the symptoms of Spigelian hernia, and did not come up
with anything very helpful. Read the following from "RE. Spigelian
Hernia." ObGyn Net.
http://forums.obgyn.net/forums/womens-health/WHF.9911/0332.html
 
 "At Mon, 8 Nov 1999, Wanda Holker wrote: >
>What are possible symptoms of a spigelian hernia?

You need to be evaluated by a surgeon for this. It is basically a
weakness between 2 muscle areas and should be able to be demonstrated
on physical exam.

>I have been doing some
>research but cannot find a list of symptoms.

there may be no symptoms whatsoever. Many people may have them and
never no it. Painis the most common, though.

>Tests I have had done for
>spasmadic pain on my right side - halfway between my ribs and pelvic
>have revealed that all my organs are functioning and no colon cancer
-
>but the pain and discomfort (belching,

Belching wouldn't normally go with a S. hernia. Irritable bowel
syndrome is a functional problem of the bowel without any Xray
findings to back it up. Just history of complaints. Another rare
consideration is a compressed nerve from the spine which innervates
the area of discomfort.

>sore spot on right side that
>varies on degree of tenderness, a pressure and or pulling feeling in
the
>area) still randomly appear. This area happens to also be the spot my
>daughter, now 11, kicked for a month and one-half straight when I was
>pregnant with her. These symptoms have been going on for about 7
>months.

Gastroenterologist, general surgeon, MRI of spine. That's what I would
do if it were me.


Epigastric Hernia:

 Occurring between the navel and the lower part of the rib cage in the
midline of the abdomen, these hernias are composed usually of fatty
tissue and rarely contain intestine. Formed in an area of relative
weakness of the abdominal wall, these hernias are often painless and
unable to be pushed back into the abdomen when first discovered.
From "Hernia" at E-medicine.
http://www.emedicine.com/aaem/topic248.htm


For further information on abdominal, and epigastric hernias, read
"Abdominal Hernia."
http://jhhs.client.web-health.com/web-health/topics/GeneralHealth/generalhealthsub/generalhealth/gastrointestinal/hernia_abdominal.html

One of the symptoms of abdominal hernias, including epigastric
hernias, is:

"Pain that increases over the course of the day or during long periods
of standing."

(You mentioned that it is hard for you to bend, or even sit on a hard
surface.)
Read


============================================================================


Irritable Bowel Syndrome:

 Though this is usually felt in the lower abdomen, the fact that you
mention that the slightest stress brings on the spasms might be an
indicator. Anxiety and irritable bowel often go together.

From "Irritable Bowel Syndrome - Background Information."
http://www.natural-products-for-women.com/ibs.htm
(Though this description is on a product-based website, it is still
accurate)
*******************************************************************************

Excerpt follows: 

Background Information

What does the term Irritable Bowel Syndrome mean?  The bowel is
irritable. IBS involves dysfunction but no anatomical abnormalities.
This is because upon diagnostic testing there is no evidence of
disease such as ulcers or inflammation. IBS is a diagnosis of
exclusion  i.e., if the doctors can’t find anything else, a diagnosis
of IBS is likely to be made.

Muscles in the bowel normally contract a few times a day, which
results in a bowel movement. It is believed that in a person with IBS,
these muscles are extremely sensitive to stimuli or triggers. While
this would not normally affect most people, triggers such as food and
stress can provoke a strong response in a person with IBS. For
example, a person without IBS may have no problem eating a salad, but
someone with IBS may have a strong response, like pain, constipation
or diarrhea. While the exact cause of IBS is unknown, there does seem
to be an underlying abnormality in the contractions of the bowel.

The fact that the cause of IBS is officially unknown from the point of
view of mainstream medicine may be due largely to the fact that
medical doctors seldom perform the specialized diagnostic procedures
needed to rule out such conditions as parasites or Candida, which may
be unsuspected causes of the disorder. These important conditions
should not be overlooked and generally will not be by holistic
practitioners. Some of the other conditions that need to be ruled out
where IBS symptoms are present are diverticular disease, infectious
diarrhea, lactose intolerance, celiac disease and infection in the
small intestine from bacterial overgrowth.

Because doctors have been unable to identify an organic cause,
emphasis has traditionally been placed on psychological factors, as
implied by the term intestinal neurosis once used to designate the
condition. Certainly stress can aggravate symptoms, even trigger them,
but there appear to be important factors involved as well.

The colon of the IBS sufferer seems to be more sensitive and reactive
to stimulation than that of most people. Intestinal spasms may result
from ingestion of certain foods or medicines and from abdominal
distention caused by gas, as well as from emotional stress. While
these factors would not cause undue GI distress in the average person,
for the IBS sufferer, they can be triggers of painful abdominal
spasms.


==============================================


Two very good articles on Irritable Bowel Syndrome also shows nausea
and fainting as symptoms.

"What You Should Know About Irritable Bowel Syndrome."
http://www.femalepatient.com/pdf/pat_0702.pdf
************************************************

Symptoms can include:
Nausea, dizziness and fainting.


"Irritable Bowel Syndrome." Intelihealth
http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/10208.html
****************************************************************

Symptoms can include:
In extreme cases, nausea, dizziness or fainting along with the above
symptoms


============================================================================


The Gastroenterology Forum, monitored by Kevin MD, one of our very own
Google Answer Researchers, is an excellent forum for you to visit.You
can enter some questions there as well.

The home page of the forum is at 
http://www.medhelp.org/perl6/Gastro/wwwboard.html
******************************************************

The following symptoms of Irritable Bowel Syndrome, as described by
Doctor Kevin, have been copied from the following thread:
http://www.medhelp.org/perl6/Gastro/messages/C35464-9.html


"IBS has broad diagnostic criteria. Abdominal pain in IBS is usually
described as a crampy sensation with variable intensity and periodic
exacerbations. The pain is generally located in the lower abdomen,
often on the left side; however, the location and character of the
pain can vary widely. The severity of the pain may range from mildly
annoying to debilitating. Several factors, such as emotional stress
and eating, may exacerbate the pain, while defecation often provides
some relief."

"By definition, patients with IBS complain of altered bowel habits.
Patients with IBS complain of diarrhea, constipation, alternating
diarrhea and constipation, or normal bowel habits alternating with
either diarrhea and/or constipation."

"Upper gastrointestinal symptoms, including gastroesophageal reflux,
dysphagia, early satiety, intermittent dyspepsia, nausea, and
non-cardiac chest pain, are common in patients with IBS. Patients with
IBS also frequently complain of abdominal bloating and increased gas
production in the form of flatulence or belching."

(Please notice the many other possible causes of symptoms that he
mentions in this thread)


 ============================================================================


Another thread on the Gastroenterology Forum, dealing with upper left
quadrant abdominal pain, may have some significant diagnoses for your
to consider. (However, I know you have said that the problem is not
really one of pain, but spasms)

The following is excerpted from Dr. Kevin's response:
http://www.medhelp.org/perl6/Gastro/messages/C35468-3.html

"I will discuss the causes of left upper quadrant pain and you may
want to present these possible reasons to your personal physician if
they have not been already covered.

Causes of left upper quadrant pain specifically include:
splenic abscess
splenic infarct
gastritis
gastric ulcer
pancreatitis

Causes of epigastric pain specifically include:
peptic ulcer disease
GERD
gastritis
pancreatitis
myocardial infarction
pericarditis
ruptured aortic aneurism

Causes of diffuse abdominal pain specifically include:
gastroenteritis
mesenteric ischemia
familial Mediterranean fever
bowel obstruction
peritonitis
irritable bowel syndrome

You can see there are many possible reasons for your symptoms - some
of which are pretty rare.

Since gastritis and peptic ulcer disease are in the differential of
left upper quadrant pain, an upper endoscopy may be prudent to rule
this out."

(Did you endoscopy include the upper left quadrant, as Dr. Kevind
suggests?)

 
============================================================================


Here is an excerpt dealing with one of your other symptoms....the
bulge in the upper left quadrant. I will highlight the question, and
leave you to read the responses.
http://www.medhelp.org/perl6/Gastro/messages/C35456-4.html

"I am a 36 year old female, 203 lbs. For the last few months, I have
had a feeling of fullness in the upper left side of my abdomen. It
feels like my upper abdomen is kind of swollen. My stools have been
kind of thin at times too. I can feel a grape sized "knot" in this
area too. I can move it around--but I can't always feel it there. I'm
wondering if I have an intestinal obstruction. No blood in stools
except when I strained & "scratched" the inside of my rectum--this was
bright red specks of blood. I am feeling in the last few days a
sensation of something there--not so much a pain but a "feeling" if
you will. I was told last year that I showed signs of gallstones from
an x-ray. The Dr. recommended I see a specialist but I never went--no
health insurance then. I have insurance now but it is only a temporary
policy. I am scared to death of what this could be. Anyone have any
comments?"

(Since there is no doctor's comment within the answers, I would take
them all with a grain of salt)


============================================================================


Another string concerning pain in the upper left quadrant might
interest you, but beware, since there are no doctor's comments.
http://www.medhelp.org/perl6/Gastro/messages/C35178-10.html

"Pain in left side under rib cage."

 "... have had so many problems in the last couple months that I
really don't know where to start. My latest is a pain in my front
upper left side right below my rib cage. It's not constant and it's
not a bad pain but just enough to bother me and worry me."


============================================================================


Some other question from the forum with some common symptoms to yours
(although mostly dealing with pain in the upper left quadrant:
http://www.medhelp.org/perl6/gastro/archive/4878.html
http://www.medhelp.org/perl6/gastro/archive/3218.html


The archive of miscellaneous questions on the forum certainly show
that you are not alone in finding a diagnosis. Although I have found
nothing dealing with spasms, other than irritable bowel, you may want
to look through the following list.
http://www.medhelp.org/perl6/Gastro/archive/Misc..html

(You may want to read the question about the "large bulge above the
navel." I realize yours is just below the left rib.....but it is still
interesting.

Forum strings by condition are located at 
http://www.medhelp.org/perl6/Gastro/faq.html


============================================================================


If you truly feel you have exhausted the resources of doctors, and
especially, a very good gastroenterologist, you might try an
alternative therapy often mentioned for abdominal spasms.
Neuromuscular therapy is a form of deep tissue pressure therapy, which
has proven helpful for many conditions, including abdominal spasms.
http://www.manual-medicine.com/why.html


However, I still want to stress that your "discernable bulge" and
prior episodes of syncope are not to be taken lightly. Did your
previous doctor mention the possible cause of the syncope? Was it
related to anxiety, or something else worth noting?


You also might try using the questionaire at ECureME's Self Diagnostic
Center.
http://www.ecureme.com/emyhealth/symptoms/games.asp
******************************************************************************

You can choose a general topic, which will take you to a
questionnaire.
The questionnaire asks you yes or no questions pertaining to various
symptoms and comes up with a possible diagnosis. It is certainly no
substitution for a doctor, but it may help you feel like you have some
control over figuring out the reason for your abdominal spasms.
(You will have to sign in, but membership is free.)


 I certainly hope you will find a diagnosis or some relief from your
symptoms. I still recommend that you seek out the best specialist you
can find, and don't  stop trying until you can find an explanation
that seems acceptable to you.

Please don't hesitate to ask for additional clarification, and let me
know if  any of the links fail to work.

Best of luck and good health!

umiat-ga
 
Google Search Strategy
abdominal spasms
abdominal spasms AND fainting
health problems diagnosis
stress AND abdominal AND spasms
spigelian hernia
epigastric hernia AND symptoms

---

Request for Answer Clarification by mouse50-ga on 16 Feb 2003 08:15 PST

Thank you so much for your excellent response and providing more links
for me to research. I did see a gastroenterologist and I was diagnosed
with IBS. I just think that there is more than that because I get the
spasms at rest and without experiencing any conscious
agitation/stress. I have been off work for nearly 3 months and my
spasms are significantly reduced without medication. I have gone from
several incidents a day to one or two a week; however, my activites
are severely limited, basically I sit or lie on a soft surface most of
the day. Just going shopping and doing some light housework can bring
on the spasms and feeling of discomfort and at times even sharp
stabbing pain in the area where the bulge protruded. I have not have
any protrution except that singular incident. I had several CATs and
MRIs read by a local radiologist and the Cleveland Clinic, none
detected any tumors or hernias. I had everthing checked except my
small intestines and I believe that may be where the problem is
located. My doctor also mentioned a Mesenteric Hernia. I would like to
know how to check the function of the small intestine. I am thinking
my tests showed nothing because I usually fasted for the tests, I am
laying down flat, and I am not experiencing any problems at the time
of the test. I wonder if spasms could be introduced while performing
the test? Also, one surgeon suggested exploratory laparoscopy which in
my mind amounts to no more than a fishing expedition which may end up
with scars, more pain, and no answers. I am trying to reach some kind
of understanding with less invasive procedures. I am so desperate for
an answer because it has severly affected my life and I am afraid to
go back to work. At work I felt miserable and in pain every day. This
is very disabling but because no specific diagnosis has been given it
is also very difficult to receive treatment and/or pursue any line of
work ( I am in the health care field myself.) If you could comment on
the Mesenteric Hernia and possible diagnostic tests for small
intestine, I would be totally satisfied with your thorough research
and response to my dilemma. Thank you.

---

Clarification of Answer by umiat-ga on 16 Feb 2003 16:04 PST

Hi again, mouse50!

 Thanks for your response! Here is some additional information for
you.

 First of all, I thought it might help to look up some basic
definitions as well as see some pictures so you have a good idea where
everything is located. (This was a "re-learning" experience for me,
also, since so many years have passed since Anatomy and Physiology!)


Basic definitions
******************

Hernia:

Hernia (her·nia) (h[schwa]rĒne-[schwa]) [L.]  the protrusion of a loop
or knuckle of an organ or tissue through an abnormal opening.

===

Mesenteric Hernia:

"herniation of intestine through an opening in the mesentery."

===


The many different type of Hernias (and there are a lot!!!) are
described on the Merck Manual Health Library website at
http://www.mercksource.com/pp/us/cns/cns_health_library_frame.jspzQzpgzEz/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_h_09zPzhtm


===


A more complex definition of a Mesenteric Hernia is found in
"The Encyclopaedia of Medical Imaging Volume VII." Amersham Health
http://www.amershamhealth.com/medcyclopaedia/Volume%20VII/HERNIA%20MESENTERIC.asp

Mesenteric Hernia:

 Herniation of the intestine through a defect in the mesentery, for
instance paraduodenal hernia and hernia that occurs through a defect
in the mesentery of the terminal ileum. Herniation of bowel can also
occur through a tear in the mesentery following abdominal trauma.
Contrast studies will either show the site of obstruction or the
abnormal course and location of the bowel and proximal dilatation of
the bowel.

===


What is the Mesentery?

"a membranous fold attaching various organs to the posterior wall of
the abdominal cavity."

"The Encyclopaedia of Medical Imaging Volume VII." Amersham Health
http://www.amershamhealth.com/medcyclopaedia/Volume%20II/mesentery.asp


===


What is the Small Intestine?

The small intestine is the portion of the digestive system most
responsible for absorption of nutrients from food into the
bloodstream. The pyloric sphincter governs the passage of partly
digested food from the stomach into the duodenum. This short first
portion of the small intestine is followed by the jejunum and the
ileum. The ileocecal valve of the ileum passes digested material into
the large intestine.

See Picture at
http://www.mercksource.com/pp/us/cns/cns_health_library_frame.jsp?cd=3d&pg=/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcnszSzcontentzSzadamzSzimagepageszSz19221zPzhtm
 
(Also, from the above picture, see how the upper portion of the
stomach lies in the top left quadrant).

===


What is the Duodenum?

The first part of the small intestine. Located between the stomach and
the ileum. After foods combine with stomach acid, they descend into
the duodenum where they mix with bile from the gall bladder and
digestive juices from the pancreas.
http://www.mercksource.com/pp/us/cns/cns_health_library_frame.jsp?cd=3d&pg=/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcnszSzcontentzSzadamzSzencyzSzarticlezSz002347zPzhtm
 

===


Components of Digestive System:

The esophagus, stomach, large and small intestine, aided by the liver,
gallbladder and pancreas convert the nutritive components of food into
energy and break down the non-nutritive components into waste to be
excreted.

See picture of all components!
http://www.mercksource.com/pp/us/cns/cns_health_library_frame.jsp?cd=3d&pg=/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcnszSzcontentzSzadamzSzencyzSzarticlezSz002347zPzhtm


===


Irritable Bowel:

Please refer to the Health Library site for some more information and
links to click on...
http://www.mercksource.com/pp/us/cns/cns_health_library_frame.jsp?cd=3d&pg=/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcnszSzcontentzSzadamzSzencyzSzarticlezSz000246zPzhtm

(As noted from the reference above, this condition may be chronic, so
you might have to start paying more attention to a dietary regimen to
alleviate some of the symptoms)

(Also note that depression is a normal symptom.......obviously, since
the condition can cause severe disruption in your life, as you have
noted)


============================================================================


Diagnostic Tests for the Upper Digestive Tract
**********************************************

Upper GI Series:

"The upper gastrointestinal (GI) series uses x rays to diagnose
problems in the esophagus, stomach, and duodenum (first part of the
small intestine). It may also be used to examine the small intestine.
The upper GI series can show a blockage, abnormal growth, ulcer, or a
problem with the way an organ is working.

During the procedure, you will drink barium, a thick, white,
milkshake-like liquid. Barium coats the inside lining of the
esophagus, stomach, and duodenum and makes them show up more clearly
on x rays. The radiologist can also see ulcers, scar tissue, abnormal
growths, hernias, or areas where something is blocking the normal path
of food through the digestive system. Using a machine called a
fluoroscope, the radiologist is also able to watch your digestive
system work as the barium moves through it. This part of the procedure
shows any problems in how the digestive system functions, for example,
whether the muscles that control swallowing are working properly. As
the barium moves into the small intestine, the radiologist can take x
rays of it as well.

An upper GI series takes 1 to 2 hours. X rays of the small intestine
may take 3 to 5 hours. It is not uncomfortable. The barium may cause
constipation and white-colored stool for a few days after the
procedure.

Preparation
Your stomach and small intestine must be empty for the procedure to be
accurate, so the night before you will not be able to eat or drink
anything after midnight. Your physician may give you other specific
instructions."

(Also see Picture)

"Upper GI Series." The National Digestive Diseases Information
Clearinghouse.
http://www.niddk.nih.gov/health/digest/pubs/diagtest/upgi.htm 


===


Upper Endoscopy:

 "Upper endoscopy enables the physician to look inside the esophagus,
stomach, and duodenum (first part of the small intestine). The
procedure might be used to discover the reason for swallowing
difficulties, nausea, vomiting, reflux, bleeding, indigestion,
abdominal pain, or chest pain. Upper endoscopy is also called EGD,
which stands for esophagogastroduodenoscopy
(eh-SAH-fuh-goh-GAS-troh-doo-AH-duh-NAH-skuh-pee).

For the procedure you will swallow a thin, flexible, lighted tube
called an endoscope (EN-doh-skope). Right before the procedure the
physician will spray your throat with a numbing agent that may help
prevent gagging. You may also receive pain medicine and a sedative to
help you relax during the exam. The endoscope transmits an image of
the inside of the esophagus, stomach, and duodenum, so the physician
can carefully examine the lining of these organs. The scope also blows
air into the stomach; this expands the folds of tissue and makes it
easier for the physician to examine the stomach.

The physician can see abnormalities, like inflammation or bleeding,
through the endoscope that don't show up well on x rays. The physician
can also insert instruments into the scope to remove samples of tissue
(biopsy) for further tests or treat bleeding abnormalities.

Possible complications of upper endoscopy include bleeding and
puncture of the stomach lining. However, such complications are rare.
Most people will probably have nothing more than a mild sore throat
after the procedure.

The procedure takes 20 to 30 minutes. Because you will be sedated, you
will need to rest at the endoscopy facility for 1 to 2 hours until the
medication wears off.

Preparation
Your stomach and duodenum must be empty for the procedure to be
thorough and safe, so you will not be able to eat or drink anything
for at least 6 hours beforehand. Also, you must arrange for someone to
take you home--you will not be allowed to drive because of the
sedatives. Your physician may give you other special instructions.

"Upper Endoscopy." The National Digestive Diseases Information
Clearninghouse.
http://www.niddk.nih.gov/health/digest/pubs/diagtest/uppend.htm



Ideas for Self-Help
*******************

You mentioned that your symptoms have calmed down sufficiently since
you stopped working. Could this be due to the fact that you have less
anxiety about the abdominal spasms and discomfort when you are home? I
would think that would be perfectly natural. It would be akin to
feeling sick to your stomach, and having to go to work, worrying that
you are going to vomit at any moment. It would sure be less
anxiety-provoking to stay at home. I cannot imagine having to go
through a workday, worrying about all the symptoms IBS can contain.

Therefore, since IBS can be chronic, it might make some good sense to
examine some alternative methods for controlling the symptoms. So many
people suffer from IBS, there is a wealth of information on the
internet about ways to alleviate the symptoms.


The following list is from "Relieving the Symptoms of Irritable Bowel
Syndrome."
http://www.irritable-bowel-syndrome-treatments.com/

dietary/lifestyle adjustments
stress management
relaxation techniques
hypnosis
specific medication
low-dosage antidepressants
drug therapy (depending upon the predominant symptom)
biofeedback therapy 
pain control
behavioral therapies
alternative medicines (e.g. 
Chinese medicine, acupuncture,
herbalism).


Here are some other links that may offer some valuable help:

"Irritable Bowel Syndrome and Alternative Medicine." DrFeely.com
http://www.drfeely.com/patientcare/research_ibs_altmed_0.htm

"Irritable Bowel and Psychological Factors." DrFeely.com
http://www.drfeely.com/patientcare/research_ibs_psyche_0.htm

"Irritable Bowel and Food Allergies." DrFeely.com
http://www.drfeely.com/patientcare/research_ibs_food_0.htm

"Irritable Bowel Syndrome Links." IBS Self Help Group (this is a
goldmine!!!)
http://www.ibsgroup.org/main/library.html#pharm

"Hypnosis for Irritable Bowel," By Mark Moran, MPH. WebMD Health
http://my.webmd.com/content/article/34/1728_87469?

"Cognitive Behavioral Treatment of Irritable Bowel Syndrome," by
Dennis Tirch and Cynthia L. Radnitz, Ph.D. Fairleigh Dickinson
University, Teaneck, NJ
http://www.apa.org/divisions/div12/rev_est/cbt_ibs.shtml 


===

Additional Reading

"Irritable Bowel Syndrome." The Health Report with Norman Swan (1998)
http://abc.net.au/rn/talks/8.30/helthrpt/stories/s10702.htm


 I know this problem is extremely frustrating for you, but I believe
you can gain a great deal of control over your symptoms if you find a
therapy or medication that works for you.

 Take care and keep your spirits up!

 umiat

Google Search strategy
mesenteric hernia 
diagnostic tests AND small intestine
relaxation AND irritable bowel

As an addendum to what I just posted, I want to say: 
  
America is a diseased country.  We are one of the leaders in cancers,
kidney and liver diseases, and many other ailments, and it has a LOT
to do with the way we eat.  Many of us eat horribly, with a diet
consisting of processed foods, sodas, too much meat, junk and fast
food, and not nearly enough necessary nutrition.  It takes its toll
after a while.
  
In general, BIG changes in health can be seen in relatively small diet
changes.  Decreasing processed food intake, junk food, meats, etc. and
increasing nutrition, fiber, water, exercise, etc. will always afford
someone improved health.
  
jbf777-ga

Also, this answer will be removed until approved... it was posted as a
clarification by mistake.

Sorry, I meant: that addendum was posted as "answer," instead of a
comment, by mistake..