[19F] Experiencing sharp upper left abdominal pain with dizziness postprandial

Patient Description

A 19-year-old female presents with sharp pain in the upper left abdomen under the ribs, radiating to the upper back. The pain has been intermittent over the past few days and has become consistent in the last couple of hours, rated at a severity of 7 out of 10. The pain typically worsens 5 to 10 minutes after eating, accompanied by dizziness. The patient has a medical history of hypermobility, Postural Orthostatic Tachycardia Syndrome (POTS), and Irritable Bowel Syndrome (IBS), and had a cholecystectomy (gallbladder removal) a few years ago. The patient is currently on Prilosec (40mg daily) and reports anxiety as an adverse reaction to Hydroxyzine. No changes in stool color, nausea, vomiting, difficulty breathing, or palpitations were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Gastritis or Peptic Ulcer Disease: These conditions are characterized by inflammation or damage to the lining of the stomach or upper small intestine. They can cause upper abdominal pain that often worsens after eating.

    • Treatment typically involves medications to reduce stomach acid and allow the lining to heal. In some cases, antibiotics may be needed if a bacteria called Helicobacter pylori is involved.
  • Pancreatitis: This is inflammation of the pancreas, which can cause upper abdominal pain that often radiates to the back. The pain can be triggered or worsened by eating.

    • Treatment usually involves hospitalization for pain control and fluid replacement. In some cases, surgery may be needed.
  • Gastroesophageal Reflux Disease (GERD): This is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause upper abdominal pain.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In some cases, prescription medications or even surgery may be needed.

Please remember that these are just possibilities and not a definitive diagnosis.

What you can do

  1. Avoid foods and drinks that can trigger heartburn, such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
  2. Eat smaller meals.
  3. Wait at least three hours after eating before lying down or going to bed.
  4. Elevate the head of your bed if you regularly experience heartburn at night or while trying to sleep.
  5. Don't smoke, and if you already do, try to quit.

What you should look out for

You should seek immediate medical attention if:

  • Your pain becomes severe or unbearable
  • You experience chest pain, especially if accompanied by other signs and symptoms such as shortness of breath or jaw or arm pain. These may indicate a heart attack.
  • You vomit blood or have blood in your stool (your stool may look black)
  • You have difficulty swallowing
  • You become jaundiced (your skin and the whites of your eyes become yellow)

Remember, it's important to consult with a healthcare professional who can evaluate your symptoms and condition for a definitive diagnosis.

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10 mo ago

People Also Ask


What are the common symptoms of gastritis or peptic ulcer disease?

Common symptoms of gastritis or peptic ulcer disease include upper abdominal pain, especially after eating, bloating, nausea, and sometimes vomiting. In severe cases, there may be bleeding, leading to black stools or vomiting blood.


How can pancreatitis be identified and treated?

Pancreatitis is often identified by severe abdominal pain that radiates to the back, nausea, vomiting, and fever. Treatment typically involves hospitalization for pain management, fasting to rest the pancreas, and intravenous fluids. In severe cases, surgery may be required.


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes to manage GERD include avoiding trigger foods and drinks, eating smaller meals, not lying down immediately after eating, elevating the head of the bed, and avoiding smoking. These changes can help reduce acid reflux and alleviate symptoms.


What are the potential complications of having a cholecystectomy?

After a cholecystectomy, some people may experience digestive issues such as diarrhea or difficulty digesting fatty foods. In rare cases, there can be complications like bile duct injury or post-cholecystectomy syndrome, which involves persistent abdominal pain and digestive problems.


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