[20F] Experiencing abdominal pain with a history of a non-cancerous pancreatic mass and acid reflux

Patient Description

A 20-year-old female has been experiencing abdominal pain since early morning, described as a long-lasting sensation akin to the stomach trying to flex, centered directly below the chest plate and rib cage. The pain intensity was rated a 6 out of 10, with lying on the stomach providing some relief. The patient's last bowel movement was described as normal, with no fever, chills, radiation of pain, or additional symptoms reported. The patient has a history of a non-cancerous mass on the pancreas diagnosed about a year ago and acid reflux diagnosed approximately two years ago. Currently, the patient takes Omeprazole as needed for acid reflux, though the exact dosage is unknown, and also has a prescription for Ibuprofen. There's no known family history of gastrointestinal diseases, and the patient denies the use of alcohol, tobacco, or recreational drugs that could contribute to the symptoms.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, possible conditions include:

  • Gastritis: This is an inflammation of the stomach lining, which can cause upper abdominal pain. It can be caused by various factors, including long-term use of certain medications like ibuprofen, and conditions like acid reflux.

    • Treatment typically involves medications to decrease stomach acid, which you are already taking in the form of Omeprazole.

  • Peptic Ulcer: These are sores that develop on the lining of your stomach, upper small intestine or esophagus. Pain from a peptic ulcer can be felt in the area you described.

    • Treatment typically involves medications to decrease stomach acid, and sometimes antibiotics if the ulcers are caused by a certain type of bacteria.

  • Gallstones: These are hard deposits in the gallbladder that can cause pain in the upper abdomen. The pain is usually severe and sudden, and may last for hours.

    • Treatment can range from watchful waiting in mild cases to surgery in severe cases.

  • Pancreatitis: Given your history of a non-cancerous mass on your pancreas, it's also possible that you could be experiencing pancreatitis, which is inflammation of the pancreas. This can cause upper abdominal pain.

    • Treatment usually involves hospitalization, fasting to rest the pancreas, pain medication, and IV fluids.

What you can do

You should make an appointment with a healthcare provider to discuss your symptoms as soon as possible. They can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to help manage your symptoms:

  1. Avoid foods and drinks that irritate your stomach. These can include spicy foods, alcohol, and caffeinated drinks.
  2. Try to eat smaller, more frequent meals instead of three large meals a day.
  3. Avoid lying down or going to bed immediately after eating.
  4. Continue taking your Omeprazole as directed by your healthcare provider.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Vomiting blood or having blood in your stool
  • A high fever or chills
  • Unexplained weight loss
  • Difficulty swallowing

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare provider.

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8 mo ago

People Also Ask

What are the common causes of gastritis and how can it be treated?

Gastritis is commonly caused by factors such as long-term use of NSAIDs like ibuprofen, excessive alcohol consumption, stress, and infections like H. pylori. Treatment often involves medications to reduce stomach acid, such as proton pump inhibitors like Omeprazole, and lifestyle changes to avoid irritants.

How can I differentiate between peptic ulcer pain and other types of abdominal pain?

Peptic ulcer pain is typically a burning or gnawing sensation in the upper abdomen, often occurring between meals or at night. It may be relieved by eating or taking antacids. If you suspect a peptic ulcer, it's important to consult a healthcare provider for proper diagnosis and treatment.

What are the symptoms of pancreatitis and when should I seek medical attention?

Symptoms of pancreatitis include severe upper abdominal pain that may radiate to the back, nausea, vomiting, fever, and a rapid pulse. Seek immediate medical attention if you experience severe pain, especially if accompanied by these other symptoms.

Can long-term use of ibuprofen contribute to abdominal pain or other gastrointestinal issues?

Yes, long-term use of ibuprofen can irritate the stomach lining, leading to conditions like gastritis or peptic ulcers, which can cause abdominal pain. It's important to use NSAIDs as directed and consult a healthcare provider if you experience persistent pain.

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