[20M] With persistent stomach pain and gastrointestinal symptoms

Patient Description

A 20-year-old male reports experiencing stomach pain, soreness, aching, gas, and acid reflux for the past four days. The pain is constant and worsens upon touch. The patient has been gassy throughout the day, with no specific food triggers identified. Bowel movements are normal, with the last one occurring this morning. The patient denies nausea, vomiting, difficulty swallowing, or significant changes in bowel habits, though there may be minor constipation. The patient is currently taking Propranolol, Lorazepam (Ativan), and Bupropion (Wellbutrin) as prescribed. There have been no recent changes in diet, exposure to new environments, substances, or stressors. The patient has no significant past medical history or family history of major illnesses.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—stomach pain, soreness, aching, gas, and acid pain for four days—here are some possible explanations:

  • Gastritis: This is an inflammation of the stomach lining that can cause pain, soreness, and a burning sensation. It can be triggered by stress, certain medications (like NSAIDs), or infections.

    • Treatment: Typically involves antacids, proton pump inhibitors (PPIs), or H2 blockers to reduce stomach acid. Avoiding spicy foods, alcohol, and smoking can also help.
  • Gastroesophageal Reflux Disease (GERD): This condition occurs when 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.

    • Treatment: Lifestyle changes such as eating smaller meals, avoiding food before bedtime, and elevating the head while sleeping. Medications like antacids, H2 blockers, or PPIs can also be helpful.
  • Irritable Bowel Syndrome (IBS): A common disorder that affects the large intestine, causing symptoms like cramping, abdominal pain, bloating, gas, and diarrhea or constipation.

    • Treatment: Dietary changes, stress management, and medications to manage symptoms.
  • Peptic Ulcer: Sores that develop on the lining of your stomach, small intestine, or esophagus. They can cause a burning stomach pain that may improve with eating or taking antacids.

    • Treatment: Medications to reduce stomach acid and antibiotics if an infection is present.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take to alleviate your symptoms:

  1. Dietary Adjustments: Avoid spicy, fatty, or acidic foods that can exacerbate stomach pain and acid reflux. Eating smaller, more frequent meals can also help.
  2. Hydration: Drink plenty of water to help with digestion and reduce gas.
  3. Over-the-Counter Medications: Antacids can provide quick relief from acid reflux and stomach pain. However, consult your doctor before taking any new medication.
  4. Stress Management: Since stress can worsen gastrointestinal symptoms, consider relaxation techniques like deep breathing, meditation, or yoga.
  5. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and get insights. This can be very helpful when you discuss your condition with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening abdominal pain
  • Blood in your stool or vomit
  • Unexplained weight loss
  • Persistent vomiting
  • Difficulty swallowing

Remember, while these suggestions can help manage your symptoms, they are not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan.

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6 mo ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines

People Also Ask


What are the common causes of stomach pain and gas?

Common causes of stomach pain and gas include dietary factors, stress, infections, and conditions like gastritis, GERD, IBS, or peptic ulcers. Identifying specific triggers can help manage symptoms.


How can I differentiate between gastritis and GERD?

Gastritis typically involves inflammation of the stomach lining and may cause a burning sensation, while GERD involves acid reflux into the esophagus, causing heartburn. Both can have overlapping symptoms, so a healthcare provider's assessment is important.


What lifestyle changes can help manage acid reflux symptoms?

Lifestyle changes to manage acid reflux include eating smaller meals, avoiding food before bedtime, elevating the head while sleeping, and avoiding trigger foods like spicy or fatty foods. Stress management and weight loss can also be beneficial.


When should I seek medical attention for stomach pain?

Seek medical attention if you experience severe or worsening abdominal pain, blood in your stool or vomit, unexplained weight loss, persistent vomiting, or difficulty swallowing, as these could indicate more serious conditions.


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