[27F] Experiencing severe upper stomach pain postprandial

Patient Description

A 27-year-old female is reporting severe upper stomach pain that occurs 2-3 hours after eating and has been persistent for over a week and a half. The pain is described as sharp, predominantly located in the upper stomach and occasionally radiating to the back. The patient experiences chills associated with the pain but no fever. She has a history of mild constipation, which is sometimes alleviated by hot coffee. The patient reports fatigue but no changes in weight, nausea, vomiting, jaundice, or changes in stool color. There is no known family history of gastrointestinal diseases. The patient is currently taking Gabapentin 400mg twice a day for anxiety. No allergies or adverse reactions to medications have been reported, and there is no other significant past medical history.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Gastritis or Peptic Ulcer Disease: This condition is characterized by inflammation or irritation of the stomach lining and can cause sharp upper abdominal pain, especially after meals. The pain can sometimes radiate to the back. It's often caused by a bacteria called H. pylori or by the use of nonsteroidal anti-inflammatory drugs (NSAIDs), but can also be caused by other factors.

    • Treatment typically involves medications to decrease stomach acid and, if H. pylori is present, antibiotics to eradicate the bacteria.
  • Gallstones: These are hard deposits in your gallbladder that can cause sharp pain in the upper abdomen, especially after eating a fatty meal. The pain can sometimes radiate to the back or the right shoulder.

    • Treatment may involve dietary changes, medications to dissolve the gallstones, or surgery to remove the gallbladder.
  • Pancreatitis: This is inflammation of the pancreas, which can cause sharp, severe pain in the upper abdomen that may radiate to the back. It can be triggered by gallstones, alcohol consumption, certain medications, and other factors.

    • Treatment typically involves hospitalization for pain management, fluid replacement, and sometimes surgery.
  • 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 and cause upper abdominal pain.

    • Treatment typically involves lifestyle changes and over-the-counter medications.

Please note that these are possibilities based on the symptoms you've described, and it's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Keep a symptom diary: Note down when your pain occurs, what you're eating, and any other symptoms. This can help identify patterns and potential triggers.
  2. Eat smaller, more frequent meals: Instead of three large meals, try eating six small meals throughout the day.
  3. Avoid known triggers: Some people find that spicy foods, alcohol, or high-fat foods worsen their symptoms.
  4. Stay hydrated: Drink plenty of water throughout the day.
  5. Over-the-counter antacids: These can help neutralize stomach acid and provide short-term relief.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Pain with fever and chills
  • Yellowing of your skin or the whites of your eyes
  • Dark (tar-like) stools or bloody stools
  • Persistent nausea or vomiting
  • Unexplained weight loss

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare provider for an accurate diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common causes of upper stomach pain that radiates to the back?

Common causes of upper stomach pain that radiates to the back include gastritis, peptic ulcer disease, gallstones, pancreatitis, and gastroesophageal reflux disease (GERD). Each condition has specific triggers and symptoms, and a healthcare provider can help determine the exact cause.


How can gastritis or peptic ulcer disease be diagnosed and treated?

Gastritis or peptic ulcer disease can be diagnosed through a combination of medical history, physical examination, and tests such as endoscopy or testing for H. pylori bacteria. Treatment typically involves medications to reduce stomach acid and, if necessary, antibiotics to treat H. pylori.


What lifestyle changes can help manage symptoms of GERD?

Lifestyle changes to manage GERD symptoms include eating smaller, more frequent meals, avoiding trigger foods (such as spicy or fatty foods), not lying down immediately after eating, maintaining a healthy weight, and avoiding smoking and alcohol.


When should someone with upper abdominal pain seek immediate medical attention?

Immediate medical attention should be sought if someone experiences severe abdominal pain, pain accompanied by fever and chills, yellowing of the skin or eyes, dark or bloody stools, persistent nausea or vomiting, or unexplained weight loss.


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