[32M] With chronic upper right abdominal pain and digestive symptoms

Patient Description

A 32-year-old male presents with chronic upper right abdominal pain that is dull and mostly constant, with a severity of 3 out of 10. The pain is relieved by eating but returns after a couple of hours, especially on an empty stomach. Accompanying symptoms include daily bloating, flatulence, and indigestion, with lighter brown or yellow stools. The patient has a history of alcohol-induced gastritis and GERD, diagnosed 6 years ago. No nausea or vomiting is reported. Indigestion is worsened by fatty, fried foods, heavier meals, and alcohol. The patient takes gallbladder supplements, NAC, vitamin D, and a multivitamin. There have been no recent dietary changes, increased stress, or travel. No family history of gastrointestinal issues or allergies is noted, and the patient is not on any regular medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Peptic Ulcer Disease: This condition involves sores that develop on the lining of the stomach or the first part of the small intestine. The pain often improves with eating and worsens when the stomach is empty, which aligns with your experience. Testing might include an endoscopy or testing for H. pylori, a bacteria that can cause ulcers. Treatment typically involves medications to reduce stomach acid and, if necessary, antibiotics to treat H. pylori.

  • Chronic Gastritis: Given your history of alcohol-induced gastritis, it's possible that chronic inflammation of the stomach lining is contributing to your symptoms. This can cause pain, bloating, and indigestion. Treatment often involves avoiding irritants like alcohol and taking medications to reduce stomach acid.

  • Gallbladder Issues: Although your symptoms don't perfectly match gallbladder disease, the location of your pain and the fact that fatty foods worsen your symptoms could suggest a gallbladder issue. An ultrasound or other imaging tests might be used to check for gallstones or inflammation.

  • Gastroesophageal Reflux Disease (GERD): Since you have a history of GERD, it's possible that this condition is contributing to your symptoms. GERD can cause indigestion and abdominal pain, especially after eating. Treatment typically involves lifestyle changes and medications to reduce acid production.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis, here are some steps you can take to manage your symptoms:

  1. Dietary Adjustments: Continue to avoid foods that trigger your symptoms, such as fatty and fried foods, and alcohol. Eating smaller, more frequent meals might also help.

  2. Lifestyle Changes: Try to eat slowly and avoid lying down immediately after meals. Elevating the head of your bed can help reduce nighttime symptoms if GERD is a concern.

  3. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and identify any patterns or triggers. This information can be valuable for your healthcare provider.

  4. Over-the-Counter Remedies: Antacids or acid reducers might provide temporary relief for indigestion and heartburn. However, it's best to consult a healthcare provider before starting any new medication.

What you should look out for

Seek medical attention if you experience any of the following:

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

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a comprehensive evaluation and personalized treatment plan.

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1 mo ago


People Also Ask


What are the common symptoms of peptic ulcer disease?

Common symptoms of peptic ulcer disease include burning stomach pain, bloating, heartburn, nausea, and the pain often improves with eating but worsens when the stomach is empty.


How can chronic gastritis be managed or treated?

Chronic gastritis can be managed by avoiding irritants like alcohol and NSAIDs, eating smaller meals, reducing stress, and taking medications to reduce stomach acid. It's important to follow a healthcare provider's advice for treatment.


What are the signs of gallbladder issues that I should be aware of?

Signs of gallbladder issues include pain in the upper right abdomen, especially after eating fatty foods, nausea, vomiting, and sometimes jaundice. An ultrasound can help diagnose gallbladder problems.


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes to manage GERD include avoiding trigger foods, eating smaller meals, not lying down immediately after eating, elevating the head of the bed, and maintaining a healthy weight. Medications may also be prescribed to reduce acid production.


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