[33F] With chronic upper stomach pain and heartburn

Patient Description

A 33-year-old female has been experiencing cramping and aching pain at the top of her stomach for about six months, with a severity of 4 out of 10. The discomfort is present most of the day and worsens after eating. She also reports nausea and severe heartburn, sometimes reaching a 10 out of 10. Certain foods can trigger the heartburn, but it can occur regardless of diet. There is a significant loss of appetite and excessive bloating. Occasionally, she has difficulty swallowing and very rarely experiences regurgitation. There is no blood in the stool or vomit. She consumes alcohol 3 to 4 times a week and uses tobacco daily. She has a history of eating disorders and was treated for leukemia as a child. Currently, she is taking Famotidine twice a day and an over-the-counter water pill with potassium.

Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

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, leading to heartburn and nausea. Your symptoms of heartburn, especially after eating, align with GERD.
- Treatment: Lifestyle changes, such as avoiding trigger foods, eating smaller meals, and not lying down after eating, can help. Medications like Famotidine, which you're already taking, can reduce stomach acid.
Peptic Ulcer: These are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom is stomach pain.
- Treatment: Treatment often involves medications to reduce stomach acid and protect the lining of your stomach.
Functional Dyspepsia: This is a term for recurring signs and symptoms of indigestion that have no obvious cause. It can cause bloating, nausea, and stomach pain.
- Treatment: Dietary changes, stress management, and medications can help manage symptoms.

Your history of eating disorders and tobacco use may also contribute to these symptoms. It's important to address these factors with a healthcare provider.

What you can do

Lifestyle Changes:
- Avoid foods and drinks that trigger your symptoms, such as spicy foods, alcohol, and caffeine.
- Eat smaller, more frequent meals.
- Avoid lying down immediately after eating.
Quit Smoking and Limit Alcohol: Both can exacerbate stomach issues and heartburn.
Track Symptoms: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.
Stay Hydrated: Drink plenty of water, but avoid drinking large amounts with meals.