[36M] Experiencing intermittent upper and lower abdominal pain

Patient Description

A 36-year-old male has been experiencing intermittent dull and sometimes sharp pain across the upper and lower abdomen for three months. The pain is rated as a 3 out of 10 in severity and is alleviated by movement. The patient has a history of acid reflux disease and is taking Pepcid 40 mg once daily. Bowel movements are regular with firm stool and no blood. There are no additional gastrointestinal symptoms such as nausea, vomiting, or changes in appetite, and no recent changes in bowel habits or unintentional weight loss. The patient has no known drug allergies and does not take any over-the-counter medications, vitamins, or supplements. There is no family history of gastrointestinal diseases, and the patient has no allergies to medications but is allergic to cats.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possible explanations for your symptoms:

  • Gastroesophageal Reflux Disease (GERD): This is a chronic condition where 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 discomfort or pain in your upper abdomen. You mentioned that you have been diagnosed with acid reflux disease, which is a form of GERD.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In some cases, prescription medications or even surgery may be needed.
  • Gastritis: This is an inflammation of the stomach lining. The inflammation can be caused by excessive alcohol use, chronic vomiting, stress, or the use of certain medications. However, it can also occur in people with chronic conditions such as GERD.

    • Treatment usually involves taking antacids and other drugs to reduce stomach acid, which helps relieve gastritis symptoms.
  • Peptic Ulcer Disease (PUD): These are sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is abdominal pain.

    • Treatment usually involves medications to decrease the amount of acid in your stomach, which helps relieve pain and promote healing.
  • Gallstones: These are hardened deposits in the gallbladder that can cause abdominal pain. The pain is often severe and located in the upper right part of your abdomen.

    • Treatment may not be necessary unless the gallstones cause symptoms. In cases where symptoms occur, surgery may be needed.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause abdominal pain, bloating, gas, and changes in bowel habits.

    • Treatment of IBS is usually focused on relieving symptoms. A variety of treatments can help, including dietary adjustments, medication, and stress management.

Please note that these are potential explanations for your symptoms, but they are not definitive diagnoses. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Here are some suggestions that might help you manage your symptoms:

  1. Monitor your diet: Certain foods and drinks can trigger heartburn and abdominal pain. These include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine. Try to identify and avoid your trigger foods.

  2. Maintain a healthy weight: Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus.

  3. Don't lie down after a meal: Wait at least three hours after eating before lying down or going to bed.

  4. Elevate the head of your bed: If you regularly experience heartburn while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches.

  5. Don't smoke: Smoking decreases the lower esophageal sphincter's ability to function properly.

What you should look out for

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

  • Severe, persistent abdominal pain
  • Bloody or black stools
  • Bloody or black vomit
  • Unexplained weight loss
  • Difficulty swallowing

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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9 mo ago


People Also Ask


What are the common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include heartburn, regurgitation of food or sour liquid, difficulty swallowing, and chest pain, especially when lying down at night.


How can gastritis be managed or treated?

Gastritis can be managed by avoiding irritants such as alcohol and NSAIDs, taking antacids or medications to reduce stomach acid, and following a diet that avoids spicy and acidic foods.


What are the signs that might indicate peptic ulcer disease?

Signs of peptic ulcer disease include burning stomach pain, bloating, heartburn, nausea, and in severe cases, vomiting blood or having black, tarry stools.


What lifestyle changes can help alleviate symptoms of acid reflux?

Lifestyle changes that can help alleviate symptoms of acid reflux include avoiding trigger foods, eating smaller meals, not lying down immediately after eating, maintaining a healthy weight, and elevating the head of the bed.


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