[41F] With chronic abdominal pain and associated symptoms

Patient Description

A 41-year-old female has been experiencing dull and burning abdominal pain located under the ribs and above the belly button for the past two months. The pain is rated 8 out of 10 in intensity and worsens after eating, though it can also occur on an empty stomach. The patient reports associated symptoms of tiredness, lightheadedness (rated 5-6 out of 10), and mouth ulcers that have since resolved. The lightheadedness is exacerbated by standing up. She has also experienced a decrease in appetite, feeling full faster, and some weight loss. The patient has not experienced nausea, vomiting, black or tarry stools, or chills. She sometimes has difficulty swallowing or pain when swallowing. Her medical history includes migraines and slight anemia, diagnosed over 10 years ago. She is currently taking Omeprazole 20 mg once a day and uses Mylanta and Tums daily. She reports being super sensitive to most medications, experiencing visual and dizzy symptoms as adverse reactions. Blood tests were clear, and a CT scan showed nothing outside of the stomach.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Gastritis or Peptic Ulcer Disease: The dull, burning pain you describe, especially after eating, could be due to inflammation of the stomach lining (gastritis) or a peptic ulcer. These conditions can also cause a feeling of fullness, weight loss, and sometimes difficulty swallowing.

    • Treatment: Typically involves medications to reduce stomach acid, such as proton pump inhibitors (like Omeprazole) or H2 blockers. Lifestyle changes, such as avoiding spicy and oily foods, can also help.
  • Gastroesophageal Reflux Disease (GERD): This condition can cause burning pain in the upper abdomen and chest, especially after eating. It can also lead to difficulty swallowing and a feeling of fullness.

    • Treatment: Includes medications to reduce stomach acid, dietary changes, and sometimes lifestyle modifications like elevating the head of the bed.
  • Functional Dyspepsia: This is a chronic disorder of sensation and movement in the upper digestive tract. Symptoms include pain or discomfort in the upper abdomen, feeling full quickly, and bloating.

    • Treatment: May involve medications to manage symptoms, dietary changes, and stress management techniques.
  • Anemia: Your history of slight anemia could be contributing to your fatigue and lightheadedness. Anemia can also cause symptoms like dizziness, especially when standing up.

    • Treatment: Depends on the cause of the anemia but may include dietary changes, iron supplements, or other medications.

What you can do

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

  1. Dietary Changes: Avoid spicy, oily, and heavy meals. Eat smaller, more frequent meals to help manage your symptoms.
  2. Medications: Continue taking Omeprazole as prescribed. You can also use Mylanta and Tums for additional relief, but be cautious of overuse.
  3. Hydration: Ensure you stay well-hydrated, especially if you're eating less.
  4. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share this information with your healthcare provider. This can help in identifying patterns and triggers.
  5. Lifestyle Modifications: Elevate the head of your bed if you experience symptoms at night. Avoid lying down immediately after eating.

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 black, tarry stools
  • Persistent vomiting or inability to keep food down
  • Unexplained weight loss
  • Difficulty swallowing that worsens
  • Severe dizziness or fainting

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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4 mo ago


People Also Ask


What are the common causes of abdominal pain that worsens after eating?

Common causes of abdominal pain that worsens after eating include gastritis, peptic ulcer disease, and gastroesophageal reflux disease (GERD). These conditions can cause inflammation or irritation in the stomach lining or esophagus, leading to pain after meals.


How can gastritis or peptic ulcer disease be managed at home?

Gastritis or peptic ulcer disease can be managed at home by taking medications to reduce stomach acid, such as proton pump inhibitors or H2 blockers. Additionally, avoiding spicy, oily, and heavy meals, eating smaller, more frequent meals, and staying hydrated can help manage symptoms.


What lifestyle changes can help alleviate symptoms of GERD?

Lifestyle changes that can help alleviate symptoms of GERD include elevating the head of the bed, avoiding lying down immediately after eating, eating smaller meals, avoiding trigger foods like spicy or fatty foods, and maintaining a healthy weight.


Why might someone with a history of anemia experience lightheadedness?

Someone with a history of anemia might experience lightheadedness because anemia can lead to reduced oxygen delivery to the body's tissues, including the brain. This can cause symptoms like dizziness, especially when standing up quickly.

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