[44F] Experiencing severe upper abdominal pain with burning sensation and diarrhea

Patient Description

A 44-year-old female has been experiencing severe upper abdominal pain for several months. The pain is described as severe and similar to heartburn, accompanied by a burning sensation. It persists throughout the day and is not relieved by eating or drinking. The patient also reports diarrhea and occasional nausea, but no vomiting. There is no blood in the stool or black, tarry stools, and no difficulty swallowing. The patient takes Lexapro 40 mg and Omeprazole once daily. There is no regular use of NSAIDs or aspirin, no alcohol consumption, and no recent travel. The patient has a history of occasional anxiety since age 14. No known allergies to medications other than Benadryl.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, 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 symptoms like heartburn, upper abdominal pain, and nausea. Omeprazole is a common treatment for GERD, as it reduces stomach acid production.

  • Peptic Ulcer Disease: This involves open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom is a burning stomach pain. While Omeprazole can help, further evaluation by a healthcare provider is necessary to confirm this diagnosis.

  • Functional Dyspepsia: This is a term used to describe recurring signs and symptoms of indigestion that have no obvious cause. It can cause discomfort or pain in the upper abdomen, bloating, and nausea.

  • Gallbladder Issues: Conditions like gallstones or cholecystitis can cause severe abdominal pain, often after eating. However, these conditions typically cause pain in the right upper abdomen and may be accompanied by other symptoms like jaundice.

What you can do

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

  1. Dietary Adjustments: Try to identify and avoid foods that trigger your symptoms. Common triggers include spicy foods, fatty foods, chocolate, caffeine, and alcohol.

  2. Eating Habits: Eat smaller, more frequent meals rather than large meals. Avoid lying down immediately after eating and try to eat at least 2-3 hours before bedtime.

  3. Elevate Your Head: When sleeping, elevate the head of your bed by about 6 to 8 inches to prevent acid from flowing back into the esophagus.

  4. Track Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and gain insights. This information can be valuable for your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or persistent abdominal pain that doesn't improve with over-the-counter medications
  • Unexplained weight loss
  • Blood in your stool or black, tarry stools
  • Difficulty swallowing or persistent nausea and vomiting

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a thorough evaluation and appropriate treatment.

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1 mo ago

People Also Ask

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

Common symptoms of GERD include heartburn, upper abdominal pain, a burning sensation in the chest, regurgitation of food or sour liquid, and difficulty swallowing. It can also cause nausea and a persistent cough.

How can peptic ulcers be diagnosed and treated?

Peptic ulcers can be diagnosed through tests such as endoscopy, barium swallow X-rays, and tests for H. pylori infection. Treatment typically involves medications to reduce stomach acid, antibiotics if H. pylori is present, and lifestyle changes to avoid ulcer triggers.

What lifestyle changes can help manage symptoms of functional dyspepsia?

Lifestyle changes for managing functional dyspepsia include eating smaller, more frequent meals, avoiding trigger foods (such as spicy or fatty foods), reducing stress, and not lying down immediately after eating. Keeping a food diary can help identify specific triggers.

What are the signs that indicate a gallbladder issue?

Signs of a gallbladder issue include severe pain in the right upper abdomen, especially after eating fatty foods, nausea, vomiting, fever, and jaundice (yellowing of the skin and eyes). If these symptoms occur, it's important to seek medical attention.

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