[47F] Experiencing upper stomach bloating, abdominal discomfort, and mid back pain

Patient Description

A 47-year-old female presents with a 6-week history of upper stomach bloating, dull upper left abdominal discomfort, and mid back pain. The abdominal discomfort is rated 2/10 in severity, increases throughout the day, and is exacerbated by bending over, but is relieved by lying down. The pain radiates towards the belly button and sides. Mid back pain, rated 5/10 in severity, has been present for 2 weeks and may be associated with a fall in December. The patient has a medical history of acid reflux disease, perimenopause, and premature ventricular contractions (PVC's), diagnosed 7 years ago. She is currently taking Atenolol and uses Ibuprofen for back pain. She also takes Tylenol as needed and Omeprazole for acid reflux. The patient has a Sulfa drug allergy. There are no changes in appetite or weight, and no fever, chills, nausea, vomiting, or changes in urine have been reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, possible conditions include:

  • Gastritis or Peptic Ulcer Disease: These conditions involve inflammation or damage to the lining of the stomach or duodenum (the first part of the small intestine). They can cause upper abdominal pain, bloating, and back pain.

    • Treatment typically involves medications to reduce stomach acid and possibly antibiotics if a bacteria called Helicobacter pylori is involved.
  • Gallstones: These are hard deposits in the gallbladder that can cause pain in the upper abdomen and back. The pain is often worse after eating, especially with fatty foods.

    • Treatment may involve dietary changes, medications to dissolve the gallstones, or surgery to remove the gallbladder.
  • Pancreatitis: This is inflammation of the pancreas, which can cause upper abdominal pain that radiates to the back. The pain is often worse after eating.

    • Treatment typically involves fasting to rest the pancreas, pain medications, and intravenous fluids. In severe cases, hospitalization may be required.
  • Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. Pain can be in the back or side below the ribs, and can radiate to the lower abdomen and groin.

    • Treatment can range from pain management and drinking lots of water to pass the stone, to medical procedures to remove or break up larger stones.

Please note that these are just possibilities and not a definitive diagnosis. You should consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Over-the-counter antacids may help with temporary relief of some of your symptoms. However, these should not be used long-term without consulting a healthcare provider.
  2. Avoid foods that aggravate your symptoms. These can include spicy foods, alcohol, and caffeine.
  3. Try to eat smaller, more frequent meals instead of three large meals a day.
  4. Stay hydrated, especially if your symptoms include vomiting or diarrhea.
  5. Rest and avoid heavy physical activity, which can exacerbate abdominal and back pain.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe pain that lasts more than a few hours
  • Bloody or black, tarry stools
  • High fever (over 101°F)
  • Uncontrolled vomiting
  • Symptoms of shock, such as cold, clammy skin, rapid heartbeat, or shallow breathing

Remember, this advice is intended to be general in nature, and specific causes may need different management. Always consult with a healthcare provider for appropriate treatment.

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10 mo ago

People Also Ask


What are the common symptoms of gastritis or peptic ulcer disease?

Common symptoms of gastritis or peptic ulcer disease include upper abdominal pain, bloating, nausea, and sometimes back pain. These conditions are often treated with medications to reduce stomach acid and, if necessary, antibiotics to treat Helicobacter pylori infection.


How can gallstones affect my digestive system and what are the treatment options?

Gallstones can cause pain in the upper abdomen and back, especially after eating fatty foods. Treatment options include dietary changes, medications to dissolve the stones, or surgery to remove the gallbladder if necessary.


What are the signs of pancreatitis and how is it treated?

Signs of pancreatitis include severe upper abdominal pain that radiates to the back, nausea, and vomiting. Treatment typically involves fasting to rest the pancreas, pain management, and intravenous fluids. Severe cases may require hospitalization.


What should I do if I suspect I have kidney stones?

If you suspect you have kidney stones, it's important to stay hydrated and manage pain with over-the-counter medications. If the pain is severe or persistent, or if you experience symptoms like blood in the urine or fever, seek medical attention. Treatment may involve medical procedures to remove or break up larger stones.


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