[54F] Experiencing abdominal pain and fullness

Patient Description

A 54-year-old female presents with ongoing abdominal pain and a sensation of fullness despite not eating, occurring on and off for several months. The pain is rated 6-7 out of 10 in severity, located near the sternum on both sides, and radiates slightly towards the belly button. Accompanying symptoms include heartburn, acid reflux, and a recent loss of appetite. Bowel movements are described as brown with small round pieces, with no noted changes in frequency or presence of blood. The patient has a history of asthma since 18 months of age and is currently taking Singulair (montelukast) and metoprolol (50mg once daily). She reports allergies to Percocet and Cipro but no family history of gastrointestinal diseases. The patient does not consume alcohol.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possible conditions:

  • Gastritis: This is an inflammation of the stomach lining. It can cause upper abdominal pain, feeling of fullness, nausea, and loss of appetite. Gastritis can be caused by various factors including long-term use of certain medications, excessive alcohol consumption, stress, or an autoimmune reaction.

    • Treatment typically involves medications to decrease stomach acid, which allows the stomach lining to heal.

  • 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 acid reflux can irritate the lining of your esophagus, causing heartburn, chest pain, and other symptoms.

    • Treatment usually involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.

  • Gallstones: These are hardened deposits in the gallbladder that can cause pain in the upper right abdomen. However, gallstones often cause sharp, cramping pain, and you didn't mention this type of pain.

    • Treatment may not be necessary if the gallstones aren't causing symptoms. For symptomatic gallstones, surgery to remove the gallbladder is the most common treatment.

  • Peptic Ulcer: This is a sore on the lining of your stomach, upper small intestine or esophagus. A peptic ulcer can cause a dull or burning pain in your stomach between meals or at night. The pain can last a few minutes or a few hours.

    • Treatment typically involves medications to decrease stomach acid, which allows the ulcer to heal.

Please note that these are possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Here are some general suggestions you can consider:

  1. Dietary changes: Avoid foods that aggravate your symptoms. These can include spicy foods, caffeine, and alcohol. Try to eat smaller, more frequent meals instead of three large meals a day.

  2. Over-the-counter medications: Antacids can neutralize stomach acid and provide temporary relief. Other over-the-counter medications, such as H-2-receptor blockers or proton pump inhibitors, can reduce stomach acid production and may help heal your stomach lining.

  3. Stress management: Stress can exacerbate many digestive issues. Techniques such as relaxation exercises, meditation, or yoga may help manage stress levels.

  4. Regular exercise: Regular physical activity can help manage many health problems, including digestive conditions.

Remember, these are general suggestions and may not be suitable for everyone. Always consult with a healthcare provider before starting any new treatment or making significant lifestyle changes.

What you should look out for

Seek immediate medical attention if you:

  • Vomit blood or have blood in your stool (which can appear as black, tarry stools)
  • Have severe or persistent abdominal pain
  • Have unexplained weight loss
  • Have difficulty swallowing

These could be signs of a more serious condition that needs immediate treatment.

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9 mo ago

People Also Ask

What are the common causes of gastritis and how is it treated?

Gastritis is commonly caused by factors such as long-term use of NSAIDs, excessive alcohol consumption, stress, or an infection with Helicobacter pylori. Treatment typically involves medications to reduce stomach acid, allowing the stomach lining to heal, and avoiding irritants like spicy foods and alcohol.

How can lifestyle changes help manage GERD symptoms?

Lifestyle changes for managing GERD include eating smaller meals, avoiding foods and drinks that trigger reflux (such as fatty foods, coffee, and alcohol), not lying down immediately after eating, losing weight if overweight, and elevating the head of the bed. These changes can help reduce the frequency and severity of acid reflux symptoms.

What are the symptoms of peptic ulcers and how are they treated?

Peptic ulcers are characterized by a dull or burning pain in the stomach, often occurring between meals or at night. Other symptoms may include bloating, heartburn, and nausea. Treatment usually involves medications to reduce stomach acid, such as proton pump inhibitors or H-2-receptor blockers, and antibiotics if an H. pylori infection is present.

When should someone with abdominal pain seek immediate medical attention?

Immediate medical attention should be sought if there is vomiting of blood, blood in the stool (which may appear black and tarry), severe or persistent abdominal pain, unexplained weight loss, or difficulty swallowing, as these could indicate a more serious condition.

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