[57F] Experiencing severe upper stomach pain

Patient Description

A 57-year-old female presents with a one-week history of severe, burning, and stabbing pain in the upper stomach. The pain is constant and severe, rated 8 out of 10, with no relief upon eating. She reports an inability to eat and had an episode of diarrhea last night. The patient denies fever, chills, vomiting, blood in vomit, black or tarry stools, and jaundice. Her medical history is significant for diabetes, chronic obstructive pulmonary disease (COPD), emphysema, congestive heart failure, and atrial fibrillation, diagnosed 10 years ago. She is not currently on any medications and reports no known drug allergies.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Gastritis or Peptic Ulcer Disease: These conditions occur when the lining of your stomach becomes inflamed or an ulcer (a sore) forms on the lining of your stomach or upper part of your small intestine. The burning, stabbing pain you're experiencing could be due to this. Gastritis or peptic ulcers can be caused by long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), infection with the bacteria H. pylori, or other factors.

    • Treatment typically involves medications to decrease stomach acid, which can help speed healing of the stomach lining. If H. pylori is present, antibiotics can be used to eradicate the bacteria.
  • Gallstones: These are hardened deposits in the gallbladder that can cause sharp, stabbing pain in the upper middle part of your stomach. The pain can sometimes be severe and may be associated with nausea.

    • Treatment can range from watchful waiting in asymptomatic cases to surgical removal of the gallbladder in more severe cases.
  • Pancreatitis: This is inflammation of the pancreas, which can cause upper abdominal pain that may radiate to the back. It can be acute or chronic, and can be associated with nausea and vomiting.

    • Treatment often involves hospitalization for pain control and hydration, and may involve interventions to address the underlying cause.

Please note that these are possibilities based on the symptoms you've provided. It's important to seek medical attention for a formal diagnosis.

What you can do

Given the severity and duration of your symptoms, it's important to seek medical attention as soon as possible. Over-the-counter antacids may provide temporary relief, but they are not a long-term solution. Avoiding alcohol, caffeine, and spicy foods may also help reduce irritation to your stomach lining.

What you should look out for

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

  • Severe abdominal pain
  • Vomiting blood or having bloody or black tarry stools
  • Shortness of breath or chest pain
  • Sudden, severe headache or loss of consciousness

Remember, I'm an AI and this advice is based on the information you provided. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


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

Gastritis or peptic ulcer disease can be caused by long-term use of NSAIDs, infection with H. pylori bacteria, excessive alcohol consumption, stress, and certain foods. Smoking and other medical conditions can also contribute.


How are gallstones typically treated?

Gallstones are treated based on the severity of symptoms. Asymptomatic gallstones may not require treatment, while symptomatic cases might need surgical removal of the gallbladder. In some cases, medications to dissolve gallstones or procedures to break them up may be used.


What are the symptoms of pancreatitis?

Symptoms of pancreatitis include severe upper abdominal pain that may radiate to the back, nausea, vomiting, fever, and a rapid pulse. The pain often worsens after eating.


What lifestyle changes can help manage stomach pain related to gastritis?

To manage stomach pain related to gastritis, it is recommended to avoid alcohol, caffeine, and spicy foods. Eating smaller, more frequent meals, reducing stress, and avoiding NSAIDs can also help. Over-the-counter antacids may provide temporary relief, but it's important to consult a healthcare provider for a long-term management plan.


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