[59F] Experiencing acute stomach pain and bloating

Patient Description

A 59-year-old female presents with a one-day history of sharp cramps located centrally under the breast, described as a 7 out of 10 on the pain scale. The pain is not localized to any side and has been gradually worsening. Accompanying symptoms include bloating, weakness that is severe enough to impact daily activities, and a loss of appetite. The patient has taken Pepto Bismol with no reported relief. The last bowel movement was described as loose and occurred the previous morning. There is no fever or chills, and no recent injuries that could explain the symptoms. The patient has a medical history of pre-diabetes and neuropathy, both diagnosed 10 years ago. There are no known drug allergies. The patient's current symptoms, particularly the acute stomach pain and bloating, warrant further medical evaluation to rule out conditions such as gastrointestinal disorders or complications related to pre-existing conditions.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Gastritis: Inflammation of the stomach lining can cause upper abdominal pain, bloating, and loss of appetite. This condition can be caused by various factors, including long-term use of certain pain relievers, bacterial infection, and excessive alcohol consumption.

    • Treatment typically involves medications to decrease stomach acid, which allows your stomach lining to heal. In some cases, antibiotics may be needed to clear a bacterial infection.
  • Peptic Ulcer: These are sores that develop on the lining of your stomach, upper small intestine or esophagus. The most common symptom of a peptic ulcer is burning abdominal pain that extends from the navel to the chest.

    • Treatment usually involves medications to reduce stomach acid and promote healing. If a bacterial infection is present, antibiotics may be needed.
  • Gallstones: These are hardened deposits in the gallbladder that can cause sharp, cramping pain in the upper right or center abdomen.

    • Treatment can range from watchful waiting in asymptomatic cases to surgery in symptomatic cases.
  • Pancreatitis: Inflammation of the pancreas can cause upper abdominal pain. Other symptoms can include nausea, vomiting, fever, and increased heart rate.

    • Treatment usually involves hospitalization for pain management, fluid replacement, and sometimes surgery.

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

What you can do

  1. Over-the-counter antacids may provide temporary relief from your stomach pain. However, they should not be used for more than two weeks without consulting a healthcare professional.
  2. Avoid foods and drinks that can irritate your stomach, such as spicy foods, alcohol, and caffeinated beverages.
  3. Try to eat smaller, more frequent meals instead of three large meals a day.
  4. If you smoke, consider quitting. Smoking can increase stomach acid and delay stomach healing.
  5. Try to manage stress. Stress can increase stomach acid and make your symptoms worse.

What you should look out for

Seek immediate medical attention if you:

  • Vomit blood or have blood in your stool (a sign of gastrointestinal bleeding)
  • Have severe abdominal pain
  • Have trouble swallowing
  • Experience unexplained weight loss
  • Have persistent vomiting or nausea
  • Your symptoms persist or worsen despite treatment

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

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11 mo ago

People Also Ask


What are the common causes of sharp abdominal pain under the breast?

Common causes of sharp abdominal pain under the breast include gastritis, peptic ulcers, gallstones, and pancreatitis. These conditions can cause pain due to inflammation, infection, or blockages in the digestive system.


How can pre-diabetes and neuropathy affect gastrointestinal symptoms?

Pre-diabetes and neuropathy can affect gastrointestinal symptoms by altering nerve function in the digestive tract, potentially leading to issues like gastroparesis, which can cause bloating, pain, and changes in bowel habits.


What are the typical treatments for gastritis and peptic ulcers?

Typical treatments for gastritis and peptic ulcers involve medications to reduce stomach acid, such as proton pump inhibitors or H2 blockers, and antibiotics if a bacterial infection like H. pylori is present. Lifestyle changes, such as dietary modifications and stress management, are also recommended.


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, severe abdominal pain, trouble swallowing, unexplained weight loss, or persistent vomiting or nausea, as these could indicate serious complications.


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