[70F] Experiencing severe upper abdominal pain and nausea

Patient Description

A 70-year-old female presents with severe pain in the upper stomach area, described as a constant ache located between the breastbone and upper stomach. The patient rates the pain as an 8 out of 10 on the pain scale and reports associated nausea. The pain has been present for approximately one hour, and the patient has vomited occasionally, starting around 5 minutes ago. The vomiting does not appear to be triggered by any specific foods. There is no reported fever, chills, chest pain, or tightness, and the pain does not radiate to other areas. The patient's last bowel movement was described as solid brown, and there is no mention of blood in the vomit or black, tarry stools. No other symptoms have been reported.

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Arora's Assessment

What might be happening

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

  • Gastroenteritis: This is an inflammation of the stomach and intestines usually caused by a viral or bacterial infection. It can cause nausea, vomiting, and abdominal pain.

    • Treatment usually involves rest, hydration, and over-the-counter medication to manage symptoms.
  • Gastritis: This is an inflammation of the stomach lining, which can cause upper abdominal pain, nausea, and vomiting. It can be caused by various factors, including long-term use of certain pain relievers, infection with the bacterium H. pylori, or excessive alcohol use.

    • Treatment usually involves medications to decrease stomach acid and possibly antibiotics if H. pylori is present.
  • Peptic Ulcer: This is a sore that develops on the lining of the stomach, upper small intestine or esophagus. The most common symptom is stomach pain, but it can also cause nausea and vomiting.

    • Treatment usually involves medications to decrease stomach acid and possibly antibiotics if H. pylori is present.
  • Gallstones: These are hard deposits in the gallbladder that can cause sudden pain in the upper right abdomen or the center of the abdomen, just below the breastbone. The pain may go away and come back, or it may be constant and sharp.

    • Treatment may involve medication to dissolve the stones or surgery to remove the gallbladder.
  • Pancreatitis: This is inflammation of the pancreas, which can cause upper abdominal pain that may radiate to your back. It can also cause nausea and vomiting.

    • Treatment usually involves hospitalization for intravenous (IV) fluids, medications to control pain, and possibly procedures to treat gallstones if they're causing pancreatitis.

What you can do

Given the severity of your symptoms, you should seek immediate medical attention. It's important to get a proper diagnosis and treatment. In the meantime, try to stay hydrated and avoid eating or drinking anything that seems to worsen your symptoms.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Blood in your vomit or stool
  • High fever (temperature over 100.4°F)
  • Rapid heartbeat
  • Difficulty breathing
  • Unexplained weight loss

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

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People Also Ask


What are the common causes of upper abdominal pain and nausea in older adults?

Common causes of upper abdominal pain and nausea in older adults include gastroenteritis, gastritis, peptic ulcers, gallstones, and pancreatitis. Each condition has specific characteristics, but they often share symptoms like pain and nausea.


How can I differentiate between gastritis and a peptic ulcer based on symptoms?

Gastritis and peptic ulcers both cause upper abdominal pain and nausea, but peptic ulcers often cause more severe pain and may be associated with bleeding, leading to black, tarry stools or vomiting blood. A healthcare provider can perform tests to differentiate between the two.


What are the potential complications of untreated gallstones?

Untreated gallstones can lead to complications such as inflammation of the gallbladder (cholecystitis), blockage of the bile ducts, pancreatitis, and increased risk of gallbladder cancer. These conditions can cause severe pain and require medical intervention.


When should I seek immediate medical attention for abdominal pain and vomiting?

Immediate medical attention should be sought if you experience severe abdominal pain, blood in vomit or stool, high fever, rapid heartbeat, difficulty breathing, or unexplained weight loss. These symptoms could indicate a serious condition requiring urgent care.


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