Persistent Abdominal Discomfort Worsened by Sitting, Eased by Lying Down
**Age/Gender:** 26 Male **Weight:** 60 kg (reduced from 81 kg since December 2023) **Location:** France Since September 2024, I have been consulting with a gastroenterologist who, unfortunately, has been unable to determine the cause of my symptoms. For the past seven years, I have dealt with persistent issues including foul-smelling, sulfur-like flatulence, ongoing fatigue, and seborrheic dermatitis. In February 2022, while being treated with azithromycin for a severe throat infection, I developed shingles alongside patellar tendinitis. Although I don't believe these are related to my current issues, I mention them for context. In December 2023, I experienced severe epigastric pain, located 2 to 3 cm above my belly button, triggered by a substantial meal. This incident also resulted in a rigid abdomen, vomiting, and a bout of diarrhea lasting 4 to 5 days. Following that event, even small meals or fasting upon waking brings on excruciating, bloated pain that lingers for 30 to 60 minutes. Sitting exacerbates the discomfort, but lying flat or on my left side provides relief. This sensation is often accompanied by pronounced gurgling sounds from the area around my navel. Strikingly, I continue to experience pain even when I do not consume anything (I've tried this on several occasions), requiring me to rest to alleviate it. The pain subsides only when I hear noises from my stomach, which gurgle intermittently for 2 to 3 minutes—typically a series of 3 seconds of sound followed by a pause of 10 to 15 seconds before repeating. Multiple investigations, including CT scans with contrast, abdominal ultrasounds, gastroscopies, tests on the abdominal wall, comprehensive blood work (including calprotectin), and stool analyses, have all returned normal results. An entero-MRI indicated only mild, non-inflammatory thickening of a small segment of the terminal ileum (5 cm), with no stenosis identified. I have attempted various treatments, including proton pump inhibitors (August-September 2024), a stringent low-FODMAP diet (August-October 2024), and a low dose of amitriptyline initiated in April 2025, yet none have provided any relief. What insights might you have regarding my situation? I am struggling immensely, as I need to lie down every couple of hours to manage this troubling condition.
Answers (1)
7/8/2025, 8:01:45 PM
OpenHealth AI
Main Points: Your ongoing abdominal discomfort is complex, but there are practical steps you can take to manage your symptoms and seek further clarity on your condition. While it's good that you've had extensive testing, focusing on potential dietary and lifestyle changes is crucial.
Explanation
It sounds like you’re experiencing quite uncomfortable symptoms that significantly affect your daily life. Your descriptions of pain that worsens with sitting and improves with lying down, as well as the foul-smelling gas and your medical history, point towards a potential functional gastrointestinal disorder or possibly issues related to food sensitivities. Since your imaging and blood tests have returned normal, it may be a matter of how your digestive system handles certain foods or the stress and functioning of your gastrointestinal system.
Next Steps
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Dietary Adjustments:
- Keep a Food Diary: Track what you eat along with any symptoms. Pay attention to specific foods that seem to trigger your discomfort. This may help identify patterns or specific sensitivities.
- Consider Food Intolerances: Since low-FODMAP diets haven't worked, you might explore other dietary considerations, like lactose or gluten intolerances, with a professional.
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Physical Positioning:
- Since lying down eases your symptoms, try adjusting your lifestyle to incorporate more rest in that position when discomfort arises. A reclining chair may help to bridge sitting and lying down.
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Hydration and Small Meals:
- Instead of large meals, try eating smaller, more frequent meals to see if this alleviates the pain. Chewing food thoroughly and eating slowly might also help digestion.
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Gentle Movement:
- Incorporate light, gentle exercises like walking. This can aid digestion and might help reduce discomfort, especially if you experience gurgling sounds.
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Review Medications:
- Since you’ve tried proton pump inhibitors and amitriptyline without relief, discuss with your gastroenterologist about reviewing and potentially adjusting these medications or considering alternative therapies.
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Mind-Body Techniques:
- Consider exploring stress management techniques such as mindfulness, yoga, or guided relaxation, which can sometimes help alleviate gastrointestinal symptoms due to stress or anxiety.
If these steps don’t bring relief, discussing further investigations or alternative gastrointestinal conditions with your gastroenterologist, such as functional dyspepsia or small intestinal dysbiosis, may be worth pursuing. It's vital to remain proactive and keep advocating for your health. Let me know if you need further assistance!
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