Mystery of Upper Abdominal Pain: A Personal Journey
At 29 years old, I’m a white male standing at 6 feet 1 inch and weighing 220 pounds, with most of my weight concentrated around my stomach. For the past two and a half years, I've been battling recurring discomfort in my upper middle abdomen. Initially, my doctors suspected I might have a peptic ulcer and prescribed a combination of 40mg omeprazole along with 40mg famotidine. After a period of relief, my symptoms returned. It wasn't until about 21 months ago that I underwent an endoscopy, which yielded inconclusive results, revealing some scarring and grainy material—likely remnants of the antacids I'd been consuming. Later, I discovered that the omeprazole was causing erectile dysfunction, prompting me to stop its use. Remarkably, I experienced a significant reduction in symptoms over the next year. During this time, I also found out that famotidine was negatively affecting my mood; thus, my physician advised me to stop taking it as long as my antacids remained effective. While I had occasional bouts of pain, using a mix of Mylanta, Pepto-Bismol, Gaviscon, and Gas-X typically alleviated the discomfort. I’ve long suspected I could be suffering from IBS or IBD, especially considering I have lactose intolerance, which contributes to my digestive issues. Fast forward to two months ago—my symptoms resurfaced, but this time the intensity and frequency of the pain escalated. After relocating, I consulted a new gastroenterologist who recommended that I undergo both a colonoscopy and an endoscopy. Due to financial constraints, I opted only for the colonoscopy last Wednesday. He also suggested I try taking famotidine again, while using Tylenol for pain management. I've since switched back to chewable Pepcid as I'm not adept at swallowing pills. Preliminary findings from the colonoscopy indicated my large intestine appeared healthy and normal. I'm currently awaiting biopsy results. Just two days ago, around 7 PM, I began experiencing a flare-up, earlier than usual as these episodes typically start after I lie down at night. After taking Pepcid, I showered, utilizing hot water on my upper abdomen and back, noticing significant bloating during this time. While normally my pain resolves within an hour, this time it didn’t. I took 1000mg of acetaminophen, but 45 minutes later, I felt no relief. I then attempted Pepto-Bismol again, but the pain continued to worsen. After several hours and numerous showers to soothe the discomfort, I took Mylanta, but again, there was no change. I followed with another 500mg dose of Tylenol two hours after my first dose—about eight hours since the onset of my symptoms. By 7 AM the next day, after enduring severe pain that felt as if I was being stabbed with hot metal, I decided it was necessary to visit the emergency room. I managed to drive myself, but by the time I reached the reception, my pain had escalated to a 10/10. At the ER, they administered morphine and Zofran, conducted metabolic tests along with a Lipase test, and performed a CT scan. Unfortunately, the morphine didn't alleviate my pain. The results showed no perforations, blockages, or bleeding—no apparent reason for my suffering. The doctor suggested I follow up with my GI and prescribed dicyclomine and ondansetron. After another dose of morphine and still feeling substantial discomfort, I was discharged. Luckily, the pain began to subside about an hour and a half later, and I finally succumbed to sleep from sheer exhaustion after the night’s ordeal. As I write now, my pain level is at about 3.5/10, following a light meal of chicken, rice, and a turkey sandwich throughout the day. I’m open to sharing my endoscopy and colonoscopy results and plan to arrange another endoscopy soon with my GI. Any advice would be immensely appreciated; I’m quite worried as that experience was one of the most painful I've ever endured, and medical professionals remain puzzled about the underlying cause. Thank you for your support.
Answers (1)
8/18/2025, 6:21:16 AM
OpenHealth AI
I'm truly sorry to hear about the intense pain and challenges you've been experiencing. It’s completely understandable to feel worried given the nature of your symptoms and the difficulty in identifying their cause. Let’s break this down and focus on some actionable steps going forward.
Main Points:
- Your recurring upper abdominal pain could relate to a number of factors including gastrointestinal conditions (like IBS or IBD), dietary issues, or medication side effects.
- Close follow-up with your gastroenterologist and ongoing management of your symptoms is crucial for finding a lasting solution.
Explanation:
Your history with medications like omeprazole and famotidine, as well as your symptoms of discomfort that are exacerbated by certain foods and activities, suggest that there could be multiple interacting issues at play. The inconclusive findings from previous tests can be frustrating, but they keep the door open for exploring other potential causes.
It's important to note that conditions such as Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD) can present similarly to what you're describing, especially in the presence of lactose intolerance. Additionally, your recent severe episode underlines the need for careful management and prompt reactions to significant flare-ups.
Next Steps:
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Keep a Symptom Diary: Begin documenting your symptoms, food intake, medication usage, and any triggers. This will provide valuable insights that can help your healthcare provider better understand your condition.
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Dietary Adjustments: Since you have lactose intolerance, consider keeping a food diary to identify if other food items may also be contributing to your symptoms. You might benefit from a low-FODMAP diet, which many find effective for IBS.
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Medication Management: While waiting for your biopsy results, closely monitor how dicyclomine affects your symptoms. If you notice any side effects or inadequate relief, discuss it with your doctor. It's also crucial to communicate any concerns about mood changes or discomfort with your gastroenterologist.
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Follow-Up Appointments: Keep your appointment with your gastroenterologist and discuss your recent severe episode. Ensure they are aware of your symptoms and your pain management experience in the ER. This will guide any additional testing or medication adjustments.
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Pain Management Techniques: Consider incorporating stress management techniques such as mindfulness or relaxation exercises, which can sometimes help manage gastrointestinal discomfort.
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Emergency Plan: Given the severity of your last episode, consider discussing a plan with your doctor on when to seek emergency care. This will help alleviate some anxiety during future flare-ups.
Stay hopeful and remember that proactive communication with your healthcare providers will be key to finding the right management strategy. If you need further support or clarification as you continue this journey, feel free to reach out.
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