Unexplained Episodes of Abdominal Discomfort
Age: 28 Gender: Female Weight: 194 lbs Height: 5’7" Current Medications: Vitamin D, Fish Oil, B Complex Vitamins, Birth Control Pills, Vyvanse 30 mg Health Background: Asthma, Eczema, Gastroesophageal Reflux Disease (GERD) Since August 2025, I've experienced three occurrences of intense abdominal discomfort that necessitated visits to the emergency room for pain management. These episodes usually strike at night, escalating to unbearable levels within around 30 minutes. None of the sitting positions seem to provide relief, and gastrointestinal medications have proven largely ineffective. Only strong pain relievers seem to alleviate the suffering. After the peak of the pain subsides, my abdomen remains sensitive for more than three days. I can accurately identify the location of the discomfort, which appears to be between the midepigastric area and near the gallbladder. The pain is difficult to articulate, yet it presents as a severe burning and aching sensation. Interestingly, there does not seem to be any specific food intake related to these pain episodes. I underwent an H. Pylori breath test that returned negative results. Additionally, I had an esophagogastroduodenoscopy (EGD). Although the biopsies were also negative for H. Pylori, they did reveal residual liquid in my stomach and a small section of intestinal metaplasia. My complete blood count (CBC) and comprehensive metabolic panel (CMP) results were normal, except for elevated LDL levels, which I’m already aware of. My gastroenterologist has recommended a gastric emptying study (GES) to evaluate the functionality of my stomach. If results indicate no issues, we will then investigate the gallbladder. Are there alternative explanations for my symptoms? Should I be worried about autoimmune metaplastic atrophic gastritis (AMAG)? While I have been diagnosed with GERD, this pain feels distinctly different from the GERD-related discomfort. I am not entirely sure it is gastroparesis, even though I occasionally regurgitate if I eat too quickly; I do not experience nausea or malnutrition. I have researched extensively, and my symptoms align with biliary colic. However, I am anxious about the possibility of gallstones not appearing in the ultrasound. My gastroenterologist is not particularly concerned about the intestinal metaplasia, but being only 28 years old, I find this worrying. As a medical student, these painful episodes significantly hinder my studies and academic progress.
Answers (1)
2/7/2026, 2:00:57 AM
OpenHealth AI
Thank you for providing such detailed information about your symptoms and medical history. I can sense that you're experiencing significant discomfort and anxiety regarding your current health issues. Let's address your concerns while providing clear, structured guidance.
Main Points:
- Your episodes of abdominal discomfort could be related to various gastrointestinal issues, including potential gallbladder problems or gastroparesis.
- The presence of intestinal metaplasia is concerning, but it's essential to explore symptoms further before jumping to conclusions about conditions like autoimmune metaplastic atrophic gastritis.
- Your gastroenterologist's approach to conduct further testing is appropriate to identify the underlying cause.
Explanation:
The type of abdominal pain you're describing—intense, burning, and located in the midepigastric area—can indeed stem from various conditions. While your negative H. Pylori test and the results from the EGD are reassuring regarding peptic ulcers or infections, the residual liquid in your stomach and episodes of discomfort warrant further investigation. Intestinal metaplasia can sometimes indicate changes that the body is undergoing; this does not definitively mean disease, especially without other concerning symptoms appearing.
Your recent mention of difficulty with episodes of intense pain that don't correlate directly with food intake, combined with your history of GERD, might suggest a few possibilities:
- Gastroparesis: This condition, which involves delayed stomach emptying, can cause similar symptoms. Your upcoming gastric emptying study will be helpful in identifying this.
- Biliary colic or gallbladder issues: It's possible that issues related to your gallbladder aren't visible on an ultrasound initially, so further evaluation may be necessary.
- Nerve-related issues or referred pain: Sometimes, abdominal pain can arise from nerve conditions or other non-gastrointestinal issues.
Next Steps:
- Prepare for the Gastric Emptying Study (GES): Follow any pre-test instructions carefully. This study will help assess how well your stomach is processing food, which can clarify your symptoms.
- Monitor Symptoms: Keep a detailed diary of your episodes, including their timing, duration, associated activities, and any potential triggers, including stress or diet (even if not directly apparent).
- Discuss Intestinal Metaplasia Understanding: Engage with your gastroenterologist about the implications of the intestinal metaplasia findings. Express your concerns, especially considering your age.
- Lifestyle Adjustments: Consider smaller, more frequent meals that are easier to digest and take note of any specific foods that seem to trigger symptoms, even if they’re not immediately apparent.
- Consider Relaxation Techniques: Since stress can exacerbate gastrointestinal symptoms, implementing relaxation techniques such as breathing exercises, meditation, or gentle yoga might help manage discomfort and anxiety.
It's understandable to feel anxious about your health, especially as a medical student facing challenging symptoms. Make sure to maintain open communication with your gastroenterologist, as they are best positioned to guide you through these investigations and interpretations. Remember, you are not alone, and with further evaluations, you are taking the right steps toward understanding and managing your health concerns.
Related Questions
Concerns About Abdominal Distension
Hello, I'm a 25-year-old female, weighing approximately 51 kilograms and standing at 155 centimeters tall. I have established allergies to Prospan and certain vitamins, which I actively avoid in my diet. My daily caloric intake is around 2250 kcal, and I supplement my nutrition with B complex vitamins, omega-3 fatty acids, and vitamins C and D. I do not have any identified food allergies that I know of. I maintain a workout regimen that spans four days each week, followed by a day of rest. However, I’ve noticed a consistent issue where my lower abdomen noticeably swells after each meal. To me, it resembles the growth associated with early to mid-pregnancy, and it seems to occur only in that specific area. This situation is worrying me, and I would greatly appreciate any advice you might be able to provide. I am contemplating visiting a gastroenterologist soon, but I thought I’d ask for perspectives here as well, just in case. Thank you for any insights you can share. Best, 'Not Pregnant, Just Full' girl
Navigating MALS Challenges: Seeking Guidance
Hello everyone! I’m a 36-year-old female dealing with multiple health conditions, including EDS (Ehlers-Danlos Syndrome), MALS (Median Arcuate Ligament Syndrome), and ulcerative colitis, among several other unrelated issues. I wanted to share my experience with MALS, which has been confirmed for me. Back in May 2024, I underwent revision surgery. Unfortunately, the recovery did not go as hoped. Due to my EDS, the celiac artery lacks the ability to function independently, which my surgeon described as it being "too floppy." At that time, I accepted this outcome because the excruciating pain had subsided, and I was able to eat and gain weight again. However, now I find myself facing a resurgence of pain that is quite intense. A CT scan I had last week revealed severe stenosis in my celiac artery, coupled with a soft tissue prominence at the diaphragmatic crus and the beginning of the celiac axis. Currently, I’m taking Norco 10-325 three times a day and Lyrica 75 mg three times daily. While these medications provide some relief, the pain is overwhelming, and I can’t help but feel as if I’ve returned to my previous struggles from two years ago. Doctors are suggesting that the only option is to go in and "clean out the adhesions". I come to you all for your insights: Do you think pursuing a clean out procedure is advisable, or could it pose too much risk considering my EDS? I appreciate your thoughts and thanks for reading my story.
Sore Throat and Tonsil Discomfort for Three Weeks
For the past two weeks, I have been experiencing significant pain in my tonsils. After consulting with urgent care, I underwent tests for both strep throat and mononucleosis, but the results were negative. The doctor advised me to be patient as the discomfort was expected to subside on its own. Unfortunately, my condition worsened, prompting me to return to urgent care three days later. During this visit, I was prescribed dexamethasone, a type of steroid, along with a ten-day course of amoxicillin. Remarkably, my symptoms began to diminish within hours. However, just three days later, I am starting to feel the throat and tonsil pain return. I am still on the amoxicillin regimen. What could be causing this resurgence of pain, and what steps should I take next?
Concerns About Persistent Cough: Is It Cardiac Related?
Greetings everyone, I’m a 20-year-old male weighing 320 pounds, which qualifies as overweight. Having dealt with asthma for the majority of my life—although it’s generally mild—I typically rely on a nebulizer during occasions of typical chest colds. For some context, I came down with a cold around January 9th. Being on a college campus frequently means exposure to a variety of illnesses, and I suspect I contracted bronchitis, given the lasting cough and breathlessness I experienced for a couple of weeks afterward. However, I believed I had fully recuperated and moved on. Recently, since about Monday, I have noticed a return of my breathlessness along with a persistent cough and a sensation of fluid in my chest and throat. I find myself coughing as I attempt to clear my throat. This comes and goes, but it tends to intensify in the mornings right after I wake up and at night when I try to sleep. Additionally, I spend time with friends who smoke on occasion, and I initially thought that secondhand smoke might be a contributing factor. My concern has grown, and I’m unsure what to think. So, I’m reaching out for guidance: could this be residual effects from my cold in January, or should I be concerned that this might indicate a more serious issue related to my heart?
Hernia Diagnosis Without Follow-Up: A Conflicting Situation
A 22-year-old male recently visited the emergency room due to discomfort in his lower abdomen. Upon examination, the medical team was indecisive about whether he was experiencing an oblique muscle problem or a hernia. Surprisingly, they opted against performing a CT scan or ultrasound and did not schedule any follow-up appointments. To the best of my knowledge, hernias typically do not resolve themselves with merely the use of ace bandages or over-the-counter pain medication; surgical intervention is usually necessary for proper treatment. Is there a specific rationale behind their reluctance to pursue further diagnostic testing or surgery?