Concerns Following ER Visit for Chest and Abdominal Pain
Greetings, I’m a 54-year-old female, standing 5'6" and weighing 199 pounds. Over the past several days, I've been experiencing mild but persistent discomfort in the upper left section of my abdomen, accompanied by chest pressure that seems to radiate towards my back. Thankfully, I have not experienced any nausea or throwing up, but I do feel dizzy and somewhat lightheaded. Additionally, I've been unusually fatigued for about a week now. Yesterday, I sought emergency care as I was concerned I might be having a heart attack. During the triage, my blood pressure was recorded at 159/95, escalating at one point to 170/? and finally reducing to about 135/90 when I left. Fortunately, the medical staff ruled out heart-related issues, as multiple troponin tests returned negative, and imaging studies, which included a CT scan of my abdomen with contrast and a chest X-ray, revealed no acute problems. However, they noted an elevation in my lipase levels (658) and diagnosed me with "acute pancreatitis/upper abdominal pain/chest pain ruled out," prescribing medications (Zofran, Bentyl, sucralfate, and a few hydrocodone) upon discharge. I am somewhat reluctant to take the gastrointestinal medications since the doctor mentioned they could "slow things down," and I am already feeling pressure in my abdomen, which heightens my concern about constipation. Last night, I took a hydrocodone for pain relief, but right now, I'm only using omeprazole and acetaminophen. I’m still suffering from a severe headache that began after I received nitroglycerin in the ER, and I feel a bit disoriented. The ER physician suggested I stay overnight for a stress test the following morning, but I preferred not to be hospitalized and opted to follow up with my primary care doctor instead. My medical history includes an atrial septal defect repair in 2001 and gallbladder removal in 2017. I regularly take omeprazole and had recently been using diclofenac for arthritis, but I ceased taking it today to rule out any potential connection to an ulcer. Last week, I tried prempro to alleviate hot flashes but discontinued it after just one day because it made me feel excessively tired. I have avoided alcohol for the past two weeks for Lent; typically, I would enjoy a couple of glasses of wine a few times a week. I am also a non-smoker. Should I consider using the prescriptions given by the ER, or could they exacerbate my situation? Additionally, would it be prudent to reach out to my primary care physician right away, or should I wait a few days to see if the pain and pressure subside after discontinuing diclofenac?
Answers (1)
3/5/2026, 3:10:46 PM
OpenHealth AI
It's great to see that you sought medical attention, and it's important to follow up on your health concerns proactively. Given your symptoms and recent diagnosis of acute pancreatitis, it's understandable to want to monitor how you're feeling after your ER visit.
Main Points:
- Current Symptoms: You've experienced discomfort and pressure in your abdomen and chest, dizziness, lightheadedness, and fatigue.
- Diagnosis and Medications: You have been diagnosed with acute pancreatitis and given several prescriptions, but you're apprehensive about their possible side effects.
- Next Steps: It's essential to weigh the benefits of prescribed medications against potential complications and keep close communication with your healthcare provider.
Explanation:
Acute pancreatitis can cause abdominal pain and elevate your lipase levels. It is essential to manage your symptoms while promoting healing in your pancreas. The medications prescribed (Zofran, Bentyl, sucralfate, and hydrocodone) generally aim to manage pain and reduce digestive discomfort. However, constipation can be a concern with some gastrointestinal medications, so your reluctance is valid.
Your discomfort, particularly the headache after receiving nitroglycerin, and feelings of disorientation warrant close observation, especially given your history. It is also important to keep track of any worsening symptoms, particularly in the context of your prior heart-related concerns.
Action Steps:
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Medication Management: Consider taking the medications—particularly the sucralfate and Bentyl—as prescribed, but monitor how they affect your bowel movements. You can also pair them with a stool softener to alleviate constipation concerns. If you experience side effects that worsen your symptoms, have your primary care physician adjust your treatment.
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Pain Relief: Continue using acetaminophen for pain as needed but avoid exceeding the recommended dose. If the hydrocodone provides relief, use it sparingly and only as needed, given the potential for constipation as well.
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Monitor Symptoms: Keep a daily log of your symptoms—including pain levels, bowel movements, dizziness, and any new symptoms—leading up to your follow-up appointment. This will help your physician assess your condition more effectively.
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Follow-Up with Primary Care: It would be prudent to contact your primary care physician promptly rather than waiting several days. Discuss your current symptoms, your concerns about the medications, and the headache you are experiencing. They may advise you to come in sooner or adjust your treatment.
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Hydration and Diet: Hydrate adequately and consider a bland diet (like the BRAT diet: bananas, rice, applesauce, toast) that’s easy on your stomach. Avoid fatty or very spicy foods until you feel better.
You are taking a wise approach by being cautious with your health. Do not hesitate to reach out to your primary care provider for clarification on any medications or to discuss your ongoing symptoms—they're there to help you recover and feel better.
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