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I Have Had Episodic Stomach Pain For 4 Years That
Question: I have had episodic stomach pain for 4 years that often progresses (with digestion?) to abdominal pain. It comes about 1/month or less often, starting early afternoon. The area feels tender, bloated, painful. It usually subsides at night and is ok in the morning. May go on 3-4 days. There is no diarrhea or vomiting, but the last few times I have coughed, then gagged, then dry heaves. After that, I feel better. I was treated for amoeba and cleared them, but symptoms continue. (eggs may have survived?) Ultra sound was negative. No blood in stools.
Brief Answer:
Very likely Dyspepsia.
Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice.
As per your complaint, it seems that you are suffering from dyspepsia.Our gastrointestinal tract has a forward propulsive movement (peristalsis) that moves the food material forward as it is digested, absorbed and finally expelled as feces. If somehow this movement gets hampered, food along with the digestive juices would stagnate, stomach acid will reflux into the food pipe.Gaging and heaving are also suggestive of ongoing acid peptic disorder.on the other hand the bowel habits would not be proper. Degradation of undigested food in the intestines by the intestinal bacteria would lead to the excess gas formation.In order to relieve yourself, you need to do the following:
* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Avoid alcohol intake (if it a part of your habit).
* Take Prilosec (omeprazole) once daily before breakfast.Take probiotic like Econorm twice daily.
* Take plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like isabgol/psyllium husk or senna. I would insist you to increase your dietary fiber intake.
* Regular morning walk and exercise to keep the bowel movements proper.
* Take curd or yogurt on daily basis. It contains beneficial bacteria and should help.
* Stress reduction has a very important role to play. Yoga and meditation should help.
Test suggested-
Endoscopy.
Follow uo with reports.
Hopefully that should help!
Very likely Dyspepsia.
Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice.
As per your complaint, it seems that you are suffering from dyspepsia.Our gastrointestinal tract has a forward propulsive movement (peristalsis) that moves the food material forward as it is digested, absorbed and finally expelled as feces. If somehow this movement gets hampered, food along with the digestive juices would stagnate, stomach acid will reflux into the food pipe.Gaging and heaving are also suggestive of ongoing acid peptic disorder.on the other hand the bowel habits would not be proper. Degradation of undigested food in the intestines by the intestinal bacteria would lead to the excess gas formation.In order to relieve yourself, you need to do the following:
* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Avoid alcohol intake (if it a part of your habit).
* Take Prilosec (omeprazole) once daily before breakfast.Take probiotic like Econorm twice daily.
* Take plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like isabgol/psyllium husk or senna. I would insist you to increase your dietary fiber intake.
* Regular morning walk and exercise to keep the bowel movements proper.
* Take curd or yogurt on daily basis. It contains beneficial bacteria and should help.
* Stress reduction has a very important role to play. Yoga and meditation should help.
Test suggested-
Endoscopy.
Follow uo with reports.
Hopefully that should help!
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you for your response, Dr. XXXXXXX
The still puzzling part to me is that between episodes (sometimes several months,) I do not have any symptoms. I'm also puzzled that the times I've had the gag response, that seems to alleviate the symptoms. That said, I will try to follow your suggestions -- don't know about giving up my wine with dinner, tho!!
Thanks again,
XXXXXXX
The still puzzling part to me is that between episodes (sometimes several months,) I do not have any symptoms. I'm also puzzled that the times I've had the gag response, that seems to alleviate the symptoms. That said, I will try to follow your suggestions -- don't know about giving up my wine with dinner, tho!!
Thanks again,
XXXXXXX
Brief Answer:
Follow up suggestions.
Detailed Answer:
Hi, again my dear patient,
Firstly you should try to give up wine however in case you find it difficult then take an omeprazole 40 mg with wine.
As per the presentation is concerned this may vary from patient to patient. So the only thing we can do is to follow proper medication with diet changes and see how you respond to it.
Hope I was helpful!
Follow up suggestions.
Detailed Answer:
Hi, again my dear patient,
Firstly you should try to give up wine however in case you find it difficult then take an omeprazole 40 mg with wine.
As per the presentation is concerned this may vary from patient to patient. So the only thing we can do is to follow proper medication with diet changes and see how you respond to it.
Hope I was helpful!
Above answer was peer-reviewed by :
Dr. Kampana
Again, I thank you.
I did read about dyspepsia, of course, since your diagnosis. There are ways it fits and ways it doesn't. I don't seem to have any excess acidity - such as burping or even when I almost vomited -- just sort of clear saliva. In fact, I've wondered if the problem is a lack of acid in the stomach. What does fit is that paristalisis seems to stop -- nothing moving UNTIL the vomiting urge. Also, if the pain does go on for a while, I also feel it in my gut -- not just upper GI. And, again, it seems odd that I don't have any problems with food or digestion between episodes. I'm sorry -- this is such a mystery to me. Do you think the parasites [Blastocystis hominis] could be the culprit -- just being active at certain times?
thanks so much, XXXXXXX
I did read about dyspepsia, of course, since your diagnosis. There are ways it fits and ways it doesn't. I don't seem to have any excess acidity - such as burping or even when I almost vomited -- just sort of clear saliva. In fact, I've wondered if the problem is a lack of acid in the stomach. What does fit is that paristalisis seems to stop -- nothing moving UNTIL the vomiting urge. Also, if the pain does go on for a while, I also feel it in my gut -- not just upper GI. And, again, it seems odd that I don't have any problems with food or digestion between episodes. I'm sorry -- this is such a mystery to me. Do you think the parasites [Blastocystis hominis] could be the culprit -- just being active at certain times?
thanks so much, XXXXXXX
Brief Answer:
Follow up suggestions.
Detailed Answer:
Hi there,
Do you think the parasites [Blastocystis hominis] could be the culprit-Easiest way go for a stool culture and sensitivity, ova and parasite test. If there is any bacteria protozoa or other pathogen it would be reflected in it. Clinically very difficult to say just on the basis of few symptoms.
Secondly breath test can be done at the same lab to rule out less acid as a cause of your problem.
Lastly text book presentations as said earlier are very rare. So you have to give it a try to see if its helping or not.
Hope i was helpful,
Feel free to follow up!
Follow up suggestions.
Detailed Answer:
Hi there,
Do you think the parasites [Blastocystis hominis] could be the culprit-Easiest way go for a stool culture and sensitivity, ova and parasite test. If there is any bacteria protozoa or other pathogen it would be reflected in it. Clinically very difficult to say just on the basis of few symptoms.
Secondly breath test can be done at the same lab to rule out less acid as a cause of your problem.
Lastly text book presentations as said earlier are very rare. So you have to give it a try to see if its helping or not.
Hope i was helpful,
Feel free to follow up!
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
My thanks, Dr. XXXXXXX It has been very helpful to be able to have this ongoing discussion with you. I will ask for both a follow-up test for parasites to see if they have re-emerged as well as the breath test for acid. I'm glad you know that is even a possibility!
If you have time and energy for another related question -- Is it possible that the problem has to do with the vagus nerve, for some reason, not stimulating the peristalsis process? I ask this because it seems to explain why the vomiting reflex seems to end the stomach pain -- and both are related to vagus stimulation, if I understand correctly. And, if you have had quite enough of my questions, I will understand!!
Thanks so much,
XXXXXXX Bauer
If you have time and energy for another related question -- Is it possible that the problem has to do with the vagus nerve, for some reason, not stimulating the peristalsis process? I ask this because it seems to explain why the vomiting reflex seems to end the stomach pain -- and both are related to vagus stimulation, if I understand correctly. And, if you have had quite enough of my questions, I will understand!!
Thanks so much,
XXXXXXX Bauer
Brief Answer:
Follow up suggestions.
Detailed Answer:
Hello again my dear Lynn;
As per your query if we come for causes then there can be of hundreds of causes which may be responsible for your symptoms. They may range from dyspepsia(which itself is an umbrella term covering a number of causes) to worm infestation to hyper or hypostimulated autonomous nerves. There can be a number of assumptions but the problem with gastroenterology is that almost every problem presents with the same or overlapping group of symptoms.
why the vomiting reflex seems to end the stomach pain -Vomiting is a reflux which is controlled by D2 receptors in the brain, therefore, prokinetic medicines are given. Having a theoretical explanation to every symptom is something very difficult therefore we have investigations and various tests to explain those things which can't be explained symptomatically. Now if we want to check involvement of nerves then a test like a colonoscopy needs to be done whereby the help of very high definition camera we could see the movement of intestines.
Hope I was helpful,
Follow-ups are welcome,
Thanks!
Follow up suggestions.
Detailed Answer:
Hello again my dear Lynn;
As per your query if we come for causes then there can be of hundreds of causes which may be responsible for your symptoms. They may range from dyspepsia(which itself is an umbrella term covering a number of causes) to worm infestation to hyper or hypostimulated autonomous nerves. There can be a number of assumptions but the problem with gastroenterology is that almost every problem presents with the same or overlapping group of symptoms.
why the vomiting reflex seems to end the stomach pain -Vomiting is a reflux which is controlled by D2 receptors in the brain, therefore, prokinetic medicines are given. Having a theoretical explanation to every symptom is something very difficult therefore we have investigations and various tests to explain those things which can't be explained symptomatically. Now if we want to check involvement of nerves then a test like a colonoscopy needs to be done whereby the help of very high definition camera we could see the movement of intestines.
Hope I was helpful,
Follow-ups are welcome,
Thanks!
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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