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Suggest Treatment For Sharp Pain In The Abdomen
Question: 30 yr old overweight male...
Curious as to what might cause recyrring nausea/sharp stomah pains?
I had a homemade steak burrito and felt the sharp pain come on after eating it yet no one else that ate from the same steak has any pain. Had some stomach pains a few days ago and took Pepto, and it felt better.
Ive had recurring gastro issues for a time now (gallbladder removal, RUQ pain that went away with diet change and fitness, etc).
Curious as to what might cause recyrring nausea/sharp stomah pains?
I had a homemade steak burrito and felt the sharp pain come on after eating it yet no one else that ate from the same steak has any pain. Had some stomach pains a few days ago and took Pepto, and it felt better.
Ive had recurring gastro issues for a time now (gallbladder removal, RUQ pain that went away with diet change and fitness, etc).
Brief Answer:
Questions so that I can help:
Detailed Answer:
Hello Chase,
Where on your abdomen is the pain? Is it in the left upper quadrant, under the ribs on the left side? On the right side where you had your gall bladder removed? In the middle just below the breast bone? Or more diffuse through your abdomen? Or lower down?
Also, is it sharp and crampy or more like abdominal pressure, or sour?
Questions so that I can help:
Detailed Answer:
Hello Chase,
Where on your abdomen is the pain? Is it in the left upper quadrant, under the ribs on the left side? On the right side where you had your gall bladder removed? In the middle just below the breast bone? Or more diffuse through your abdomen? Or lower down?
Also, is it sharp and crampy or more like abdominal pressure, or sour?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The nausea is a general overall symptom, but the sharp pain seems to be in the central abdomen. Ive noticed a slight soreness on the left and right sides (just above the pelvis) despite not working those muscles out. I would say the pain is a mix of sour and slight sharpness .
Brief Answer:
Information
Detailed Answer:
If the sharp pain is in the center, particularly upper central area, this may be gastritis/duodenitis (inflammation of the lining of these structures), and the general soreness is possibly due to gas in the intestines.
I am assuming the area that was painful when you had your gall bladder out is not an issue right now (right upper quadrant).
If the sharp pain continues as in occurring on a daily basis, consider taking ranitidine (Zantac) 150 mg twice a day to decrease acid production to let the lining of your stomach and duodenum heal. Depending on the severity and duration of symptoms, you may need to do this only for a few days or for a few weeks.
For the lower abdominal pain, consider taking simethicone (Gas X). This breaks up larger gas pockets that can cause pain from distention. You can take this as needed (but don't exceed the amount per directions on the product).
If however, you don't start to see improvement within a day or two, or if the pain is increasing, then do go in to be seen. There are many different things that can go wrong int he abdomen (stones in ducts even after gall bladder is out, problems with the pancreas, etc), and an abdominal physical exam would be important in this case.
But most likely, something in the steak burrito, a spice or the steak itself, or a combination, just set off your digestion. Some people find that a particular food just doesn't agree with them. If it just occurs occasionally after a particular food, taking Pepto or Zantac that day may be all that is needed.
I hope this information helps. Please let me know if I can provide further information.
Information
Detailed Answer:
If the sharp pain is in the center, particularly upper central area, this may be gastritis/duodenitis (inflammation of the lining of these structures), and the general soreness is possibly due to gas in the intestines.
I am assuming the area that was painful when you had your gall bladder out is not an issue right now (right upper quadrant).
If the sharp pain continues as in occurring on a daily basis, consider taking ranitidine (Zantac) 150 mg twice a day to decrease acid production to let the lining of your stomach and duodenum heal. Depending on the severity and duration of symptoms, you may need to do this only for a few days or for a few weeks.
For the lower abdominal pain, consider taking simethicone (Gas X). This breaks up larger gas pockets that can cause pain from distention. You can take this as needed (but don't exceed the amount per directions on the product).
If however, you don't start to see improvement within a day or two, or if the pain is increasing, then do go in to be seen. There are many different things that can go wrong int he abdomen (stones in ducts even after gall bladder is out, problems with the pancreas, etc), and an abdominal physical exam would be important in this case.
But most likely, something in the steak burrito, a spice or the steak itself, or a combination, just set off your digestion. Some people find that a particular food just doesn't agree with them. If it just occurs occasionally after a particular food, taking Pepto or Zantac that day may be all that is needed.
I hope this information helps. Please let me know if I can provide further information.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ive actually had RUQ pain as of late, however when i changed my diet and got into an exercise regiment, it went away completely. Considering that ive sort of reverted to the old diet, its not surprising that its back. My gastro doc has been involved since that pain started and cant find whats wrong.
But with this recent pain, it feels almost localized on the middle to bottom right side of the abdomen (almost like a small pressure that also causes a type of nausea). Is it normal to last until the next eveningfor this type of reaction when food doesnt agree with you?
Sorrry for such a long response doctor.
But with this recent pain, it feels almost localized on the middle to bottom right side of the abdomen (almost like a small pressure that also causes a type of nausea). Is it normal to last until the next eveningfor this type of reaction when food doesnt agree with you?
Sorrry for such a long response doctor.
Brief Answer:
Thoughts on this.
Detailed Answer:
Middle to bottom right side of the abdomen can be from gas in colon, but it can also be from an inflamed appendix (appendicitis). Nausea can go with that too.
Usually with appendicitis, the pain increases over time and localizes more to the lower right side. The pain generally increases with walking or jarring motions. The only way to diagnose it is to go in and be seen where the doctor can do a physical exam, and imaging studies can be done, such as an ultrasound.
So if that pain is continuing, best to go in to be seen.
Thoughts on this.
Detailed Answer:
Middle to bottom right side of the abdomen can be from gas in colon, but it can also be from an inflamed appendix (appendicitis). Nausea can go with that too.
Usually with appendicitis, the pain increases over time and localizes more to the lower right side. The pain generally increases with walking or jarring motions. The only way to diagnose it is to go in and be seen where the doctor can do a physical exam, and imaging studies can be done, such as an ultrasound.
So if that pain is continuing, best to go in to be seen.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Understood doctor. If this were to not be appendicitis, would you go with the analysis of gas pockets? Ive had something like this but much more extreme about a year ago, where i thought my appendix was bursting, and it turned out to be nothing, even though i was doubled over. The doc said that it couldve been diverticulitis. Yay or nay?
Brief Answer:
Thoughts on this
Detailed Answer:
Diverticulitis is also a possibility. Did you have any further evaluation done at the time (colonoscopy? ultrasound?).
Without doing an exam, it really isn't possible to say definitively what is going on. With appendicitis, usually the symptoms progress, and as I mentioned, things like walking make it hurt more.
If the pain is continuing, I do recommend going in to be seen, because while I can provide some general information on line by discussion, that is very limited.
Thoughts on this
Detailed Answer:
Diverticulitis is also a possibility. Did you have any further evaluation done at the time (colonoscopy? ultrasound?).
Without doing an exam, it really isn't possible to say definitively what is going on. With appendicitis, usually the symptoms progress, and as I mentioned, things like walking make it hurt more.
If the pain is continuing, I do recommend going in to be seen, because while I can provide some general information on line by discussion, that is very limited.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
A CT scan was all that he requested. He thinks that the RUQ pain is something pancreatic related, given that when i ate better and exercised, i felt better (which makes sense). But this pain is in the lower spectrum and theres still mild nausea (since monday). Im seeing my PA tomorrow because i feel really ill. I was just curious if this could be/sounded like something life threatening o cancerous. r
Brief Answer:
Information
Detailed Answer:
Well a CT of the abdomen will provide quite a bit of information, especially if it includes an ERCP (study of the pancreas with dye).
You are right though, that the pancreas doesn't usually cause problems in the lower abdomen.
I am concerned that the practitioner you will be seeing is a PA and not a physician. PAs have limited training. I'm not saying that because I'm a stuck up doctor, but from what I've seen first hand, including care my relatives have received.
By the way, I don't know if I have already mentioned this, but even after a person has their gallbladder removed, a stone can still form, in the common duct for both the liver and pancreas which drains into the first part of the small intestines (duodenum). So people can have inflammation of the pancreas or liver because of that, and have RUQ pain or left sided pain.
I can understand thinking about the possibility of cancer, but the CT will help sort that out. Abdominal symptoms related to digestion are very common and only rarely is it due to cancer.
The CT scan will also help show if there is diverticulitis. So I think this a reasonable thing to do.
Where I live and practice, we usually start with an abdominal ultrasound (which gives preliminary information, and sometimes that in itself is enough). If there are abnormal findings, then the next step here is usually MRI. But simply going directly to a CT is reasonable too. (The ultrasound is less expensive in general and saves time and more complicated, more extensive testing, but the MRI if a next step is needed is more expensive than a CT.)
Information
Detailed Answer:
Well a CT of the abdomen will provide quite a bit of information, especially if it includes an ERCP (study of the pancreas with dye).
You are right though, that the pancreas doesn't usually cause problems in the lower abdomen.
I am concerned that the practitioner you will be seeing is a PA and not a physician. PAs have limited training. I'm not saying that because I'm a stuck up doctor, but from what I've seen first hand, including care my relatives have received.
By the way, I don't know if I have already mentioned this, but even after a person has their gallbladder removed, a stone can still form, in the common duct for both the liver and pancreas which drains into the first part of the small intestines (duodenum). So people can have inflammation of the pancreas or liver because of that, and have RUQ pain or left sided pain.
I can understand thinking about the possibility of cancer, but the CT will help sort that out. Abdominal symptoms related to digestion are very common and only rarely is it due to cancer.
The CT scan will also help show if there is diverticulitis. So I think this a reasonable thing to do.
Where I live and practice, we usually start with an abdominal ultrasound (which gives preliminary information, and sometimes that in itself is enough). If there are abnormal findings, then the next step here is usually MRI. But simply going directly to a CT is reasonable too. (The ultrasound is less expensive in general and saves time and more complicated, more extensive testing, but the MRI if a next step is needed is more expensive than a CT.)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Understood doctor. The only reason i scheduled with the PA is because the DO was full this week and my gastric doctor is booked all of XXXXXXX The PA ran some blood and urine tests (looking at white and red cell counts for infections, metabolic panel, etc) and everything came back fine. When i had the CT a few weeks back, it came back normal sans a 4mm liver cyst in which my gastric doctor said that it was nothing at all to be concerned of. He said that this could possibly be GERD due to me having it as an infant .
Brief Answer:
Thoughts on this
Detailed Answer:
If the abdominal CT was normal except for the very small cyst, then this could be gastritis/duodenitis.
GERD usually gives symptoms of heart burn in the chest, pain under the sternum, acid or sour taste in the mouth, or sore throat and cough. Those are typical symptoms of GERD.
For either though you can use the H2 blocker Zantac 150 mg twice a day. Or a proton pump inhibitor medication, but nowadays with what we know about ppis, I like to start with an H2 blocker because they are safer and don't have the problem of increasing the hormone gastrin and causing rebound hyperacidity after discontinuing them. But if the Zantac helps but not enough, then a PPI is the way to go - at least for a few weeks.
I am wondering if at any point you have had a test for h.pylori which can cause stomach ulcers?
Thoughts on this
Detailed Answer:
If the abdominal CT was normal except for the very small cyst, then this could be gastritis/duodenitis.
GERD usually gives symptoms of heart burn in the chest, pain under the sternum, acid or sour taste in the mouth, or sore throat and cough. Those are typical symptoms of GERD.
For either though you can use the H2 blocker Zantac 150 mg twice a day. Or a proton pump inhibitor medication, but nowadays with what we know about ppis, I like to start with an H2 blocker because they are safer and don't have the problem of increasing the hormone gastrin and causing rebound hyperacidity after discontinuing them. But if the Zantac helps but not enough, then a PPI is the way to go - at least for a few weeks.
I am wondering if at any point you have had a test for h.pylori which can cause stomach ulcers?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You know i was wondering if this was h. pylori myself. Would/could it cause lower quadrant aching and nausea solely though? The PA gave me a prescription to treat the nausea, and an over the counter medicine for the possible reflux, and they're sort of helping but not completely, due to them not treating the source .
Brief Answer:
Thoughts
Detailed Answer:
More typical symptoms of h. pylori would be pain in the stomach area (upper middle and upper left), and a gnawing pain when the stomach is empty. But bloating can happen with a gastritis too, and that pain is usually diffuse.
So the aching is only in the lower quadrant... that would be more consistent with lower GI problems (large intestine usually). But the CT looked ok so diverticulitis is much less likely. I am wondering if you might be having some sort of referred pain from the genitourinary tract. Usually that pain is in the pelvis though. Inflammation or problems of the prostate or testes can cause an aching pain and nausea.
If absolutely nothing can be found, and that CT (with contrast I am assuming)was recent, there is the possibility of irritable bowel syndrome. Really that should be a diagnosis only after exluding other things though. And IBS usually is associated with either diarrhea or constipation (or both) and the pain is often relieved after having a BM.
How soon can you get in to see your primary doctor and can you get on a cancellation list with the gastroenterologist?
The CT used contrast, and was of the abdomen only, right?
Also, I assume you have not been having fevers, sweats, light headedness or diarrhea - is that right?
And when you had the CT a few weeks ago it was because of the current symptoms right? I am asking the last question because I want to make sure during the CT they would have seen whatever is causing the current problem if it was happening at the time.
Thoughts
Detailed Answer:
More typical symptoms of h. pylori would be pain in the stomach area (upper middle and upper left), and a gnawing pain when the stomach is empty. But bloating can happen with a gastritis too, and that pain is usually diffuse.
So the aching is only in the lower quadrant... that would be more consistent with lower GI problems (large intestine usually). But the CT looked ok so diverticulitis is much less likely. I am wondering if you might be having some sort of referred pain from the genitourinary tract. Usually that pain is in the pelvis though. Inflammation or problems of the prostate or testes can cause an aching pain and nausea.
If absolutely nothing can be found, and that CT (with contrast I am assuming)was recent, there is the possibility of irritable bowel syndrome. Really that should be a diagnosis only after exluding other things though. And IBS usually is associated with either diarrhea or constipation (or both) and the pain is often relieved after having a BM.
How soon can you get in to see your primary doctor and can you get on a cancellation list with the gastroenterologist?
The CT used contrast, and was of the abdomen only, right?
Also, I assume you have not been having fevers, sweats, light headedness or diarrhea - is that right?
And when you had the CT a few weeks ago it was because of the current symptoms right? I am asking the last question because I want to make sure during the CT they would have seen whatever is causing the current problem if it was happening at the time.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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