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What Causes Abdominal Pain After Eating Food?
Question: Hello. A few days ago I posted a question concerning what I had believed was a second flare up of pancreatitis, since it is such a distinct feeling of pain. Per the doctor's recommendation that I visit the ER, my husband and I promptly went. Unfortunately the ER here, at times, can be only a little more helpful then the local urgent care. One doctor in particular holds a stance that if you are not immediately in medical danger of dying (an emergency), then you are asked to leave. And so after some blood work and some pain meds, I was asked to leave. Now the problem has become much more sever. I cannot sleep at all because of the pain. Any type of food that I eat causes extreme pain within seconds! Even a tiny sip of water! My primary doctor cannot see me for another week. But with theses new symptoms (pain seconds after eating, foul smelling breath, stomach feels heavy and weighed down, horrific horrific pain, etc) Do u know of what else this could be? Still possibly pancreatitis ? Should we drive the hours trip to go a different emergency center?? I would very much appreciate your advice Thank You!!
Brief Answer:
pancreatitis, ulcer,gallbladder infection/ stone
Detailed Answer:
Thank you for asking!
Pancreatitis pain is usually around umbilicus and refers to the back like a stabbing pain.It can also be in epigastrium (hollow portion under the ribs junction) and below each rib cage mostly on the right side.
Now the pain exacerbating on the food intake is most likely a hepatobiliary infection.As you are a woman of young age, my suggestions would be to sort out a complete hepatobiliary and pancreatic profile. Abdominal ultrasound would be a good start for sorting out any gallbladder stones as sludge of it or small stones are very likely be the reason it self for pancreatitis. If the pain after eating is also felt in tips of the shoulder then my suspicion would rise further.
So get all the work up like, amylases in both urine and serum, lipases, amylase to lipase ration, CT and MRCP if need be, liver function tests, renal function tests, electrolytes and calcium levels and try to be on fluids only meanwhile to prevent any complications.
If the above labs come back negative then the next suspicion of postprandial pain would be a duodenal ulcer as itself is the very common presentation of such duodenal ulcers. That would need a prophylactic triple regimen for H pylori as it is the most likely cause of gastritis. Avoiding NSAIDs for the maximum possibility and spices and hot and carbonated beverages would also be required to avoid.
In nutshell, irrespective of the cause and the etiology of the pain, The likely possibility lies in the hepatobiliary region and that needs an expertise of a gastroenterologist.
As you mentioned foul smelling breaths, heavy feelings after meals with postprandial pains, i personally think it is a gastric/ duodenal ulcer with GERD and would still need a gastroenterologist. You will be fine just do as directed by me.
Take good care of yourself and dont forget to close the discussion please.
May the odds be ever in your favour.
Regards
S Khan
pancreatitis, ulcer,gallbladder infection/ stone
Detailed Answer:
Thank you for asking!
Pancreatitis pain is usually around umbilicus and refers to the back like a stabbing pain.It can also be in epigastrium (hollow portion under the ribs junction) and below each rib cage mostly on the right side.
Now the pain exacerbating on the food intake is most likely a hepatobiliary infection.As you are a woman of young age, my suggestions would be to sort out a complete hepatobiliary and pancreatic profile. Abdominal ultrasound would be a good start for sorting out any gallbladder stones as sludge of it or small stones are very likely be the reason it self for pancreatitis. If the pain after eating is also felt in tips of the shoulder then my suspicion would rise further.
So get all the work up like, amylases in both urine and serum, lipases, amylase to lipase ration, CT and MRCP if need be, liver function tests, renal function tests, electrolytes and calcium levels and try to be on fluids only meanwhile to prevent any complications.
If the above labs come back negative then the next suspicion of postprandial pain would be a duodenal ulcer as itself is the very common presentation of such duodenal ulcers. That would need a prophylactic triple regimen for H pylori as it is the most likely cause of gastritis. Avoiding NSAIDs for the maximum possibility and spices and hot and carbonated beverages would also be required to avoid.
In nutshell, irrespective of the cause and the etiology of the pain, The likely possibility lies in the hepatobiliary region and that needs an expertise of a gastroenterologist.
As you mentioned foul smelling breaths, heavy feelings after meals with postprandial pains, i personally think it is a gastric/ duodenal ulcer with GERD and would still need a gastroenterologist. You will be fine just do as directed by me.
Take good care of yourself and dont forget to close the discussion please.
May the odds be ever in your favour.
Regards
S Khan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you Dr. can u please list out all tests you think I should get? All that information was a little hard to understand. I've had my gall bladder removed and got pancreatitis after they pulled out forgotten stones in my bile duct. But I have had lots of issues since then. Thank you again doctor! I would really really appreciate that list if you wouldn't mind. I see my primary doc at the end of next week and can get them all set up. oh and by the way...last minute... I've been tested for h-pylori and I'm all clear :) thanks again"
Brief Answer:
Work up list mentioned
Detailed Answer:
Thank you for asking!
Here is the list of work up you need for the likely differential diagnosis of your trouble with ulcer and Pancreatitis on top
endoscopy
Radiography
Angiography
Serum Gastrin Level
Secretin Stimulation Test
Biopsy and H Pylori Testing
Liver Function tests
Serum AMylase, amylase to lipase levels,
urinary lipases
Serum electrolytes, BUN, creatinine, glucose, cholesterol, and triglycerides
Complete blood count and hematocrit
C-reactive protein
Ultrasound
ERCP
MRCP
CT Abdomen
I suggest get to a gastroenterologist or a hepatobiliary surgeon and let them start with the tests most needed and do them on priority basis.
Take care.Dont forget to close the discussion please
S Khan
Work up list mentioned
Detailed Answer:
Thank you for asking!
Here is the list of work up you need for the likely differential diagnosis of your trouble with ulcer and Pancreatitis on top
endoscopy
Radiography
Angiography
Serum Gastrin Level
Secretin Stimulation Test
Biopsy and H Pylori Testing
Liver Function tests
Serum AMylase, amylase to lipase levels,
urinary lipases
Serum electrolytes, BUN, creatinine, glucose, cholesterol, and triglycerides
Complete blood count and hematocrit
C-reactive protein
Ultrasound
ERCP
MRCP
CT Abdomen
I suggest get to a gastroenterologist or a hepatobiliary surgeon and let them start with the tests most needed and do them on priority basis.
Take care.Dont forget to close the discussion please
S Khan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
ok thank you so much for doing that for me doctor! I will call my Gastro Doc right away! Thanks again!
Brief Answer:
:)
Detailed Answer:
you are welcomed my friend.dont forget to close the discussion please and let me remember if there is any thing else i can be of some help with.
regards
s XXXXXXX
:)
Detailed Answer:
you are welcomed my friend.dont forget to close the discussion please and let me remember if there is any thing else i can be of some help with.
regards
s XXXXXXX
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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