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Gastroenterology  (Expert Forum)
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Chronic upper stomach pain - tests look normal.
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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MedHelp Member's Question

Chronic upper stomach pain - tests look normal.

by patniemeyer, Aug 23, 2003 12:00AM
I'm writing for a friend (31 year old female in otherwise good health) who is suffering with severe chronic upper stomach pain.  She has had this off and on for years but the past six months or so have been debilitating.  The pain is dull and sounds from the description like acid reflux (rising feeling of pain) but antacids do not help.  The pain does seem to be worse when she is under stress.  She has been prescribed Prevacid/Prilosec which sometimes helps briefly after taking, but does not last.  The pain is rarely associated with a sharper pain in her abdomen.  On one occasion we went to the ER for fear of an appendicitis but nothing was found.



Over the past few months she has had a stomach bacterial test, ultrasound (last year), a CAT scan and xrays, and most recently an upper endoscopy.  All appear normal (which is a relief, but frustrating...)



I would very much appreciate any ideas or suggestions.





Thank you,

Pat Niemeyer



Doctor's Answer

by Kevin Pho, MD, Aug 24, 2003 12:00AM
A pretty comprehensive evaluate has already been done - including normal H Pylori test, ultrasound, CT scan and upper endoscopy.  This would make things like ulcers or inflammation less likely.  



As for further testing, I would suggest more specialized testing such as a 24-hr pH study - which can definitely rule in or out GERD or a HIDA scan with CCK stimulation to evaluate for the gall bladder ejection fraction.  



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.

Member Comments (6)

by Julie72, Aug 23, 2003 12:00AM
I had my gall bladder removed 2 years ago, and still have problems with the pain, vomiting food and bile, and loose bowel.  In fact I just recently had to be put in the hospital for this very condition and still not any real concrete answers.  I would like to know if anyone else is experiencing what I am going through.

by MTV, Aug 25, 2003 12:00AM
To: Julie
I had my gallbladder removed in April 2002.  Since then, I have suffered almost constant abdominal/stomach pain.  I have pain in my stomach and it is very tender when I push on myself in that area.  Very tender and sore.  Pain in my RUQ and pain in my lower right side.  Constant nausea.  No vomitting yet, but on a few occasions, have come close.  Also pain in my back.  I can't get any answers either.  I have had an endoscopy done, radioactive CT scan done on my abdomen/pelvis area to rule out masses and aortic anyeurism (because I have a pulsating aorta), x-rays, bloodwork, you name it.  Nothing.  I am so frustrated right now.  There has got to be a reason for the pain.  Never had anything like this prior to the gallbladder coming out.  I am so desperate, that I am now seeing a general surgeon and I am considering exporatory surgery to possibly find the cause.  Believe me, I don't want anyone going in me again, but I feel I am running out of choices.  I wish you all the luck in finding some help.  You are not alone.  Keep me posted.  My email is ***@**** if you ever need to talk.



Melinda

by SHELBYbytheSEA, Sep 10, 2003 12:00AM
My gallbladder was removed on 7/3/03.  I had been having pain in my side and right upper quadrant for atleast 3 months before I was admitted to the hospital.  The pain increased and became increasingly harder to handle.  

On May 17 I thought I was having a heart attack and went to the hospital.  After spending 2 nights and a stress test I was discharged and told it could be my gallbladder.  My chest was tender to touch and any position other than reclining or standing was nearly impossible. CT scan and ultra sound were both normal.  Finally, on Monday, June 23 I was admitted to the hospital.  I had a G.I and surgeon assigned when admitted but I had an emptying scan on Tuesday and it came back normal.  The surgeon was removed from the case.  Wed, the G.I saw the results and wanted to check to see if possibly I had arthritis in my rib cage but ended the conversation with it could still be the gallbladder.  Thur, my primary interrupted my question about the test and said it wasn't my gallbladder that it was depression and anxiety and wasn't going to have my gallbladder removed because I wanted it done.  No other Dr came to see after 8am on thursday.  Friday the G.I wanted to know if the pain management team came, told him no, asked if the test could be wrong, said yes.  We made a deal, I agreed to a nerve block and if it didn't work he said he would find a surgeon who would take out my gallbladder.  Primary didn't come in on Friday and no one from his group showed up either.

Saturday June 28 primary's partner showed up, said I didn't look sick enough to be in hospital, I requested a psych consult because of comment from primary.  Psych came in said no this pain would not be happening because I have bipolar but could be contributing to me being down.  Yes I have manic depression and I swear I get so much **** from the medical profession because of that.  Sunday, partner showed up again and told him that pain meds weren't working, had been saying that since Tuesday, and he said I need to give it some time.

Monday, had nerve block, 15 minutes later my mother showed up with a quater pounder w cheese, the greasiest thing I could think to eat.  The pain was still there.

G.I came in and said he would find me a surgeon.  We then agreed to a colonoscopy and endoscopy to rule everything out.

Primary came in after that and said well looks like we are going to be taking out your gallbladder.  

Told him he owed me an apology, asked if he read what psych wrote and he said "I didn't order a psych comsult"..my response was "no, I did"  I told him he owed me an apology and asked him to leave my room.

Tuesday July 1, the only day I was out of pain because they gave me fentynal for the colonoscopy. Colon is fine and yes I have a hiatel hernia.  Surgeon asked if I could wait til thurs because of his schedule.  What's one more day right.  They changed my meds and I was once again out of pain.  

After all this ****, I am still in pain.  After yet another a CT scan, they don't know what is wrong with me.  The G.I. thinks it is nerve damage and the pain DR agrees with him.  Hed said that out of say 100 patients maybe 2 will have damage to the nerve that has been cut.  He said it could take up to 6 months to heal.  

I have missed a ton of work because sitting is so uncomfortable and doing everyday things is near impossible with-out the use of percocet and anti-flammatory's.

My hernia acts up and now am on protonix 2 x's a day and man what a difference that has made.  All the other things out there, just don't work.  I am also on 1600mg of Nuerontin a day a that also seems to be helping.

Long story to make a quick point.  Do not allow the Dr to lead you to believe that it is all in your head.  Tell your Dr you want off the prilosec and want protonix. I am not alone in telling you it is a good drug.  Let them know you want to try the neurontin, keep looking for a Dr who will listen to you.

good luck,

CJ

***@****

by jennie jones, Sep 25, 2003 12:00AM
All I see posted is negative responses and complications resulting from gall bladder