I am a male aged 26 working in a stressful job (medical resident)
I have been diagnosed with a significant anxiety disorder, hypochondriac and obsessive compulsive.
For the past 3 months I have been enduring constant 24/7 abdominal pain in right lower quadrant and umbilical area, and constant nausea. Both symptoms unaffected by food intake, and do not interfere with sleep, although I wake up feeling exhausted and constantly anxious about the cause. The character of the pain is a dull ache and "tightness" in my stomach. I vomit most mornings before work due to anxiety. nil symptomatic relief from any standard meds for the nausea, although I notice it less with alprazolam. I had an identical episode of pain like this in 2003 which appeared to resolve itself after about 9 months, and similar nausea 9 months ago which responded to amitriptylene 10mg, but now even 50mg cannot give me relief. I do have known severe GERD and barrett's esophagus for several years. appendix out 2003 with no relief.
I have been extensively investigated with head ct, abdo ct, endoscopy, colonoscopy, ultrasound, upper GI series, biochemisry, haematology, coeliac markers, liver function, urine metenephrines and 5hiaa, thyroid tests- all normal except for barrett's esophagus.
current meds are rabeprazole, antispasmotics, amitriptylene 50mg at night, xanax prn
I feel constantly exhausted, tearful and fragile. My family doctor and specialist both strongly believe my symptoms are psychosomatic, and I find this difficult to accept. The pain and nausea are so severe and unremitting! I am terrified I have cancer that has been missed and spend all my time looking up my symptoms on the internet driven by fear and the symptoms themselves. I comleted my medical residency last eyar and I had so much more stamina and stress then compared to now. the only thing I am really anxious about are my symptoms!
Please assist if you think the above story makes sense- I am continuing to be managed by my GI specialist, but I wonder if anxiety or stress really can cause all this. the pain and nausea really are all day long
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