Psychosomatic abdo pain and constant nausea

Dear Sir,

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

[Oblique]

Additional info: urine and stool tests x3 also normal.
I cry very easily too

[Leddj0002]

Hey man, I am very sorry to hear about your troubles. Don't worry, you are not alone.
I have the same ab pain and everything. An SSRI took the edge off.

Try to constantly imagine and visualize yourself feeling fine. Even laugh when you are thinking about the pain.

"It's just that old anxiety pain again."

You will rebound and do better, you don't have cancer, that is just the OCD imho.

[Oblique]

thanks I appreciate it!