Abdominal Discomfort persists even after tests came back clean.

Hi,

I'm 28 year old male and I've been having abdominal problems for a couple of years now. They seem to be getting progressively worse.

I've been to the doctors numerous times and after have been given Somac to see if it would help. While my symptoms improved slightly the problems persisted. Later I had a blood test for H.Pylori and it came back positive so I was put on an antibiotic treatment. This seemed to improve my symptoms for quite a while, but eventually they returned.

Just last week I had an endoscopy done and it came back clean. I had no ulcers or inflammation or any signs of H.Pylori. I also had an ultrasound of the liver, kidney and gallbladder and it came back clean. My specialist told me he couldn't find anything wrong with me and said it could be stress related. I told him I didn't feel stressed, at least not enough to warrant the kind of pain and discomfort I've been going through. He told me to take some slippery elm to see if that would help.

A couple of years back I did take codeine for something else rather frequently and my problems did seem to start at that point. I try to avoid it now, but when I do take it the next day I'll be in a lot of pain, especially right below the sternum.

The symptoms mainly come at night. I feel bloated with a pushing sensation on the lower part of my stomach as I lie down. The discomfort usually gets worse and I find myself waking up several times during the night having to get up and walk around, and taking a paracetamol before going back to bed. I don't think its GERD as antacids don't help and somac didn't stop me from waking up several times a night. Although, these symptoms have improved ever since I stopped taking somac. While I was taking somac I was having difficulty digesting food.

The discomfort is the kind that feels like as if I had eaten too much before going to bed, even though I hadn't or only ate light. This does not occur every night, but it does occur often enough to cause me a great lack of sleep. I end up only sleeping a couple of hours some nights. If I do have these problems at night, they tend to persist throughout the following day.

Sometimes, I'll turn over to lie on my stomach during the night and I'll feel a throbbing sensation just below my sternum. Just today I accidentally pressed on it and I could feel an intense pain and throbbing sensation which made me feel naseous and uncomfortable throughout the whole day.

I accept that it could have something to do with stress although the discomfort and pain seem to come intermittently and have little to do with how much I've been stressed that week or day. I could have a very relaxing day but at night still end up having all the symptoms I described at night.

one more note, If I have a few alcoholic drinks say on a friday night, it tends to soothe my stomach and allow me to sleep for a couple of nights following although the problems eventually return.

Any help would be appreciated.

[Kevin Pho, MD]

An upper endoscopy as well as an ultrasound can rule out many of the major causes of the symptoms.  Further testing can be considered with an abdominal CT scan - which can better image the pancreas.  

More specialized testing can be considered, including a 24-hr pH study (looking for GERD) or a gastric emptying scan (looking for gastroparesis).

Also, looking outside the GI system can be considered.  A stress test and/or echocardiogram can be considered to evaluate the heart, as well as chest imaging to evaluate the lungs.

These options can be discussed with your personal physician.

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.

Kevin, M.D.
kevinmd_

[mosostow]

Thanks. I hadn't considered (or was told about) gastroparesis.

I'm curious, can narcotics like codeine (something I was taking quite extensively) cause any permanent irreversible damage to the stomach/digestive system?

I ask this as most of my problems began around the time when I took a lot of codeine and didn't disappear even after I completely discontinued it. This might be a coincidence, but I'm still curious as the link appears to be strong.

[marys966]

Not sure what to do at this point.  Had every test done for gallbladder problems and everything comes back fine.  Had the tests done after the attack. Is is possible that the "attacks" flush out everything until it builds up again and then all the discomfort starts.  Wondering if anyone has had this problem and where and what to do now.  Two doc's say they think that it is gallbladder but need something conclusive.  Is this just a waiting game?  Have lived with this for toooo many years.

[chgr]

I am 23 year old male,
please help this likes to make me crazy.
Though your symptoms is different from me we have some similarities.
Before 3 years i start to have these signs; want to vomit & weaknes during morning
wakeup, loss in appitite specially during morning and if i slept during day.This increases from time to time for 2 years and developed high constipation.
Then i went to a specialist doctor last year, after checking my blood, stool&urine he told me i am H pylori positive.As a treatment he gave me the antibiotics ammoxaxilin, calathromycin,omoprazole(lucid) for 14 days.i didn't take the ammoxaxilin  correctly case i do afraid of these medicine after taking at one time before for another treatment , but i did take the two antibiotics.it seem better during taking the medicine but it returns after all the medicine is taken.then i went back to the dr, he did nothing and told me he can not check for hpylori now it will be only checked after 2 years.
Though life was difficult i did live for 10 monthes by  wakeup around 5a.m with disturbed stomach & drinking water all this to make my engineering study.During my final exam tests of the year i again did have high vomiting during morning specially when i am very hungry during the night .
Then i went to another dr,after blood test he told hpylori positive & give the same treatment as above for 14 days i did  take it (except the ammoxaxilin).But there is no change then i back to the doctor after a month he did check d-test for hpylori and told negative result.And gave me ranitidne & worms i took these but there is no change still.Though i did try all this with financial problems of the expensive medicines &lab tests nothing is changed.I can not take more testes like urea breathtest,endoscopy,biopsy becase they are not available here.
ANY ONE WHO HAS THE SAME SYMPTOMS LIKE  ME  OR ANY WHO CAN GIVE ME ADVICE IS VERY APPRECIABLE
My current situation is
1)I do have vomiting during morning
2)high constipation(if feaces gose off on time my appitite increase)
3)burning at my back side
4)very weak feeling in my legs starting morning up to late morninig
5)i don't have any reflux acid
6)i don't have burninig or pain in my stomach
7)I have no any addiction to any drug or alcohol.
   sorry for my bad english.
   you can contact me through grmahun_2006***@****

[cari0]

I am having the same symptoms but no vomiting.  I am a 29 yr old female.  I wake up with a bad dull aching in my abdomin (abdomen) usually early in the morning and it's hard to get up because of the pain.  It feels like somebody has been kicking me all night in my sleep and like all of my internal organs around my rib cage are bruised.  My regular doctor ordered me to have blood drawn and tested for H.Pylori which was negative and my liver enzymes were normal.  He referred me to a Digestive Disease Center who ordered me an ultrasound and a UGI x-ray.  Both were normal.  I have a follow-up appointment to the same Digestive Center in an hour.  I don't know what they will do now.  I've read enough of these message boards that I have no faith in doctors finding anything wrong at all.  I'll keep you updated.

[chgr]

Thanks god,for all you and my nurse.After taking cimetidne and daiazepam what my nurse ordered i have no any vomiting and weakness during morning.but i do have filling unconfortable after eating meals and constipation.

[cari0]

The Doctor wants me to try taking Librax.  This medication prevents spasms in the muscles of the gut and bladder by relaxing them, and reduces the production of stomach acid.  I try to be positive, but truthfully I don't think this is it, but I will try it just to see.  It may just be one more thing I can rule out.  I would rather find out exactly what it is, and THEN treat the problem for what it is, but then how would these doctors successfully push us to bankruptcy?  Ughhh

[mosostow]

Hi,

With regards to the problem I posted, I found out the major causes of the worst parts of my symptoms were due to me taking somac (a proton pump inhibitor). After discontinuing it I feel 20 times better. Although I still occasionally get mild stomach discomfort (enough to keep me up some nights and making me cranky during the day) but not nearly as much as before. Mostly the symptoms don't keep me up any more.

the doctors and Specialist all think it may be stress related (I'm doing my postgraduate studies so this may have contributed). In fact, when I'm not as stressed my symptoms do subside somewhat.

But the thing that I think was causing the original symptoms to happen and being put on somac in the first place (which made my symptoms worse) is either food allergy or food intolerance. I've taken dairy and wheat completely out of my diet to see if I've built up some kind of intolerance to them. So far I haven't touched dairy for 2 days and the symptoms haven't come back so in the end it all might have started with lactose intolerance... but who knows, its only been 2 days so I'll see.

I'm also going to see a doctor or allergy specialist to check for allergies (food or other general allergies) because apart from having gastrointestinal symptoms, I also get headaches and itchy skin and dark circles under my eyes occasionally, so it could all be related.

Anyway, I hope this may given others with similar symptoms an idea of what to look out for.

[adamjm]

I have exactly the same symptoms as you. I also use to take a lot of codine+ibuprofin tablets. I have since discovered that the symptoms seem to be caused by my back problem which is Sciatica in the low back. If I treat the sciatica with external anti inflamatories and do excersises it seems to fix the abdominal issues. I am trying to get some more info regarding the link between back pain and abdominal discomfort and throbbing...

[Lindseystaff]

A related discussion, Gastritis? was started.