I don't know what is wrong with me.

For about 6 months I have been living with the following symptoms: upper stomach pain, lower back pain, frequent urination, belching.  The symptoms always appear in conjunction with one another - never by themselves.  My doctor thought it was GERD and put me on Protonix.  I began feeling better, but had a relapse.  I have had an Upper GI, esophogram, H pylori test, but all have been negative.  The symptoms are worse in the morning and seem to get better when I eat something or drink milk.  Belching also helps to relieve the pain, though only momentarily.  The symptoms usually last for about 2 weeks and then I have a few days where I feel perfectly fine.  My doctor has recommended that I have a pelvic ultrasound to check for ovarian cancer since he cannot figure out what else it might be.  He has also changed me over to Nexium.  I am worried about not knowing what this is.  My father has suffered his entire life with stomach ulcers and my older brother was just diagnosed with Barrett's.  What might I have?

[Kevin Pho, MD]

Hello - thanks for asking your question.

I'm not sure if all the symptoms are related.  Your upper stomach pain is suggestive of dyspepsia (i.e. peptic ulcers, gastritis, GERD, esophagitis).  Other causes would be biliary pain, pancreatitis, cancer, or irritable bowel.  You have had an upper GI, esophagram, and H Pylori - all negative.

I would suggest an upper endoscopy.  This is the most definitive test - it can pick up things that are missed by the barium tests you had.  

Another test to consider would be a 24-hr pH study.  This is to test GERD.  If you are continuing to have discomfort despite nexium/protonix then a definitive diagnosis of GERD may lead to surgical options.

If everything continues to be negative (i.e. negative endoscopy, 24-hr pH test etc.), then I would consider either an abdominal ultrasound to evaluate for gall bladder disease or CT scan to evaluate the pancreas.

In terms of the frequent urination/back pain a urine test to evaluate for infection or a kidney ultrasound (looking for cysts or masses) would be reasonable next steps.

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.