Stomach Pain, Nausea and Diarrhea

I'm a 42 year old woman, and until lately have been very healthy.  I'm not overweight, and I live a healthy lifestyle.

For the past six months or so, most of my bowel movements (which always occur in the morning) are very loose, or when not, are black and tarry.  In the last two months, I've started to have stomach pains (acid right in the middle of my stomach, but not resulting in reflux into my esophagitis) and nausea (but not vomiting).  This occurs about an hour or so after eating.  These "attacks" last on average for 3 hours, and are accompanied by bloating.  Nothing I do helps to lesson the pain/discomfort.  I just have to wait it out.  My doctor has perscibed Aciphex 20 mg 2x per day which has helped, but not prevented, these "attacks".

In the past fews weeks I've had blood work (normal), an ultrasound (normal), an upper pan (they found a gastic ulcer but don't think it can be the cause of my symtoms (symptoms)) and a colonoscopy (normal).  I recently had a CAT scan, but don't yet know the results.  

Are there any other tests I should have done?  My doctor doesn't feel my stomach pains are related to the diarrhea.  What could I have?

[Kevin Pho, MD]

I agree with the testing thus far, and it would rule out many of the major GI symptoms.  

The colonoscopy can exclude malabsorption or colitis.  I would also send off stool tests to exclude infection and malabsorption.  Blood tests can be done to exclude celiac disease.

The upper endoscopy is the most comprehensive test of the upper GI tract.  Further testing can include a 24-hr pH study to definitively exclude GERD, as well as a gastric emptying scan to evaluate for gastroparesis (which can lead to nausea).

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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com