Acute Sporadic Episodes of Severe Abdominal Pain

Following is my case, please see if anyone can help or relate:

I randomly get "periodic episodes" of severe stomach pains that occur roughly about 2-3 months apart, almost always a few hours (anywhere from 1-4) hours of having a dinner (that is, almost all episodes occur at night time right before or at about bed time); each generally lasting 7-9 hours on the average. There have been a few shorter episodes and a few much longer, with differing intensities but generally a typical episode on the pain scale level of 1-10, 10 being worst, starts at about level 1-4 with peaking at about pain level 7-9 for the most part of an episode and then suddenly diminshing after about 6-7 hours of severe duration.

Note, the pattern of each episode is almost always about the same from start to finish - a sensation (kinda "feel like") of some heaviness in the stomach, then gradual increase in pain in abdominal area (about half an hour to an hour after that "heavy feeling"), which then quickly shots up to a severe pain scale level 7-9 that would last most through the night and then eventually resolving on its own after about 5-8 hours of peaking.

During a typical episode what I experience, almost always in the same order of occurrence: (1) A feeling that an episode is about to happen, a few minutes to about half an hour right before it actually starts - (this is important to mention because this is an onset of an episode where my body alerts me to stop intaking any food/drinks of any sort; howeveer, this initial stage is also full of anxiety and mental pressure with an unpleasant "sixth sensation" of a sort, if you will, that I am about to start facing yet another night of restlessness; (2) A mild to severe pressure in stomach and general abdominal area, lasting for a few minutes to about half an hour, that would signal positive that the episode has now begun; (3) a wave of cyclical/sinusoidal pain wave that suddenly increases in intensity from severe to extreme; typical time duration for each sinusoidal pain-wave lasts about a 1-2 minutes duration each, a low-peak-low acute cycle of sharp stabbing/burning sensation and intense pressure in the general mid-abdominal area, lasting about 5-7 hours; (4) during the peak pain hours my stomach muscles/wall may harden several times for 5-10 minutes for each time; I may lay down, get up, kneel, crouch, fold in fetal position, walk, pace, rub/massage my tummy, and try to use toilet to allow me pass gas/stool or throw up to help lower the pain and to get some relief from constant churning going on in my belly; (5) a feeling of chill/cold occurs during the early hours of an episode, followed by mild to severe dryness in mouth, that eventually is followed by a bit of nausea and/or mild-to-severe burbs upon which I "make" myself to vomit that often yields positive in throwing up of whatever may had been leftover inside the stomach by then; (6) the pain generally peaks out after 5-6 hours of acute/sharpness in severity, eventually subdueing itself almost suddenly; (7) I finally able to go to sleep after about 6-8 hours of intense pain.

I am generally so tired and full of fatigue towards the end of each episode that I fall asleep in no time and wake up in the morning all fine as if nothing ever happened - with no pain or any signs of it!  Apart from being tired the morning after and having to cope with general fatigue throughout the next day due to the restlessness night, I am able to resume all functions just as normal like no problem - that is, normal eating and normal bowel movements!  

I must state, during these episode, I do not have any fever (despite feeling chills/cold), headache, backache, diarrhea, blood in stool/vomit or anything else of that sort. I make myself to go to the bathroom several times during an episode to see if that would help and I am able to go with normal bowel movement (while the pain in the belly is still going on) and pass normal stool - with no extraordinary smell, blood or any abnormal discoloration - suggesting that the issue is not with my large intestine (colon).  I strongly suspect that this whole thing occurs and is confined to my small intestine. However, no doctor, gastrointestinal specialist, and even expert surgeons have been able to diagnose or detect any problem with any of my organs or digestive tract.  

I have had all sorts of blood and stool tests, ultrasounds, x-rays, colonoscopies, endoscopies, barium swallows, tests at the best-of-the-best hospitals and by the best-of-the-best specialists in my area but, alas, yet all to none avail. I do have insurance despite of which it has still cost me several thousand dollars in deductables.

I have had tried maintaining a food diary to isolate if there may be an issue with my diet, an unknown food borne allergy or malabsorptions, but, that too had not been helpful except to suggestively (but not conclusively) suspecting some ingredients such as certain fruits and veggies, etc, that perhaps may be the culprits. However, none of those suspected food items can be positively identified to be the actual culprits because some episodes had occurred even in absence of the suspected ingredients!

As a subject for a case-study: I am (otherwise) a healthy adult male with healthy lifestyle and normal dietary habits. I don't smoke, don't drink, nor eat/abuse junk/fast food nor go on eating binges. My preferred choice of drink is simply plain cold water. I avoid all sorts of sodas, sugary/salty drinks/snacks, and coffees etc. as much as possible. I do take a cup of hot black tea every morning and occasionally a glass of plain low-fat milk at bed time. I, in fact, have what known to be a balanced/healthy dietary lifestyle. It has been ruled out that I do not have intolerance to dairy, eggs, cheese, wheat/breads, cereals, etc.  I prefer chicken and fish over red meat, however, I have not shown any signs of indigestion after eating a meal containg beef or lamb meat.  I do get some stress on times but generally it's no more than any guy next to me and probably just what an average healthy normal adult would get during a working week. I do get to relax and excersize time to time (but not as regularly as I used to some years ago) since I pack quite a busy daily routine that does not allow me to even think or feel about having any extraordinary level of stress.

My stomach problom started about two and a half years ago (October 2009) and has been so typical in its recurring patterns that, by now, I have become accustomed to handling each occurrence as to just endure the pain through the whole night rather than rushing to an ER or going to see a doctor about it.  That said, it is still quite troubling (and annoying!) when it occurs and I have not (yet) lost all hope in finding a cure for it.  If anyone else out there suffering with similar issue(s), please kindly share. Thank you so very much.

[margypops]

Ask the doctor to do a Heavy Metal test to see if there is anything toxic in your system .

[Sechmeth]

I have three things you can try.
First: a dietary intervention. if you have a problem in your small intestine, it can be bacterial, fungal or even parasitic in origin (I would say parasitic, since you say it is cyclic, and the hot, stabbing, burning pain you describe.). All three just love sugar and starch. Look up special carbohydrate diet, which was invented for crohns and is very low on carbs. It might help at least to manage the symptoms.
Second: Get a scotch tape test done, which tests for pinworms/threadworms (enterbobiasis). This is the parasite I suspect always first, since it is so common and highly infective.
Third: if you dont believe its a parasite, look up metametrix. They have a great stool test which is called GI profile, where they test for EVERYTHING. They look for probiotics, bug and parasite DNA, inflammation markers etc. It is expensive, but it picks up so much more than any normal stool test. I have done it after they told me it was all in my head, and I got my diagnose, and my life back.

Good luck!

[mintfloss]

I was curious if you have found an answer yet for your mystery abdominal pain. it seems very similar to what my daughter is going thru.

[Letz222]

I have been searching and searching the web for answers to the exact same problem you are going through!  In fact I feel like I"m dying right now going through an acute episode.  You described it to a tee.  I've gone through multiple tests, had my gall bladder out and still have episodes.  Have you found any answers?  One of my possible suspects might be MSG allergy.  Not the classic symptoms but find that these terrible pains (same onset like you with the flushing then extreme bloating followed by intense pain for 8 - 10 hours into the night) usually happen after eating asian food so I suspect possible MSG?  the other thing that kills me is even small doses of aspartame.  not sure if it's related but that's what I'm currently looking for in my foods.  I don't always suffer after eating asian food but more than likely a buildup then a HUGE attack.   if you come up with anything else please let me know as I too want to stop suffering!

[sheniy]

Im going thru the same thing!! Its horrible... Iv just had an 'episode' and its so weird that when it stops for a bit i totally forget the pain i was just in!? Mine seems to happen when im not hungry, but havent eaten for a whlie( Due to my work)... Doctors have no clue these days and we really need to know what this!!! I also started to have really bad hangovers lol which never happened b4 all this :-/
So glad iv found this so thread :) im not alone at least

[Maxere]

My first episode occurred about 5 years ago which laid me out for 12 hrs or so. Second came on a year later. I had a gall bladder scan which confirmed a stone was present so the episodes were put down to a fragment blocking the bile duct temporarily. I still have my gall bladder & stone. Later episodes occurred with months or weeks in between. They always happen after about 6 hours from eating and last several hours. Its very worrying but a day after I'm pretty much back to normal and the urge to eat overcomes the fear of more pain. I put these episodes down to my gall bladder duct being temporarily blocked by the stone within temporarily upsetting the balance for proper digestion ie acid levels to high in the  small intestine. I am 76 years old & male, reasonably fit & active.

[Carolyn521961]

What you describe is very similiar to what I have been going through for the past 4 months. I've had an upper GI test with biopsies of my stomach and smaller intestine to rule out ulcers. Had a colonoscopy. Had my gallbladder removed. Had blood work to rule out bacteria and stool work to rule out parasites. Am now on probiotics and will go back on Nexium.

My burning stomach pain always starts 4 hours after I eat lunch (my first meal of the day) and lasts 6-8 hours. I've charted all that I eat and the medicines I have tried to reduce the pain, and the timing, duration, and pain level on my scale of 1-10. I do not eat during the pain and sometimes eat a small meal after then immediately go to sleep because I'm so worn out. I sleep well and wake with no pain. I usually wait 4 hours until I eat lunch, so I'm pain free for 8 hours during the day.

Sometimes I try to take 'a day off from pain' by not eating, and still around 4 pm the burning stomach pain starts. The daily late afternoon/evening pain has completely taken over my life and I have had to cancel all social events.  

[msdee139]

I am wake up with a sharp hunger pains and even when I eat about an hour later I'm hungry again! And when I don't eat at that time I feel like I'm going to vomit. My stomach feels like a sharp pain that seems to me to go to the core of my stomach when it strikes it makes me wonder if it's a ulcer but the systoms are not all there for me to say its a ulcer. Now when the pains hit it makes me feel like i want to throw up.  But I don't it's like nausea and i' have been searching before I go to the doctor on this week. Now maybe once I felt this sensation in the back of my throat that made me think it might be associated with heart burn. Help any answers to my problem