Chronic Stomach and Abdominal Pain (mornings)

[paulath]

Nearly every morning for the past year or more I have awakened with dull pain in either my stomach or lower. It always goes away completely after I get up and move around. I am a 48 year old female, 5' 6" and 130-135 pounds. I have had problems with gastritis and reflux in the past. I generally eat a healthy diet except I don't get enough green vegetables. I drink moderately (wine only) and have never smoked. My doctor told me to give up wine, aspirin and advil, and coffee when I described my symptoms. I don't believe any of those to be the cause, since coffee is the only one I consume nearly every day, and giving it up temporarily did not help. The pain seems to move slowly from the stomach into the lower intestinal tract (one morning it will be in my stomach, the next lower), and may be related to my bowel movements (though whether or not I am "regular" seems to have little effect). I get plenty of exercise - I use a pedometer and average 20,000 steps a day. Any idea what may be causing this?

[Kevin Pho, MD]

Tough to say without evaluation, however there are plenty of possibilities.  This can include GERD, an ulcer, inflammation of the upper digestive tract, liver/gallbladder problems, or irritable bowel disease.  

I would consider an upper GI series or upper endoscopy to evaluate the upper digestive system (looking for GERD or an ulcer).  Blood tests for a bacteria known as H Pylori (associated with inflammation or an ulcer) can be considered.  

If these tests are negative, you can then consider an abdominal ultrasound to look at the liver and gallbladder.  

If there is an association with change in bowel habits, you can consider irritable bowel disease as a diagnosis and optimize treatment for this condition.

You can discuss these options with your personal physician or in conjunction with a GI evaluation.

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.
Medical Weblog:
kevinmd_b

[paulath]

I forgot to mention I also have frequent gas and bloating.