Help, abdominal pain

[MarkUSA]

I'm 29 years old, I've had upper middle abdominal pain for about 3 months strait.  It feels like somebody punched me in the gut a couple minutes ago and the pain won't die out.  Sometimes I think eating large meals may help slightly, but not always in a significant way. It seems like I'm fairly constipated or have normal bowels for a few days then I'll have sharp cramps in my lower abdomen and have diarrhea for half a day or so, then it's back to just the constant upper-middle abdominal pain.

I had a normal abdominal ultrasound and bloodtests, but my upper gi series showed "some kinda of inflammation" The doctor who I've been seeing referred me to a gastroenterologist who "can not" see me for FOUR MONTHS and their office won't overbook me and when I call to complain of pain to my doctor they basically ignore me and tell me to keep taking Prilosec

I would like to know:  
1) Do you think I would be irrational and do you feel it's necessary to start making stronger demands to my doctor
2) what do you say could be my differential diagnosis given symptoms and inflammation on upper gi series?  (aparently the inflammation was in the duodenum I believe).  
3) Should I be able to get an ECD or other tests I need if I just go to a major ER?  
4) Should I have an abdominal CT?
5) Does the upper gi series differentiate between ulcers, tumors, cancer and other inflammations (ie-would they have known it was an ulcer based on the upper gi series or not).

[Kevin Pho, MD]

To answer your questions:
1) If the symptoms continue, further testing may be indicated.  An upper endoscopy can be discussed as the next step.

2) Gastritis or duodenitis can lead to upper GI discomfort.  This is inflammation of the lining of the GI tract, and can be associated with a bacteria known as H Pylori.  A blood test for this can be done, and appropriate antibiotic therapy given if present.

3) Not necessarily.  If it is determined that the symptoms aren't life threatening, they may simply schedule the EGD electively.

4) Yes, but it is not 100% accurate.  An EGD (upper endoscopy) would be a more comprehensive test.  This is what I would suggest if the symptoms continue.

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_

[MarkUSA]

Inflammation in the duodenum.