Intense Upper-Middle Stomach Pain

[BPL]

I am a 36 y.o. white male. I've been suffering from chronic acid reflux for several years now.(Aprox. 9 years with increasing severity/frequency). I recently had a barium (upper) x-ray study which did not reveal a hiatal hernia, but did show acid reflux. I am scheduled for an endoscopy next month. I am most concerned about a problem that I have been getting for the last few years which my gastroenterologist has not addressed as yet. I go through my day/night normally and go to bed. Sometime in the night I wake up with extremely intense pain in  my upper, middle stomach area, in the solar plexus region, and suffer with that pain for several hours, which is then followed by diarrhea. These episodes occur usually only 2 or 3 times a year, though their frequency lately seems to suggest they are trying to occur more often. I typically have what I consider to be "normal" bowel function. No noteable problems with constipation or diarrhea other than the above stated. If the episodes are related to specific food/drink consumption, I have as yet been unable to recognize a definite pattern or culprit. The most recent of these episodes occurred last night after a fairly large meal that included the consumption of alcohol. Additionally, I did wake up first with acid reflux trying to come on and then the episode ensued after. The pain is best described as an intensely painful cramping sensation that comes in waves. It will cramp and pain for aprox. 1 minute followed by about a minute of let-up. I will stand in the shower and run hot water which seems to help it and me relax. I get out of the shower when I think I'm improved, but then bend to get a towel or something of that nature and the pain starts again. Any suggestions or insight into the matter is appreciated at this point as I await future follow-up with my doctor. I did make my doctor aware of this issue on my last visit. Other than scheduling the endoscopy no verbal explanation or insight was offered on what I might be experiencing with these very painful nighttime episodes. Thank You. BPL

[Kevin Pho, MD]

The upper endoscopy a reasonable next test to pursue.  This can comprehensively evaluate for a variety of upper GI disorders that can lead to your symptoms - including an ulcer, inflammation of the upper digestive tract or anatomical abnormalities.

If GERD continues to be a problem, you can consider a 24-hr pH study to document its severity.  If medications do not help the symptoms, you can consider endoscopic or surgical treatment to help.  

Other possibilities can include the gallbladder or pancreas - which can be evaluated with an ultrasound or CT scan.  

More atypical causes such as gastroparesis or esophageal motility disorders can also be considered and tested for if clincally suspected.  

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

Kevin, M.D.
http://www.straightfromthedoc.com

[sarikate]

Have you ever had an abdominal ultrasound?  Gallstones can cause intense, intermittent pain like you describe, as well as nausea and/or vomiting.  Abdominal ultrasound is extremely effective in detecting them and is a very easy test.

[yoshi]

HAVE YOU BEEN TESETED FOR HECTOR PYLORI BACTERIA??

[BPL]

No H.Pylori test as yet, and no ultrasound or ct scan. So far I do not experience any stomach upset or vomiting, just the cramping pain in waves in my upper center abdominal region followed by diarrhea. Thanks for the suggestions. Hopefully my doctor will be willing to track down every lead until a definite diagnosis is made.

[versute]

Are you on any acid reflux medication?  If so, I would strongly suspect that as the cause.  I had the same sensations it sounds like, and I determined(note "I", not my doctor(s)) that the medication could be causing it, as abdomenal (abdominal) pain is listed as a side effect of Prevacid.  I backed off the Prevacid for a couple days, and the pain went away.

[Jesterwitch]

Wow- this sounds exactly like what I've been having over the past 3 months.  I've been getting about 2 "episodes" a month and they range from mild crampy waves in the upper mid stomach area to really painful- enough where I've actually vomited from it.  I'm going to a gastro secialist at the end of next month, and I assume they'll set up an endoscopy. My mother says this sounds like what she has as well; she has a hiatal hernia and acid reflux.  The way she had it explained to her was that acid gets back up the espohagus causing these spasms, which creates the pain we seem to be having.  
I've been using Mylanta before I eat to coat my stomach and am taking 40 mg of Nexium a day.  I've been on Nexium for about a year though, and these "attacks" just started a few months ago, so I'm not sure it's helping!  When I do start getting the pain, I usually take a big swig of Mylanta and a Xanax (I use it on an "as needed" basis for anxiety and now, conveniently, for this) and sometimes sipping hot water helps.  Mostly I just have to ride it out for the 1-3 hours it lasts.

If I find out anything helpful from the gastro doc, I'll be sure to post it, but my appointment isn't til November 30.

[tuff case]

I had nasuea and upper abdominal pain.  I many test endo., colon, ultrasound, CT, gatric emptying CT, different blood work up for liver, cancer..  It sounds as though you may just be begining and hopefully they can find what the problem is in your first round of tests.  I then had an ERCP and had my bilinary duct cut this is call SPHINCTER OF ODDI DYSFUNCTION.  This is normally causes by a gall stone that passes through the duct and damages it, only I had my gall bladder out many years prior to this diagnosis, also the pain continued and I had to have another one done at a University hospital where they could measure the pressures being built up on the Biliary duct/valve and the pancreatic valve,  and during the second both valves were cut again.  After each of the tet the Dr. wanted me to believe it was all IBS and due to stress.  After the second ERCP, a year and 2 months later, I was relieved of the abdonminal pain.  I say this just to say do not give up.

Good Luck, Amelia

[jed24]

I am very excited to hear about your symptoms, not that I would wish the pain on anyone, but that it tells me I am not crazy, I have been experiencing the same pain for a little over a year. My description is more related to the feelings of contractions prior to child birth, it comes and goes like a contraction for selveral hours usually at night, and for me nothing helps. The first time it happened I went to the ER becuase I thought there might have been a complication from my third child which I had had 3 weeks prior, The doctors focused more on my gallbladder area because i had that removed 4 years prior and they thought there may have been stones still remaining, or something going on with the scar tissue, after some blood and urine tests they did an altrasound and found nothing abnormal with any of the test, so they gave me pain meds and sent me on my way.........I followed up with a GI doctor who did an ERCP and agin found nothing.
  I don't know what to do anymore, the pain still comes about every six weeks or so, and the doctors can't figure it out, and I guess knowing someone else is having it gives me hope that there wil eventually be a diagnoses and a treatment. I have just been trying to deal with it when it happens, and if it gets too bad I drive to the ER, since the occurences seen to only happen at night when the doctors offices are closed, I don't feel like the doctors are really listening to me, so I havent gone back to the GI doctors, but if I am able to get an idea of whats going on maybe I can bring that the doctors for more specific testing........please update me if you are able to get a diagnoses, or anyone for that matter..
thanks,
Jen
dugan_J21***@****

[katch]

A related discussion, Same here! was started.