Sharp Abdominable Pains

[Rhythmstrummer]

I have recently been suffering from chronic abdominable pain a few tines a week for the past 6 weeks. Recently, I was drinking a glass of Apple Juice before I left for school when a sharp pain in my stomach/abdomin. This caused me to double over and I've had a slight, acute pain in my abdomin since. Any ideas on what may be the cause of my pain and what I can do to treat it?

[J T Junig, MD PhD]

Yes- as J said, an abdominal pain workup is a complicated venture that considers the organs, the abdominal wall, the fascia, the vascular supply- the likelihood of different conditions will depend on your age, other illnesses, etc.

I doubt that drinking apple juice would induce sudden pain;  it may have been a coincidence.  I say that because the lining of the stomach includes a thick mucous coating over cells that are resistant to strong acid;  if you have an ulcer, perhaps the juice could induce pain from the acidity of the juice, but if that were the case you would be doubled up in pain all the time, as the normal acid released in the stomach is much stronger than apple juice.

This is a good time to point out that in this forum I am really meant to take on questions of 'chronic pain'-- which for the most part are pains which have been through a work-up and usually diagnosed.  When a person goes to a chronic pain clinic with abdominal pains, they are referred to a surgeon or gastroenterologist to do a work-up and diagnose the condition-- this is a MANDATORY step, since there are things that can cause abdominal pain that can kill a person.  For example, if this writer actually has gastric ulcers, there is the risk of perforation, or of the sudden erosion of the ulcer into a major blood vessel, causing a 'GI Bleed'.  

So what AM I good for, you ask?  If this person has had the work-up and found that he has chronic pancreatitis, I could give you some treatment ideas.  I am going to repeat this point a few times in posts asking for diagnostic information for a couple reasons;  the first is because in most cases I would just be guessing. If a doc who examines you, checks your labs, and looks at your x-rays doesn't know what is going on, I won't either!  But more importantly, asking us docs on the internet to come up with a diagnosis could potentially delay finding out the cause of your problem-- and as I said, a delay can sometimes be dangerous.  Please, everyone, do not be offended if I reply in this way.... consider taking your question to a person dealing with 'acute' issues, but also consider finding a good doctor to actually see and examine you, and find out what is going on.

[Jaybay]

Dr. Junig (or anyone else) really needs more information to even venture a guess.  Is the pain on the right or left side; is it upper or lower?  Is it sharp or dull?  Does anything make it better like over-the-counter antiacids?  Does eating make it better or worse?  Does the amount or type of food you eat make a difference?  Have you noticed any changes in bowel or urinary habits?

Your pain has gone on long enough to warrant a visit to your doctor.  The more information you can give him, the better your chances of diagnosis.  If he palms you off with an instant diagnosis of IBS, dump him and go to a different doctor.  IBS is a diagnosis of exclusion, which means every other medically known cause has been tested for and/or ruled out.  Instantly diagnosing IBS without even considering other problems is a sign of a lazy doctor.

In the meantime, you might try Prilosec over-the-counter for a couple of weeks.  If it helps, that information can also help your doctor with a diagnosis.