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Digestive Disorders / Gastroenterology Forum
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Stomach Pains


  Hi, I am 39 year old female with congestive heart failure, a-fib,
  single lead pacemaker and stroke in 2-95.
  This past week, I have developed intense stomach pains that range
  from belly button up to breastbone area.  After these pass, I still
  am extremely sore in that area.  Several days, I have also had diarrhea.
  In between these times I develop a series of symptoms we've come
  to call the "cold clammies"  My skin becomes flushed and ice cold
  to the touch, yet I sweat profusely around my head and neck.
  Since my  symptoms come and go it is impossible to be at the doctor
  or hospital when they happen.  Besides, the PCP on my HMO is
  without a clue about anything.
  My current meds are coumadin, lasix, monopril, K-dur, slo-mag,
  lanoxin, coreg and aspirin daily.  I have been on these meds several
  years so I don't feel like they are causing my problems, Thanks!
____________
Dear Lisa,
I was surprised to read that by age 39 you have already had congestive heart failure, a-fib, a single lead pacemaker and stroke.  The cuase for this cardiovascular problem could also be implicated in the development of your abdominal pain.  As initial evaluation you would probably benefit from x-ray studies to exclude structural abnormalities of the gastrointestinal tract.  If your condition permits, you should have a barium enema and an upper Gi with small intestine x-ray.  If these tests are normal, then pancreatic disease should be excluded.  Blood tests and a CT scan of the abdomen will evaluate the pancreas as well as other retroperitoneal structures. Gastroparesis should be comsidered if you have a history of diabetes or thyroid disease.  If a cause is still not found, one must consider mesenteric ischemia.  This is a condition in which the intestine does not get enough blood when working i.e.during digestion.  Mesenteric ischemia can be subtle in presentation.  The classic symptoms are  pain with eating that leads to reduced food intake and weight loss.  Sometimes, patients may have only weight loss as the problem.  Rarer presenting complaints are vomiting and nausea.  If your symptoms are thought to be related to ischemia, then you will need a mesenteric angiogram to exclude the diagnosis.
This information is presented for educational purposes only.  Always ask specific questions to your personal physician.
HFHSM.D.-rf
*keywords: abdominalpain, mesenteric ischemia
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