Stomach problems

[garyland]

I am male, 53, non-drinker, non-smoker. I had my gallbladder removed in 1995. I recently had an ultrasound of the liver and pancreas with a follow up with a CT scan of the liver, pancreas, and biliary tree. My duct was 6mm and not dialated. All normal. I have been having stomach aches for about 2 months now which are not severe. It is more discomfort than a pain. It is more discomfort that pain. Sometimes I will get bloated with it. I may go a one to 3 days without any problems, and then have a problem for a day or two. The aches are usually between the bottom of the breast bone and the navel. Within the last few weeks I have been getting minor pain in the shoulder blade area. I have had heartburn for many years that comes and goes. But I find the PPI's and H2blockers after a few days to a week actually GIVE ME heartburn. Without them I can go a week or two with out any heartburn. I was thinking maybe CARAFATE would work. Does this sound like an ulcer? They checked me out for H-pylori (blood test) which came back negative about 3 weeks ago. If I take an Ativan it seems to help the stomach aches. I am concerned about this new back pain (I know it is not muscular)as well as the stomach aches. Coincidently, my 84 year old father is now sitting in the hospital with a bleeding ulcer. Any thoughts? Does it sound serious. I see the Gastro next week.

[Jester800]

Ok, I have been diagnosed with an ulcer in the stomach and irritable bowel, and gastro-reflux.  I have never been checked for these symptoms.  Just meds were administered.  I just wondered if anyone with the same probs. ever been associated with chest pain and what it could be?

[jdelectric]

my husband has been having problems with his stomach .. usually around 20 minutes after he eats .. his stomach gets upset.. and he gets diahharea  ..not with everthing he eats but mostly greasy foods is the worst. he can take a pepcid ac and it helps ..his stomach has gotten  more distended in the past  yr also where it makes him uncomfortable to bend over.  he is a big pepsi drinker .. and a truck driver .. i know the stress  and the diet schedule has a big factor to do with it .. eating habits..  if any one has suggestions.     i apprecitate it ...

[joujou]

I have had stomach aches ~but it's been all my life. The past few years it's increased...to the "severe" stage. Just recently as in..the last week, it's taken a different turn..to the same discomfort as Gary. I'm not starting to feel this bloating. There is tenderness that begins sternum/breast bone to the navel. At first I thought...perhaps..I cracked a rib. When I eat anything...this tenderness is inbetween the breast bone and navel.
With a sliding hiatal hernia....what is the treatment?

[tessa0825]

Hi, I was wondering if you had found out anything....Im happy that it turned out to not be real serious....Take care of yourself.....Tessa

[garyland]

Hi Tessa,

I appreciate your concern when you read my post. If I had your email address I would have thanked you personally. I just wanted to tell you that they finally found out what was causing my stomach aches and heartburn. They said it was partially all of the stress I have been under combined with having a SLIDING HIATAL HERNIA. At least I know it is nothing serius.

Gary

[Kevin Pho, MD]

Hello - thanks for asking your question.

There already has been significant discussion on this question.  I agree with what is said below - an upper endoscopy should be performed.  There are various causes of dyspepsia (i.e. upper GI discomfort) including an ulcer, inflammation of the esophagus or stomach or GERD.  The upper endoscopy would be the most comprehensive test to evaluate for this.  

You can also consider a 24-hr pH study to evalauate for the presence of GERD.

If the upper GI workup is negative, then you may want to consider other GI causes, including the pancreas or Sphincter of Oddi dysfunction.  With a normal CT scan, pancreatic problems is less likely - but I would obtain an amylase and lipase to make sure.

Sphincter of Oddi (SOD) dysfunction is more prevalent in those who have had their gall bladders removed.  Testing for this would include an ERCP with SOD manometry.  This possibility can be discussed with your gastroenterologist if all the other tests are not revealing.

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.

Thanks,
Kevin, M.D.

[tessa0825]

Gary, the ulcers were in my esophagus and the pains are varied and many....Most of my pains are around the sternum area or upper stomach, except for the painful swallowing, that definitely is in the esophagus.....Tessa

[GI.PA]

There are some individuals that have "acid-related disorders" without having typical heartburn/indigestion commonly refered to as GERD.  These include ulcer disease (for whatever reason..too much acid..too little protective enzymes in the stomach, NSAIDS (aspirin, aleve, motrin which degrade the protective enzymes)), or non-ulcerative dyspepsia (my stomach hurts like I have an ulcer but I have no visable ulcer...or my stomach is ultra-sensitive to normal levels of acid production.  

Patient with "acid related disorders" can present with a slew of symptoms including chest pain, upper ab pain, belching, nausea, cough, horseness..ect..So you can see that you dont have to have "heartburn" to have an acid problem.

A GI is the next place to go.  They may try a different combination of medicines related to acid suppression or may treat this more as a functional (increased stomach sensitivity or lack of sufficient stomach emptying).  No doubt an EGD (you are sedated, flexible lighted tube down your throat to look around in your stomach/esophagus)  If you have not had a colonoscopy this is the time to this as well (you are over 50 with stomach troubles..see if they will do them both at the same time) so you can approach this problem from both ends (no pun intended!..ok so maybe a little pun).

Erin
Gastro-Physician Assistant

[garyland]

Tessa,

Thanks for the help. I will definitely pursue this matter. I have an appt with the gastro for next Thursday (next week). I am sure he will want to scope me out. I will let you and others know what he finds.

Gary

[garyland]

Tessa,

I am a little confused. How can you have an ulcer from acid reflux unless the ulcers are in your esophegus? And did you have the Hpylori? As I do not.

Gary

[tessa0825]

I dont think you implied that at all, you listed it as one thing that you know you have...I just ran with it as Im known to do when it comes to reflux...However, from my (personal)experience with reflux it can cause and create many symptoms that people dont relate to it..Stomach pains being one of them. I also think people have a tendency to downplay reflux and as any good GI will tell you, acid-reflux can be resopnsible for many complications. You mentioned ulcers being one of your big concerns, I had three that were bleeding and cost me many days of hospitalization and transfusions, all caused from the damage of REFLUX  ...Im certainly no Dr. and you will get wonderful advise from the one that moderates this board...Good luck......Tessa

[garyland]

Thanks for the advice. I realy appreciate it. I hope in my question I did not give the impression that my heartburn is of the most concern to me. I have had HB my whole life from time to time and I treat it with TUMS which seems to work for me. My main concern is the stomach aches.

[tessa0825]

I hope your GI does an EGD so he can see exactly what might be going on..If it is acid-reflux or complications of such, he will find them.....Ive never heard of PPIs causing reflux, although I dont think they absolutely stop it either...They arent intended to stop reflux but rather slow or stop the production of acid in your stomache, if no acid then no acid reflux!!!...For severe reflux that isnt controlled with PPIs, sometimes they, GI spec, will try you on a motility drug such as Zelnorm, (i know its supposed to only help women) if you are male, there is new studies indicating that zelnorm may work as well in men as women for SOME GI disorders...Some Drs. thinking with zelnorm, reglan, etc. with reflux, is to push everything through your system so it isnt hanging around causing reflux....You could also ask about taking a GI cocktail...."lidocaine, donagel,and mylanta, sometimes bentyl"... for times when you are having a bad flare up, but it all depends on if you are experiencing acid reflux and complications or if your problems are something else all together...If your symptoms are caused from reflux and the meds dont help then you might want to talk to a surgeon about fundoplication surgery, however, make certain that you see a surgeon that has done many of these surgeries...... Just some ideas I wanted to share with you...Good luck...Tessa

[tessa0825]

No, I did not have H-Pylori my ulcers were caused from the damage that occured as a result of the acid refluxing, I had much scar tissue that also formed strictures that I have dialated approx every 4-6 wks, I am very avid at forming scar tissue.....I had extreme damage up to and including barretts esophagus with dysplasia..Im going to tell you something because Im going to assume that you dont take heartburn to be a serious symptom, none of us ever do....It was my only symptom for 30 yrs. then I couldnt swallow anymore without horrible pains and spasms....Thats when I finally saw a GI Spec. and found out all about untreated acid-reflux and symptoms and complications...I guess the best thing for you to do is to just see a GI Spec. and make sure you tell him about all the yrs. you are saying you've had heartburn and of course your other symptoms....Chances are it may be no big deal, but it could be...Tessa