Irritated stomach after ingesting alcohol, spicy food, and NSAIDs

[popdoc]

Patient profile: 24 y/o male with no previous medical history; formerly a light smoker and current social drinker

I have been having the following symptoms for about a year now associated with alcohol intake, eating spicy food (or even seasoned with small amounts of pepper or garlic), and NSAIDs:

- Gurgling/slight burning pain in the epigastric region lasting for up to 2 weeks after ingestion of alcohol/spicy foods/NSAIDs
- Occasional reflux (no heartburn, however)
- Symptoms are worst when hungry

Additional info & history:

- Pain usually starts with some delay after ingesting the above, sometimes as much as 1 or 2 days later
- Having a hard drink on empty stomach causes severe, debilitating pain the next day
- Had an endoscopy done about 6 months ago which showed nothing. A biopsy obtained during the endoscopy showed no H. pylori infection. No ulcer was found in either stomach or upper duodenum, and there was no visible inflammation of the stomach wall
- Have tried the following with very limited success: omeprazole OTC (20mg) by itself, sucralfate by itself, and currently on a combination of sucralfate and esomeprazole (40mg); these therapies have reduced the gurgling slightly, but have far from gotten rid of it
- I have tried avoiding the triggers (alcohol, seasoned food, NSAIDs) a few times and the symptoms have gone away; however, as soon as I ingested even a tiny amount of the irritating substance, the sympotoms came back with full force
- I have not experienced any black or tarry stools, nor any changes in my stool movements.

Although I am consulting with health providers on this, no one has made a definitive diagnosis. My own belief is that it's either GERD or functional dyspepsia. The most troubling part is that no cause can be found even when the symptoms are present, not even an inflamed stomach lining despite the irritants being clear.

Although the symptoms are tolerable, my primary concern is that the continuation of this disorder may lead to a more serious disease down the road. If having to choose complete abstinence from the above-mentioned irritants or the presence of symptoms without diet modification, I'd rather go with the latter. The only factor that may convince me otherwise would be the development of a more serious disease. This means that a definitive diagnosis would be helpful (as in, GERD increases cancer risk, functional dyspepsia does not).

Any help or suggestion with how to proceed would be helpful. Should I go for another endoscopy? Should I consider getting a colonoscopy?

[Flycaster305]

You wrote: " Although the symptoms are tolerable, my primary concern is that the continuation of this disorder may lead to a more serious disease down the road."
Of course it will.  When I was your age, I would have ignored it, too.  I'd suggest eating something before drinking, as drinking on an empty stomach seems troublesome to you.  Think about mixing in red wine rather than hard spirits, and eat a bagel prior to ingesting alcohol.  Simply stay away from high fat foods like pizza, fried and burgers.  It's not complicated, just common sense.  Also take your drugs exactly as prescribed.  If you take them willy-nilly, they will just produce expensive urine.  Keep us informed.

[selmaS]

  Hi and welcome to the GERD forum.

There is no easy way to treat this but to listen and re read ur own statements, u had severe stomach pains while drinking hard alcohol on an empty stomach....alcohol is something we r told to avoid when having issues like these as well as spicy foods, u seem to know what ur triggers are.....many times avoidance need only been done until u have it under control and then in moderation u should be  able to consume some of the items u like....u have the power to keep this in check so nothing further develops....and the power to allow it to grow...meds will not stop it if u continue to agitate it ....

This is ur choice....also look to see if u have a lot of stress as it can also be a trigger.

Good luck to u.