Gastroenterology Community
31.6k Members
Avatar universal

Acute Sporadic Episodes of Severe Abdominal Pain

Following is my case, please see if anyone can help or relate:

I randomly get "periodic episodes" of severe stomach pains that occur roughly about 2-3 months apart, almost always a few hours (anywhere from 1-4) hours of having a dinner (that is, almost all episodes occur at night time right before or at about bed time); each generally lasting 7-9 hours on the average. There have been a few shorter episodes and a few much longer, with differing intensities but generally a typical episode on the pain scale level of 1-10, 10 being worst, starts at about level 1-4 with peaking at about pain level 7-9 for the most part of an episode and then suddenly diminshing after about 6-7 hours of severe duration.

Note, the pattern of each episode is almost always about the same from start to finish - a sensation (kinda "feel like") of some heaviness in the stomach, then gradual increase in pain in abdominal area (about half an hour to an hour after that "heavy feeling"), which then quickly shots up to a severe pain scale level 7-9 that would last most through the night and then eventually resolving on its own after about 5-8 hours of peaking.

During a typical episode what I experience, almost always in the same order of occurrence: (1) A feeling that an episode is about to happen, a few minutes to about half an hour right before it actually starts - (this is important to mention because this is an onset of an episode where my body alerts me to stop intaking any food/drinks of any sort; howeveer, this initial stage is also full of anxiety and mental pressure with an unpleasant "sixth sensation" of a sort, if you will, that I am about to start facing yet another night of restlessness; (2) A mild to severe pressure in stomach and general abdominal area, lasting for a few minutes to about half an hour, that would signal positive that the episode has now begun; (3) a wave of cyclical/sinusoidal pain wave that suddenly increases in intensity from severe to extreme; typical time duration for each sinusoidal pain-wave lasts about a 1-2 minutes duration each, a low-peak-low acute cycle of sharp stabbing/burning sensation and intense pressure in the general mid-abdominal area, lasting about 5-7 hours; (4) during the peak pain hours my stomach muscles/wall may harden several times for 5-10 minutes for each time; I may lay down, get up, kneel, crouch, fold in fetal position, walk, pace, rub/massage my tummy, and try to use toilet to allow me pass gas/stool or throw up to help lower the pain and to get some relief from constant churning going on in my belly; (5) a feeling of chill/cold occurs during the early hours of an episode, followed by mild to severe dryness in mouth, that eventually is followed by a bit of nausea and/or mild-to-severe burbs upon which I "make" myself to vomit that often yields positive in throwing up of whatever may had been leftover inside the stomach by then; (6) the pain generally peaks out after 5-6 hours of acute/sharpness in severity, eventually subdueing itself almost suddenly; (7) I finally able to go to sleep after about 6-8 hours of intense pain.

I am generally so tired and full of fatigue towards the end of each episode that I fall asleep in no time and wake up in the morning all fine as if nothing ever happened - with no pain or any signs of it!  Apart from being tired the morning after and having to cope with general fatigue throughout the next day due to the restlessness night, I am able to resume all functions just as normal like no problem - that is, normal eating and normal bowel movements!  

I must state, during these episode, I do not have any fever (despite feeling chills/cold), headache, backache, diarrhea, blood in stool/vomit or anything else of that sort. I make myself to go to the bathroom several times during an episode to see if that would help and I am able to go with normal bowel movement (while the pain in the belly is still going on) and pass normal stool - with no extraordinary smell, blood or any abnormal discoloration - suggesting that the issue is not with my large intestine (colon).  I strongly suspect that this whole thing occurs and is confined to my small intestine. However, no doctor, gastrointestinal specialist, and even expert surgeons have been able to diagnose or detect any problem with any of my organs or digestive tract.  

I have had all sorts of blood and stool tests, ultrasounds, x-rays, colonoscopies, endoscopies, barium swallows, tests at the best-of-the-best hospitals and by the best-of-the-best specialists in my area but, alas, yet all to none avail. I do have insurance despite of which it has still cost me several thousand dollars in deductables.

I have had tried maintaining a food diary to isolate if there may be an issue with my diet, an unknown food borne allergy or malabsorptions, but, that too had not been helpful except to suggestively (but not conclusively) suspecting some ingredients such as certain fruits and veggies, etc, that perhaps may be the culprits. However, none of those suspected food items can be positively identified to be the actual culprits because some episodes had occurred even in absence of the suspected ingredients!

As a subject for a case-study: I am (otherwise) a healthy adult male with healthy lifestyle and normal dietary habits. I don't smoke, don't drink, nor eat/abuse junk/fast food nor go on eating binges. My preferred choice of drink is simply plain cold water. I avoid all sorts of sodas, sugary/salty drinks/snacks, and coffees etc. as much as possible. I do take a cup of hot black tea every morning and occasionally a glass of plain low-fat milk at bed time. I, in fact, have what known to be a balanced/healthy dietary lifestyle. It has been ruled out that I do not have intolerance to dairy, eggs, cheese, wheat/breads, cereals, etc.  I prefer chicken and fish over red meat, however, I have not shown any signs of indigestion after eating a meal containg beef or lamb meat.  I do get some stress on times but generally it's no more than any guy next to me and probably just what an average healthy normal adult would get during a working week. I do get to relax and excersize time to time (but not as regularly as I used to some years ago) since I pack quite a busy daily routine that does not allow me to even think or feel about having any extraordinary level of stress.

My stomach problom started about two and a half years ago (October 2009) and has been so typical in its recurring patterns that, by now, I have become accustomed to handling each occurrence as to just endure the pain through the whole night rather than rushing to an ER or going to see a doctor about it.  That said, it is still quite troubling (and annoying!) when it occurs and I have not (yet) lost all hope in finding a cure for it.  If anyone else out there suffering with similar issue(s), please kindly share. Thank you so very much.
101 Responses
535822 tn?1443980380
Ask the doctor to do a Heavy Metal test to see if there is anything toxic in your system .
Avatar universal
I have three things you can try.
First: a dietary intervention. if you have a problem in your small intestine, it can be bacterial, fungal or even parasitic in origin (I would say parasitic, since you say it is cyclic, and the hot, stabbing, burning pain you describe.). All three just love sugar and starch. Look up special carbohydrate diet, which was invented for crohns and is very low on carbs. It might help at least to manage the symptoms.
Second: Get a scotch tape test done, which tests for pinworms/threadworms (enterbobiasis). This is the parasite I suspect always first, since it is so common and highly infective.
Third: if you dont believe its a parasite, look up metametrix. They have a great stool test which is called GI profile, where they test for EVERYTHING. They look for probiotics, bug and parasite DNA, inflammation markers etc. It is expensive, but it picks up so much more than any normal stool test. I have done it after they told me it was all in my head, and I got my diagnose, and my life back.

Good luck!
What was your diagnosis?
Avatar universal
I was curious if you have found an answer yet for your mystery abdominal pain. it seems very similar to what my daughter is going thru.
Avatar universal
I have been searching and searching the web for answers to the exact same problem you are going through!  In fact I feel like I"m dying right now going through an acute episode.  You described it to a tee.  I've gone through multiple tests, had my gall bladder out and still have episodes.  Have you found any answers?  One of my possible suspects might be MSG allergy.  Not the classic symptoms but find that these terrible pains (same onset like you with the flushing then extreme bloating followed by intense pain for 8 - 10 hours into the night) usually happen after eating asian food so I suspect possible MSG?  the other thing that kills me is even small doses of aspartame.  not sure if it's related but that's what I'm currently looking for in my foods.  I don't always suffer after eating asian food but more than likely a buildup then a HUGE attack.   if you come up with anything else please let me know as I too want to stop suffering!
Avatar universal
Im going thru the same thing!! Its horrible... Iv just had an 'episode' and its so weird that when it stops for a bit i totally forget the pain i was just in!? Mine seems to happen when im not hungry, but havent eaten for a whlie( Due to my work)... Doctors have no clue these days and we really need to know what this!!! I also started to have really bad hangovers lol which never happened b4 all this :-/
So glad iv found this so thread :) im not alone at least
Avatar universal
My first episode occurred about 5 years ago which laid me out for 12 hrs or so. Second came on a year later. I had a gall bladder scan which confirmed a stone was present so the episodes were put down to a fragment blocking the bile duct temporarily. I still have my gall bladder & stone. Later episodes occurred with months or weeks in between. They always happen after about 6 hours from eating and last several hours. Its very worrying but a day after I'm pretty much back to normal and the urge to eat overcomes the fear of more pain. I put these episodes down to my gall bladder duct being temporarily blocked by the stone within temporarily upsetting the balance for proper digestion ie acid levels to high in the  small intestine. I am 76 years old & male, reasonably fit & active.
Avatar universal
What you describe is very similiar to what I have been going through for the past 4 months. I've had an upper GI test with biopsies of my stomach and smaller intestine to rule out ulcers. Had a colonoscopy. Had my gallbladder removed. Had blood work to rule out bacteria and stool work to rule out parasites. Am now on probiotics and will go back on Nexium.

My burning stomach pain always starts 4 hours after I eat lunch (my first meal of the day) and lasts 6-8 hours. I've charted all that I eat and the medicines I have tried to reduce the pain, and the timing, duration, and pain level on my scale of 1-10. I do not eat during the pain and sometimes eat a small meal after then immediately go to sleep because I'm so worn out. I sleep well and wake with no pain. I usually wait 4 hours until I eat lunch, so I'm pain free for 8 hours during the day.

Sometimes I try to take 'a day off from pain' by not eating, and still around 4 pm the burning stomach pain starts. The daily late afternoon/evening pain has completely taken over my life and I have had to cancel all social events.  
Avatar universal
I am wake up with a sharp hunger pains and even when I eat about an hour later I'm hungry again! And when I don't eat at that time I feel like I'm going to vomit. My stomach feels like a sharp pain that seems to me to go to the core of my stomach when it strikes it makes me wonder if it's a ulcer but the systoms are not all there for me to say its a ulcer. Now when the pains hit it makes me feel like i want to throw up.  But I don't it's like nausea and i' have been searching before I go to the doctor on this week. Now maybe once I felt this sensation in the back of my throat that made me think it might be associated with heart burn. Help any answers to my problem
Avatar universal
I am suffering the exact same symptoms as MeBZ100 described (all described) Always night, awake for 5 or more hours, moving doesn't make it better or worse, toilet doesn't help etc. After excruciating pain under my bellybutton for hours the pain just goes away, got a mind of its bloody own. I also know when I am going to get an episode.  The pain, dull, starts in my pelvis in the vaginal bone area then an hour or so the pain is full on.  Just a constant stabbing pain for over 5hrs. I went to the doctors and she gave me pain killers for extremely bad period pain which helps with swelling and bleeding, mainly for swelling for me. But since I didn't have period pain or heavy bleeding the drug just didn't work. I went to the pharmacy and got the strongest pain killers you can get over the counter,  without a prescription. I used the strong pain killers last night, while having an episode, and the pains went away an hour earlier but I can't be sure because I have no idea if the pain was going to exceed 5hrs.  I have been experiencing these pains for a month and a bit now, they are once a week and always start at night. Have no idea what's going on but if I find out I'll be back to let you guys know.
Avatar universal
I experienced the exact same symptoms but had fever and tenderness in the stomach area the next morning as well. First few times it was manageable but the last 3 times it happened I had to go to ER. Doctor took blood test and ultrasound and couldn't find anything abnormal but said that there's an infection which caused the fever and my white blood cells had increased by a lot. As it happened at midnight so the doctors said to wait till morning to see if the pain subsided, and to rule out appendicitis. As the pain was gone so the doctor just sent me home without giving me an explanation.

It happened again and I was in ER again.. This time doctors were not sure of the cause as well so they said as the appendix were a bit inflamed, I should just take it out. There were no symptoms suggesting that it was appendicitis except for the fever. But I went on with the operation and after 4 years, I did not experience the pain again.However, i still doubt that it was appendicitis.
Avatar universal
I have been dealing with this mystery for over a year now,  in fact as i type i am having severe one. I heard sucrose which is found in propel can cause this so i stopped drinking it. Ib have gastro doctor who has done scope , scraping inside intestines and diff spots and 2 colonoscopies , xrays , blood work and ultra sound to find nothing. My Gall bladder was removed in 2001. I am 37. They thought might be celiac but it came back negative. My doctor thinks i might have gluten and dairy intolerance so they changed diet. I soooo hate this because it stops make in my tracks and they say well i can't find anything, i don't know what to tell you. I believe you but ... so they prescribe a medicine to see if that helps. Which doesn't. Soooo frustrated. Don't know what else to look into. I know i have really  low vitamin E. And vitamin d could use a little boost. So if anyone finds out what this mystery is please share with us.thanks
Avatar universal
This amazingly matches the symptoms I have been having over the last several months. I was given some anti-cramping / spasm medicine to help with the pain during these acute episodes. It helps, but very little. I also, have had all the tests. According to my GI doc the next step is visiting the surgeon and doing a scope to get a better look. I do not wish anyone this type of agony. I typically have pain the whole night and then need the day to rest and re-coup from the severe pain as I am so, so drained. I have missed work it and it has totally affected my life. Please let me know if you have any updates and than you for your posts!!!
Avatar universal
Describes me to a tee and so incredibly frustrating to hit roadblocks trying to find out what is the cause. I've had a colonoscopy, endoscopy, blood tests, stool test, and awaiting ct scan results which I am pretty sure will come back negative. Particular food do not trigger an attack and I've given up all soda and sugar replacements. I am going to print the description to my GI doctor as is accurately how I feel during the entire episode. I'm curiously following this post.
Avatar universal
I suffer with exactly the same problem but was beginning to think I was the only one!!!
The pain for me started in June 2011 and has been occurring on and off ever since, I've tried dietary changes-cutting out wheat, dairy, taking the complete whole food eating to a new level!! It's probably worth noting that I was starving myself excessively, I lost 5 stone through eating 600 calories a day and replacing my meals with a strong coffee!! I have since managed to refrain from starving myself though and returned back to an average calorie amount, although the desire to starve myself does reappear occasionally, I usually manage to fight it off!!
I've been to the doctors on numerous occasions about it but they don't seem to have a clue, they told me I had a suspected stomach ulcer and gave me Omeprazole which didn't help!!
I found relief a couple if times when I drank cold full fat milk at the beginning of the attack-as there's a couple of minutes warning before the onset, but on the third time I used the milk I vomited it back out and it hasn't helped since!!
My symptoms are a dull ache the moves it's way up my stomach until it reaches the right side of my stomach under my rib cage where it turns into a hot sharp stabbing, then I know I'm in trouble!!!!!!
The pain goes from 0-60 in a matter of minutes, the pain though always there comes in waves, my body usually takes over and makes me sick, sometimes being sick brings relief, other times it doesn't!!
There's no pattern in what I've eaten to create the problem, the doctors seemed to think it was due to severe constipation, (as well as a stomach ulcer) meaning the stomach isn't ready to take more food in and digest it because it's still full!!
The pain usually goes between 30 minutes to 5 hours after it starts, when it's finished I feel like my stomach is bruised inside, it hurts to roll over onto my side, stretch, stand up or even hiccup!!
I too don't have any blood in my sick or stools, and the stools are always normal consistency!! I usually crash out completely for about 2 hours after an attack because my body has been so pumped full with adrenaline and is worn out!!
I would really like to know what to do to prevent such an attack!! There must be a cause and a diagnosis but it doesn't seem that the doctors have a clue!!!! I am female, 29, healthy, I don't drink, I don't eat excessive sweets or refined sugary foods or salty takeaways very often! I do suffer with obsessive compulsive disorder (OCD) anxiety disorder and severe depression and think that the pressure of trying to fit in to day to day life (which I do, albeit slightly altered to suite my obsessions and compulsive behaviours) could be attributed to it!!
I have been on a new medication for a couple of weeks and gained a large amount of water weight-one of my obsessions is weight loss, I've been worrying a lot about my appearance and funnily enough have suffered an attack today!! I was put in the waiting list for CBT in July 2013 but am not likely to have any intervention until at least February 2014!!! Although I am  hoping that'll make a change!! Has anybody had any luck since posting here?
Avatar universal
As I read your story, it was almost as if I was seeing you tell MY story! It sounds almost identical except that I have dealt with these episodes for probably around 20 years.  In that time, the episode has happened maybe 10 times but thoser times are memorable! The last one happened about a month ago and there is no telling when it will happen again. Could be in a week or even in a year. I, too, have been to the ER a couple of times for this but all I got were pain pills and fluids. They were concerned during those visits that my blood pressure greatly dropped but I'm convinced that that was because of the pain.
One definite thing that I know has triggered them for me is vegetables. Raw veggies on an empty stomach or too many veggies in a day a sure-fire way to bring on one of those painful episodes! I have gone from periods, in those 20 years where I have gone from very fit and lean to very overweight but that  has made no difference in the appearance of the episodes. The only common denominator was the veggies! I hope we can both find answers and relief soon!
Avatar universal
Thanks for your posting. Just wen through an 8 hour attack. I get them about twice a year usually pretty far apart though there was a period when I had three in one week. I couldn't describe the systems anymore accurately then you did. Reading your post was the first time I've seen someone else with the same issue. I tend to think of the pain in terms of cramps however as the intensity cycles from slow beginning to unbearable and then down again over the course of a minute or so. I've also been to a number of doctors and various tests to no avail. Sometimes though not always anti cramping medication can help. Also when I get that feeling like it might start I ve also quickly had a few glasses of redwine. Can't really say if it prevented the attack but it's never manifested after I've done that. I  super healthy, on aloe carb high protein diet and strength train and run regularly. 34 year old male. I also would love a solution to this, it's a horrible experience every time it happens.
Avatar universal
Hey also I forgot to mention I was recently tested for porphyria and results came back as a possible match for the disease with a heightened count in my urine. Could this be the cause?
Avatar universal
Same problems.  Went to see more docs  than I can remember.  Had CT, MRI etc at VA Hosp in Tucson.

I am now living in Ecuador.  I recently had an attack.  I was with my Ecuadorian Girlfriend.  She is 63 yrs old.  

She told called the pharmacy and got some Sertal Compuesto

She gave me the injection.  All of the pain stopped within 15 mins.

You can also get Sertal in pills.

Key.  You will probably have to go to Mexico or South America.  Probably available in Miami underground.

This drug to my knowledge is not FDA approved.  But either are the drugs in Europe, Asia and South America or Mexico.  You get the idea.

People believe that if it is not in the data box of the USA FDA that the drug will not work or it is dangerous or it is unsafe or it is a hoax.  So naive.  

Fabiola told me that is is worse than having a baby.  

Read about this drug.  The docs in the states say that it is used by gringos because they have problems with the foods in the south, etc...that is such a lie and they know it.  Find a doc that will tell you the truth.  It is all about big pharma and not being able to patent the drug and not wanting to pay another drug company for their products.

I haven't met anyone that can tell me why this is happening.  The pain is horrible.  I have done one thing though!!

When you get the initial feeling drink 2 glasses of warm water.  Wait 5 mins.  Go vomit and "repeat".   This seemed to work for me 2 times.  It is also a suggestion from doctors here in Ecuador.  

Read about this!

THERAPEUTICS ACTION: Sertal COMPOUND N. F. is a spasmolytic - analgesic medicament for the therapeutic and symptomatic genital pathogenic spasmodic syndromes of gastrointestinal, hepatobiliary , urinary, or whatever their degree of intensity. The new presentation in tablets promotes rapid gastrointestinal absorption , which more timely remission of symptoms is achieved .
Avatar universal
Dead on, describes what I have been and am currently experiencing.  I dont know what this is yet, everytime i do a web search to try to identify the cause (and to make sure im not dying, even though every time it clears in the mid morning hours as if nothing was ever wrong) and finding this page is the first time finding something that matches my symptoms...  I have only consulted a doctor after these episodes and they are mystified (the first time i was prepared to goto the emergency room in the morning, but the pains stopped abruptly).  

Several notes:
i feel as if i can track the pains moving through my digestive tract with the pain intensifying as it progresses through.
I have taken really hot baths mid way through these episodes (to help my body "cook" it away) and it really helps with the pain (until exiting the bath).
I cant pinpoint a certain type of food that causes this, but my current thought is that it could be brought on by low water intake before and durring a meal (extreamly low daily water intake) ...

Any additional thought?  I will check back to this page periodically to see if anyone comes up with a solution or diagnosis, as its my first confirmation of symptoms i have seen any where...

Almost through this episode, someone kill me, please!  (This is a joke, but the pain is intense)
Avatar universal
I just had my first attack yesterday -- very similar!!  My father has an attack about once a year since he was in his mid-30s.  When he explained his experience to me it was exactly the same....which is extremely similar to everything people have talked about here.   I'm going to see a GI specialist  -- and will be sure to let you know what they say.  We should all make a point to list out what tests have been done and what the results where...while we might all have the same thing, I think the chances are good that most of us do.  

I thought the note about Porphyria was interesting though.  Since I obviously inherited it from my fathter and Porphyria is a genetic thing.  Also, some types of Porphyria cause psychiatric disorders, and my brother has manic-depression, which was specifically mentioned.  I"ll asked to be tested before I bring that up to the fam....but it would be nice to get one and done diagnosis!!

I'll keep you posted -- and thanks so much for this thread!!

Avatar universal
Having the same thing for years now. Episodes come on in the evening, starting with a dull ache in my back and abdomen that turns into excruciating (gas?) pain accompanied by severe bloating. Pain lasts almost exactly 6 hours every time and then suddenly disappears. I also have daily stomach heaviness, mild nausea, and intermittent bloating, constipation and low energy. I have had scopes and stool tests, finding nothing. After 2 years of not eating wheat or dairy, as suggested by my doctor, I got a US Biotec IIG food intolerance test and discovered I was having an immune reaction to a laundry list of foods, including soy, corn, peanuts, tree nuts, citrus, coconut, eggs, mushrooms, among others. I feel like this is not normal and there may be an underlying cause for all these food allergies. I have not been successful at avoiding all these foods for very significant periods of time. But in general I feel like crap and I am going to try again for a six month period. Will keep you posted.
Avatar universal

I am 31, and had my left kidney removed approx ten tears ago due to kidney stones and stomach abscess, since then I have been fairly normal, I do smoke and drink but not excessively and I love fruit and veg and have a fairly healthy diet. The only symptoms I have had since my ops, has been acid reflux for which I'm prescribed omeprezole and that I haven't been able to lose any weight. (i was five stone after ops, and had to be out on a weight gain diet for two years, after which the weight pulled on by itself) Since December 2014 I have had a pain in my right abdomin which ranges from sparodic epeisodes to constant pain for weeks at a time. I have just got my ct scan result back today and have nothing, no callcification or inflammation shadows, etc and every organ scanned is "unremarkable". But I still have the pain. I have no known intolerances to food except milk and its Gorton worse regardless of what I eat or drink ,and to me the pain feels like kidney infection as its a tightness that I can feel in my back and stomach. It's sounds similar to what has been mentioned in previous posts so I will keep you updated as I'm not going to let this go and will find out what this is. Sheena x
Avatar universal
Hello my 20 year old son has been suffering with these symptons for 2 years. After finding this page I have researched a lot, and I think that many if the people on this page are suffering from CVS or Cyclic Vomiting Syndrome. There are organizations and support for this condition but self education is your best bet. Good luck all I will post my progress in getting this diagnosed in my son. It is a horrible condition and I hope to find a way to help him get rid of or at least manage it.
Avatar universal
Symptoms start in the late afternoon warning of an attack.  At bedtime, around 9:30pm, the serious pain starts gradually, increasing in intensity to pain that is 10/10 - sometimes I cry out in the early hours.  It feels like my entire intestinal area in being crushed and exploding at the same time.  By 5am, I am exhausted and I fall asleep completely.  When I wake up i press gently on my upper and lower intestinal areas, which given the level of pain I have endured, should be hurting and sore but there is hardly any tenderness and everything is suddenly back to normal.  I thought it was stomache flu the first time because I shook so bad from being cold.  However, having had my third episode in 6 months, it's not stomache flu but that's what I tell them at work. I still get the chills toward the end of an episode but they are hardly noteworthy.  I won't bother to see another doc or specialist.  

Background - I did have my appendix out when I was 10.  I did go to Mexico once and got sick. Raw vegetables are not my friends in large quantities.  Yeasty breads or sandwhiches are not my friends but crackers are.  If I take a vitamin supplement, my lower legs get excrusiating pains at night. I don't drink alot of water, but I'll start.

Yesterday i had a special cookie directly from Asia and raw veggies - last night I thought I would die. Please continue to post so we might find the small threads and maybe link them together so we have some idea as to how we can overcome this debilitation.  
Have an Answer?
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Learn which OTC medications can help relieve your digestive troubles.
Is a gluten-free diet right for you?
Discover common causes of and remedies for heartburn.
This common yet mysterious bowel condition plagues millions of Americans
Don't get burned again. Banish nighttime heartburn with these quick tips
Get answers to your top questions about this pervasive digestive problem