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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.
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Avatar universal
Hi everyone,

It is crazy to think there are 95 people in here who have the same symptoms that progress in the same way and follow the exact same pattern. This tells me it is not just any old IBS or "Stress" - it's too similar to be a coincidence in my opinion. At first I was shocked when I discovered this forum, it was almost as if I'd written that initial post myself.

Ever since I read that first post I have been following this forum in the hopes of finding a solution/cure/any information that can contribute really.

My story is very similar to everyone else here:

My symptoms started (August 2012) almost 6 years ago. The attacks are usually 2-3 months apart, but lately it hasn't followed any rules and it's sometimes been 5 months, other times 5 weeks...

Pre-Attack:
I will know an attack is happening before it happens. My body warns me with a mild pain that references the one that comes later and after five years I know that this pain is like any other and that I am due an attack that night. I usually get them at night and on weekends. I have had one or two in the morning or during the day.

During Attack:
I will usually feel the first sign at about 6pm and then it will properly be in full force by 10pm. I will have cold shivers to the point that I feel my bones cannot keep warm. I will have excruciating pain in a very specific point in my abdomen (about 5cm above the belly button) Like a constant sharp stabbing. This will continue no matter how I sit or lie (though sitting up sort of bent over is preferable at times). Bowel movements are either non existent or frequent but don't help the pain either way. I usually start belching a lot towards the end and my stomach is very distended before, during and after. It is also Extemely sensitive to touch.

The only thing I have ever found that helps me is Iburprofen (in the beginning Doctors were always baffled by this as stomach pains should not be treated with that at all, but this is how I knew it was inflammatory long before I saw any blood work) and MOST IMPORTANTLY - a VERY hot water bottle directly on the source of pain. I usually take the bottle out of it's sleeve so it almost burns my skin, the hotter the better.

Post Attack:
I am usually so exhausted from the pain that I eventually fall asleep and wake up covered in sweat as if I'd just had a very bad fever. From then I will only have the residual pain as if I have stretched a muscle within my stomach/abdomen. Going over bumps in a car etc makes me wince, I am obviously exhausted and a bit sore but otherwise I am completely well within myself. This has always amazed me. It comes as quickly as it goes.

Triggers:
I will mention a few things that I have noted but I don't believe anything is a trigger per se.

1. Hunger
I usually find if I get to the point of "stomach eating itself hungry" it can 'trigger' an attack
2. Stress
I usually always get an attack after something stressful, even if I don't realise I'm stressed myself, it can be the tiniest thing
3. Getting Cold
If I feel myself get cold during the day or shiver, I sometimes find it can be a precursor for the shivers to come later

To rule out food allergies as a trigger - I have been tested for all kinds of food intolerance. I can confidently say - at least in my case - it isn't food related. I have quit Sugar, Dairy, Wheat, Alcohol, Gluten - even niche things that a very high-end intolerance test pulled up: Crab, Pineapple, Amaranth etc... I still got an attack anyway.  

I too have had hundreds of blood tests, endoscopy + biopsies, gall bladder ultrasound, liver fibroscan, gall bladder checked, H. Pylori checked, I've been tested for Familial Mediterranean Fever, stool samples... ALL completely normal!

The only thing I have found is that my CRP levels in my blood tests (inflammation markers) are always elevated. My ALT (liver enzymes) for the last two tests have been slightly elevated as well. Hence the liver scan which was absolutely normal.

Has anyone else found their CRP levels are raised? I haven't noticed anyone else mention that of yet.

If anyone else has anything else to add, any leads, finds or cures, or even a source of comfort or solution to the pain during an attack I'd be really grateful :)
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How are your wbc?
My WBC has always been normal in post-attack blood tests. The only anomaly in the tests are raised CRP and SAA levels - I've also done the SAA  & CRP tests when in the interim between attacks (when I have felt completely well) and the results have been completely normal - no inflammation. So, my inflammation markers only spike pre, during and post an attack - they (thankfully!) aren't raised all the time.
Avatar universal
I have similar bouts 2-3x/year for the last 4 years.  It starts with what feels like a barely noticeable yet irritating burning 2 inches above the belly button within 30 minutes of eating for a day or two.  That sensation subsides replace with a minor yet irritating 'throbbing pain' to the left of the belly button about 2-4 inches.  This goes on for a day or two then I begin getting a sympathetic, very noticeable throbbing pain radiating from the left side of my spine outward to the left 45 degrees up & the same down.  After exhausting all the usual tests (CTs, colonoscopy, etc), I insisted on a scan of my pancreas & my gallbladder which came back showing normal functions for both.  I'm at wits end to figure out what this is beyond some mild form of IBS or very "quick and small" kidney stones (it seems that both of these diagnoses are par for the course for sources of pain in this region when nothing shows up on scans).   Like most others here, I don't drink alcohol regularly (maybe a glass on NY or at a special occasion), I have never smoked, I do not take prescription nor non-perscription drugs, I drink water and black coffee only (no sodas, etc), I do have dairy fats in my diet but not to any excess (a pat of butter or two for cooking if I cook, some low fat milk added to a rare oatmeal or to a recipe, 2 tbsp of white cheeses to top salads, etc ), I eat beef & chicken maybe 1x/year & never touch fish, & most of my fruits & veggies come from my farm.   It's all very weird indeed.  Now one thing I did ask the doctor since I eat a lot of peanut butter/peanut butter powder is whether this might be a late life food allergy/intolerance.  His answer was expectedly "no" since I constantly eat peanut butter & the symptoms are rare occasions.   Who knows really.... it wouldn't bother me but for the fact that I realize pain doesn't occur without a reason & I'm fearing something like "cancer" isn't being detected (I do have very low Vit D levels no matter how much I supplement w/D3).   Anyway, UR not alone.  OTOH, if U haven't had your pancreas & gallbladder checked out, you might want to have your Dr. give U an Rx to have these scanned.
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Avatar universal
After reading the symptoms described in all these posts, I believe there are multiple GI issues going on here.  So, even if someone did find a "cure", it would probably not resolve everyone's problem on this thread.  I am posting on here for both of a type of support group therapy, and a hope of finding a cure.  I pray that everyone suffering from any of their symptoms does find a cure.  I also encourage anyone who has found relief or a cure to post their story on this thread.  I am interested in anything that anyone has to say about what has helped them.
I am a 42 yr old male who has been suffering for about 30 years from most of the symptoms described here.  I'm "glad" to have found this thread, because for all these years I thought I was the only one who suffered like this.  I have been through multiple doctors and most of the standard GI tests throughout my life.  I finally gave up going to doctors about 10 years ago when the last specialist I saw diagnosed me with IBS.  That's the first time I ever received a diagnosis.  And even though it felt good to have an actual diagnosis, did it really help?  No, because I still suffer.  My episodes are unpredictable, and I live in constant fear of them occurring, especially during an important social event or just a fun night out with friends.  It's been such a big part of my life for so long, that it's always on my mind without me even being consciously aware of it (if that makes sense).  So, in a way it controls my life and I hate it for that.

I'd like to break down this post down into 3 different sections, if only for the sake of the therapeutic properties of telling my story.  First, I will describe my symptoms.  Second, I will discuss what I KNOW brings on my symptoms, and also what I THINK might bring them on.  Last, I will tell you what I do to help myself ride-out these "episodes".

1.  Around the last 30 years of my life, my symptoms have remained pretty consistent.  It's a dull pain WITHOUT NAUSEA (different from most symptoms in this thread).  Time and pain varies a little with each episode, so the following will describe what generally happens.The episodes happen once every 3 months on average.  It starts in the mid-afternoon and lasts between 6-9 hours. I begin to feel a dull pain in my upper right abdomen.  It progressively gets worse throughout the evening, peaking at about a 8 or 9 on the pain scale before subsiding almost instantly.  It kind of feels like something "moves" in my bowels out of the pain area, and that's how I know that the pain is about to subside.  I also start to feel hungry , sometimes even when the pain is still at its worst, but I dare not eat for reasons I'll describe below.
Anyways, the pleasure from the lack of pain is extremely welcome by the time an episode is over.  I'm finally able to relax and fall asleep.  I should mention that over the last few years, heartburn sometimes occurs with these episodes, and Tums helps that, but not the other pain.  The next morning I'm fine, but will still be "tender" in that area for the next few days.  Sometimes an episode will occur two or three nights in a row, but that is not the norm.

2.  Here are a few things I've learned to avoid over the years, which almost certainly bring on an episode.  Obviously, these are not the only things that bring on the pain.  Otherwise, I'd just avoid them and be fine:

- Overeating - I have been teased many times for "eating like a bird".  This means that I eat light meals and snack, rather than eating large meals.  When I eat too much, it seems to just sit like a lump in my stomach and will eventually bring on an episode (not always, but very often).

- Spicy foods - I tend to avoid them.  Occasionally, I'll eat food with some spiciness and I'm fine, but I've noticed that episodes have come on after eating very spicy foods.

Here's a list of things I THINK may also cause an episode:

- Strenuous activity after eating:  I seem to be okay with light activities like walking after I eat.  But one time an attack came on after I ate lunch and helped my brother install flooring.

- A traumatic event occurring during the day - something out of the ordinary that happened that day which disturbed me emotionally.

- Stress over a period of time - Stress at work, home, etc. that goes on for days or weeks

- Special Events - I've had several episodes during vacations.  Not sure if it has to do with stress from travel, routine being out of the norm, or whatever.  One episode also came on the night I was throwing a bachelor party for my brother, as I was the best man.  I had to leave the party and leave my cousin in charge.  I've also had attacks on a couple of Christmases, where my family and I had to visit multiple families in the same day.  Not sure if this was stress induced, or overeating.  Maybe both.

- This may seem weird, but I've had some episodes occur after I was wearing new (maybe tight?) pants.

As I stated above, this is definitely not an all-inclusive list, because many episodes have occurred when I haven't eaten anything spicy nor had been through anything stressful or done anything against my normal routine.

3.  Although I haven't found a "true" cure, here's some guidelines I follow to get through these attacks.

- NOT Eating or drinking during an episode - I've learned that eating or drinking ANYTHING will only make it worse (more pain and/or last longer).  I get really thirsty and hungry toward the end of my episodes, but dare not put anything in my stomach until I'm sure it's over.  Sometimes, I'm actually able to lessen the time-frame of the attack by not eating or drinking during it.

- Soaking in a hot bath temporarily helps ease the pain.  It also relaxes me, sometimes helping me to fall asleep shortly after I get out of the bath.

- Massaging muscles in my rib cage around around the painful area and also in my back behind the pain area.  Sometimes I can't tell if the pain is coming from my back or my abdomen.  I'm not sure if this is due to nerve connections, or if maybe it's because my body tenses up during these episodes, causing my back to hurt as well.

- Here's a weird one, but I think it's worth mentioning because it helps ease my pain.  No body position had ever helped my pain until I discovered one a few years ago.  If I lean over the arm on a couch in a certain way, it somehow eases the pain. I kneel on the edge of the couch cushion, with my knees against the bottom of the arm.  The arm must be high enough to support me in a "half-fetal" position, to where I can put the full weight of my chest on the upper part of the arm.  I let my head and neck relax so that I am staring down at the floor to the side of the couch.  My head does get some pressure from the blood being pulled to it by gravity, but this uncomfortableness is worth it due to the ease of pain that this position provides.  I try to stay in this position as long as possible until the pain subsides.  I've even been able to fall asleep and stay asleep, waking up after the pain has left.  I have no idea why this helps.

Well, that's everything I can think of so far to write in this post.  If I think of anything else or happen to find more ways to relieve the pain, I'll post again.  Until then, may God Bless us help us find comfort and ease our suffering.

- 311Brodel
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I've found that when the 'signs' begin, I immediately standup to elongate and stretch my torso with arms stretched up overhead. I could be doing this for as long as I think it'll help....could be an hour off and on, but I dont sit down. While standing/stretching, I'll also lightly massage my upper GI area in a downward movement creating the feeling that the pain is moving down. Another movement that helps to stave off an attack is to sit straight up, posture very aligned, and do tight upper abdominal crunches (and hold the crunch). Also, taking a deep breath while sitting, posture straight back aligned,  and allowing your stomach to expand to as big as you can, all the while feeling relaxed and holding that then exhaling slowly helps. Im not typing this as well as I could explain it to anyone. I had a 'flareup' coming on today and IMMEDIATELY started in with all of the above, as well sipping water,,,,not a lot but just little slurps. I had a few jabs to my upper abdomen but nothing like I typically experience. Ive taken great notes to all suggestions above and just over the moon that Im not suffering alone.
Avatar universal
Not sure how long ago this post is. Several years ago I had almost the exact thing. With the episodes lasting that long. Always at night. Eventually though started lasting s little longer and it was memorial weekend that I guess it was an attack and was out of town so I dealt with the 3 days of excruciating pain. When we got back we went to the hospital and found out I had a gullstone attack
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Avatar universal
Female - 66 years old
I have absolutely the same problem that many of you have and you have no idea how *nice* it is to know that I'm not the only person who is suffering with this pain and no explanation as to why!! I had considered (and only just 'considered'...lol) telling my family GP about it but since you all have had so many tests,procedures,etc.,I'll definitely be saving myself the trouble,now! The first time I experienced this pain was about 7-8 years ago...about 4-5 hours after supper and it lasted about 6 hours. I hadn't had it again until about 6 months ago and it's happening 1-3 times a week,now!! I have found that I dare not over eat...I have to be careful to not eat any meat (beef or pork) and not a lot of chicken or fish! Last night I was suffering again until about 2:00 a.m....I had 3 mouths-full of baked ham! I've given up having butter on my mashed potatoes and trying to stay completely away from any fat,of any kind at suppertime. Then I make a huge mistake (I think) by having a very small bowl of ice-cream at 7:00 p.m.! I'm starting to think that the ice-cream is a/the culprit (the kind I eat has a very high fat content)! This evening I'm having a small bowl of chicken soup for supper and I'm going to try to stay away from the ice-cream container!!
I haven't read about many of you having "spasmodic" pain...my spasms last about 20-30 seconds and then eases up/off for 3-5 minutes or so and then another spasm lasting 30 seconds or so...and yes,it's pretty much about a "10" on the pain scale (I've found that deep breathing during the pain helps 'deal' with the spasm). I don't get nauseated (no throwing up) nor do I need to use the bathroom....I just have pain directly above my navel/belly-button! Pepto Bismol did help to ease the pain many times but never stopped it (and I'm saying about 4-5 tablespoons...not the piddly little amount suggested on the bottle)!
Have ANY of you ever been tested for "H-pylori"?? (Helicobacter pylori....a type of bacteria & these germs can enter your body and live in your digestive tract). It's "curable" with 2 different antibiotics but I'm allergic to most antibiotics,couldn't take those so I'm left to suffer.
It's a very simple blood test...nothing invasive! I tested positive for it about 20-25 years ago but was having no pain,then....just a VERY "sensitive stomach"!
*My* pain,now could very well be caused by/due to the bloody H-pylori....which,btw can also cause ulcers!
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1 Comments
I apologise for the 2 identical posts!
Avatar universal
Female - 66 years old
I have absolutely the same problem that many of you have and you have no idea how *nice* it is to know that I'm not the only person who is suffering with this pain and no explanation as to why!! I had considered (and only just 'considered'...lol) telling my family GP about it but since you all have had so many tests,procedures,etc.,I'll definitely be saving myself the trouble,now! The first time I experienced this pain was about 7-8 years ago...about 4-5 hours after supper and it lasted about 6 hours. I hadn't had it again until about 6 months ago and it's happening 1-3 times a week,now!! I have found that I dare not over eat...I have to be careful to not eat any meat (beef or pork) and not a lot of chicken or fish! Last night I was suffering again until about 2:00 a.m....I had 3 mouths-full of baked ham! I've given up having butter on my mashed potatoes and trying to stay completely away from any fat,of any kind at suppertime. Then I make a huge mistake (I think) by having a very small bowl of ice-cream at 7:00 p.m.! I'm starting to think that the ice-cream is a/the culprit (the kind I eat has a very high fat content)! This evening I'm having a small bowl of chicken soup for supper and I'm going to try to stay away from the ice-cream container!!
I haven't read about many of you having "spasmodic" pain...my spasms last about 20-30 seconds and then eases up/off for 3-5 minutes or so and then another spasm lasting 30 seconds or so...and yes,it's pretty much about a "10" on the pain scale (I've found that deep breathing during the pain helps 'deal' with the spasm). I don't get nauseated (no throwing up) nor do I need to use the bathroom....I just have pain directly above my navel/belly-button! Pepto Bismol did help to ease the pain many times but never stopped it (and I'm saying about 4-5 tablespoons...not the piddly little amount suggested on the bottle)!
Have ANY of you ever been tested for "H-pylori"?? (Helicobacter pylori....a type of bacteria & these germs can enter your body and live in your digestive tract). It's "curable" with 2 different antibiotics but I'm allergic to most antibiotics,couldn't take those so I'm left to suffer.
It's a very simple blood test...nothing invasive! I tested positive for it about 20-25 years ago but was having no pain,then....just a VERY "sensitive stomach"!
*My* pain,now could very well be caused by/due to the bloody H-pylori....which,btw can also cause ulcers!
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1 Comments
I am a 63 y/o female, suffering this debilitating pain so many of you describe, for 20+ years now. I have been to the ER numerous times and be "diagnosed" with a myriad of issues ranging from chronic appendicitis to "maybe a ruptured ovarian cyst?" to stomach flu. All were simply good guesses and not correct.
Never nauseous nor constipated, but if I force myself to vomit it typically brings some relief, though not complete resolution. The pain lessens enough that more often than not, I can fall asleep for a while.
My episodes seem to occur once or twice annually and I've never been successful at pinpointing a 'cause' whether of food etiology or environmental. However, I've noticed several of you have mentioned mold allergy, bulk/high fiber foods and lactose intolerance. While I have tested positive for mold allergy, I'm not 100% certain that is my personal trigger; however, the fiber and lactose components could be culprits, something I have never considered but will DEFINITELY stay away from now as I have recollection of ingestion of such food items prior to having an attack!
Bentyl is the only Rx that has had any positive effect, but only to a partial degree of easing the pain from a 10 to a 7 and also helping me fall asleep, as it cause drowsiness.
Finally, thank you Swarovsky, for H-pylori! I had ulcers years ago but am now allergic to many antibiotics, also. I am going to mention this possibility to my Doctor as well.
This is the first time I've found others who suffer with this issue and, at the very least, I can provide this thread to my Doctor to show that it isn't "all in my head". Should I have any beneficial updates/information about this problem, I will return and share with the thread.
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