Chronic abdominal cramp/pain

[DLM40]

I have developed chronic abdominal cramp/pain below my rib age all the way across since June 2011.  It is all day, every day.  It does not matter what I eat, do, think, whatever, its just always there.  I have seen a Gastro Dr.  I do not get constipation, don't get the runs, regular bowel movements.  The pain does not change after bowel movements.  I get nausea from the cramping pain.  I have had a CAT scan, Barium Swallow XRays, Stomach Scope, Colonoscopy, blood tests, Celiac test, allergy testing, everything comes back normal other than allergies, I am allergic to alot of outdoor stuff nothing unusual.  They have me on Remeron to help with nausea and sleep and Klonopin for anxiety.  I get very tired during the day, probably from not sleeping well and this just wearing on me but I don't know.  The higher dose of Remeron helps with the fatigue during the day, so that is what I take now 37.5 mg.  It does make me hungry, but with the abdominal pain eating is still "strange."  I have tried Elavil and Pamelor as well for the pain, but could only take those drugs for about three weeks but never noticed any difference, my sinus cavities get so dry from those drugs (I have had four sinus surgeries, so I do rinses twice a day and take 1 pill of Mucinex D in the morning which keeps my sinus cavities open enough).  I tried Cymbalta as well, for the pain, but could not tolerate the drug.  Became very "spacy" and could not focus at work.  Felt like I was in cartoon land.  I have been seeing a counselor as well to try and work with the anxiety and depression this is causing.  My brain keeps thinking about this pain constantly and the Dr.'s don't know what else to do.  Its frustrating and discouraging.  I don't drink beer, don't smoke, and don't do illegal drugs and never have.  Heck I have never even taken a drink of alcohol.  I am 37, male.  I take Cozaar and Mucinex D along with Klonopin and Remeron and a vitamin (I was low on Vitamin D so they have me taking that).  I take Advair for asthma and it works well for that.  I eat a normal diet, rarely eat fast food.  I have tried stopping milk but made no difference.  Any other ideas?

[patient915]

I didn't mean to imply that I thought your issues were all in your head.  I meant to mean that your problem doesn't sound like you have something wrong with your GI tract (esophagus, stomach, small intestine, large intestine, rectum, gallbladder, liver, etc.).  I think this could be some sort of pain condition where your brain is getting signals from your abdominal region causing you pain, even though there is nothing physically wrong with your GI tract.  RSD (reflex sympathetic dystrophy) or CRPS (chronic regional pain syndrome) which is a chronic pain condition that affects part of the body (although the abdomen wouldn't be the usual location for this).

[DLM40]

What is RSD?  I know I have anxiety, but the 24x7 cramping pain is puzzling for sure

[DLM40]

I think that is why they have me on Klonopin I guess.  Very frustrating and discouraging and sometimes disabling.

[patient915]

It sounds like your issues are not related to your GI system.  This could be some nerve problem or a problem like RSD (although you don't really have the typical symptoms for this).

[DLM40]

Remeron at higher dose (37.5mg right now) helps me sleep, and actually helps fatigue during the day.  Without the Remeron, I would have nausea and pain at the same time, that is the way it was from June 2011 to November 2011, thats when the Remeron was started.  The cramping pain is 24X7 no matter what I do, think, eat, whatever.  I can excersise and it stays the same.  I eat it stays the same.  Bowel movements do not help it either, and are normal.  Just always the same.  I wake up with it, go to bed with it.  Like a dull knife raking across under my ribs, or being punched over and over I guess, or like my guts are being twisted around.  Oh, I have also taken PPI's like Prilosec and Prevacid, they don't seem to help much one way or the other either.  The gastro said I probably have some acid reflux, so he told me to still take 20mg of Prilosec, mainly because its cheap and Prevacid or Zegerid made no difference either.

[patient915]

Welcome to the gastroenterology community!  Does the nausea go along with the pain?  Does anything make the pain/nausea worse (ex. time of day, eating, exercising)?  Remeron can definitely make people feel sleepy during the day which could be making your daytime fatigue worse, but it can also help with fatigue during the day by helping you sleep better at night.