HomeAnswersMedical GastroenterologygastritisI am a 32-year-old male suffering from severe abdominal pain for the last five days. Blood work and CT appears normal. What could be the reason?

What causes persistent severe abdominal pain?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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iCliniq medical review team

Published At September 26, 2023
Reviewed AtNovember 30, 2023

Patient's Query

Hello doctor,

I am a 32-year-old male. I weigh 270 lbs and my height is 5 foot 10 inches. I have severe abdominal pain for the last five days. I went to the ER today and had a CT scan done along with blood work. Everything was fine, but I am still having excruciating pain. Currently on insulin for diabetes.

Please help.

Thank you.

Answered by Dr. Ghulam Fareed

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

Kindly share your CT (computed tomography) scan report and blood workup.

Kindly answer a few important questions for me to guide you better.

  1. Where exactly are you having the pain? Specify whether in the upper or lower abdomen, left or right side.

  2. Is the pain diffuse?

  3. Do you have any nausea, vomiting, or diarrhea?

  4. Do you have the habit of eating out?

  5. Did you have any recent alcohol intake?

  6. Were you on any medications or painkillers recently?

  7. Did they prescribe any medications in the ER (emergency room) and are you taking them?

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

The pain is in the upper mid-section under my rib cage on the left side. I have had a little nausea but that is mostly from the pain. I have eaten very little since Wednesday when this started as it causes pain on eating. When I was at the hospital, they gave me Morphine and sent me home with Tylenol. They gave me Dicyclomine and Pepcid to take at home. I have been constipated for the last 2 days.

Thank you.

Answered by Dr. Ghulam Fareed

Hi,

Welcome back to icliniq.com.

Thanks for providing detailed clinical information.

Mid-upper abdominal pain, more towards the left is the area of the stomach. Other supporting points are nausea and unable to tolerate a normal oral diet, which increases the pain after eating. The possible diagnosis is severe gastritis, acid peptic disease, ulcer, or gastric spasm. This would be due to eating out, alcohol consumption if any, eating reheated meals, or any medicine especially painkillers. There are certain other causes as well but the above are more common.

I would suggest you continue with Paracetamol and Dicyclomine, but can switch Pepcid (Famotidine) to some better acid suppression medicine like tablet Pantoprazole 40 mg half an hour before breakfast for seven to ten days. You can also add a regular antacid syrup like Gaviscon (Aluminium hydroxide and Magnesium carbonate) 10 ml after every meal.

Consult your doctor, talk to them, and take the medications as per their advice.

I would also suggest you add probiotics or yogurt to your diet. Eat home-cooked soft meals and avoid eating out or alcohol consumption if any.

Your normal CT scan and blood workup are reassuring, but if you have persistent symptoms, you should be checked for Helicobacter pylori bacteria which causes stomach infection or gastritis.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ghulam Fareed
Dr. Ghulam Fareed

Medical Gastroenterology

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