What causes stomach pain despite taking medicines?

Question

Hello doctor,

I have been dealing with a stomach issue for almost four years. It originally was extreme pain and tarry stool once. It was first diagnosed as an ulcer as I was negative for H. pylori. I was given antibiotics just in case, PPIs and H2 blockers. Since then it has gotten worse, gotten better and so forth. I do drink a good amount of alcohol, although I stopped cold turkey two months ago because it was causing pain. I am currently taking Carafate; several PPI's a day and H2 blockers. I eat extremely low-fat diet, I have lost 20 pounds in the past two months. I eat a low acid diet, no caffeine, no alcohol, I take my PPI's on time, as well as Carafate, and as directed. I have no pain during sleep. Once I awake, the pain comes back in flat position. If I get up, it does not or is less pain. The pain is in one point upper abdomen, center, directly below or behind the sternum. It is helped by drinking cold water. Sometimes, it goes away after I eat. Made worse if I eat fatty food, even moderate amounts of fat. The pain is very close to the surface of the abdomen, and it does not go to my back.

I have had sore throats as well. I would imagine that it is from acid reflux. I did have acid reflux for 8 to 10 years, off and on, and I did not do a good job of controlling it at first. I have taken Prilosec, Nexium and recently Dexilant. A year and a half ago, I had a cat scan with fluid drank before hand (I believe it was called a HIDA scan) and an ultrasound. The only thing that was found was a fatty liver, and no other problems were found. Is there any other type of prescription or medication I can pursue?

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern for GI (gastrointestinal) symptoms. All your treatment is appropriate. You might have a hiatus hernia associated GERD (gastroesophageal reflux disease), which is responsible for the appearance of intermittent symptoms.

A hiatus hernia can be diagnosed by upper GI endoscopy or in CT scan with oral contrast (lying in a particular position).

Do not lie down immediately after dinner. Take minimum amount of liquid along with meals.

Another possibility is the development of gallstones, which also cause similar pain. The only difference is that the pain in gallstones will be after food intake.

Surgery is ideal for this condition, but you can take analgesic and the anti-spasmodic group of medications to control pain in case of confirmed gallstones.