Q. I get severe stomach pain from belly button to the lower stomach with previous history of IBS. Please help.

Answered by
Dr. Arbab Muhammad Kashif Khan
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jul 22, 2020 and last reviewed on: Aug 08, 2020

Hi doctor,

Every four or so months, l get these episodes of severe stomach pain that radiates from my belly button and to my lower stomach. These pains often last for four hours with it being constant. It feels like something is stabbing me internally and like my intestines are being ripped. With movement, the pain is the worst and causes my stomach to bloat to twice its size. The pain is so bad that l often get nauseous and cannot sleep until the pain has stopped. Even after the pain has gone my stomach is still tender. I have IBS and the foods l eat that day are my usual foods so it is weird. l was born with duodenal atresia but was operated on. I have been having these episodes since I was 13 and never have been to the emergency as l was often too weak to say or move. I am currently on contraceptive pills.

#

Hello,

Welcome to icliniq.com.

What medication are you using for IBS? Are you taking it regularly or not? Do you have constipation or diarrhea? Have you experienced any vomiting, loss of weight, fever or burning micturition? Does your stress have any relation with your symptoms? Does your pain wake you up from sleep? Does your pain aggravate with meals?

If you have not tried any medicine then please start with the following.

I hope it will help.


The Probable causes:

Irritable bowel syndrome.

Investigations to be done:

Complete blood count. C-reactive peptide. Ultrasound abdomen.

Differential diagnosis:

Postprandial distress syndrome.

Treatment plan:

Tablet Levosulpiride 25 mg thrice a day before meals for one month, Mebeverine 135 mg thrice a day for one month.

Preventive measures:

Physical exercise.

Thank you doctor,

I use herbal teas such as peppermint but nothing other than that. Usually, with my IBS it is gluten intolerance so I get constipated when I eat gluten and I have experienced vomiting more than usual. I would drink two alcoholic drinks on a weekend and vomit the next day until I started vomiting bile. Yes, the pain does wake me up and often cannot sleep until this pain is over. Yesterday, when this pain happened I had something to eat during and it did not make it worse or better.

#

Hi,

Welcome back to icliniq.com.

If you are vomiting bile then you should get an upper GI (gastrointestinal) endoscopy done for excluding distal obstruction and biliary gastritis. Meanwhile, you may start the following treatment and see the response.

By the way, do you remember what surgery was performed for duodenal atresia (gastrojejunostomy or what)?


Investigations to be done:

Upper GI endoscopy.

Treatment plan:

Capsule Omeprazole 40 mg once daily 30 minutes before breakfast for one month, Levosulipride 25 mg thrice a day before meals for one month, Mebeverine 135 mg thrice a day for 1 month. Ispaghol husk two teaspoons in a glass of water every night.


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