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Experiencing Sharp Pain After Eating. No Relief From Exium. Is This Related To GERD Or Ulcers?

Posted on Thu, 16 May 2013

Question: Hi,
I sometimes get a sharp pain lasting maybe in total half an hour after eating, roughly in the stomach area. I do have some indications of GERD but only through the diagnosis of an ENT surgeon, so he did not look at stomach or esophagus.
Is there anything which might cause this sharp pain apart from ulcers and does it need further investigation?
It does appear to be worse with spicy food but I am wondering why having taken nexium a day before does not seem to provide relief. The pain comes with gas and bloating.

Answered by Dr. Poorna Chandra K.S (9 days later)

Hi and thanks for contacting XXXXXXX
The cause of Postprandial pains depends on the type of pain and the location -
1) Burning and upper abdomen - GERD or gastritis/Ulcer
2) Boring, upper abdomen and lasting for hours - Pancreas related and is usually associated with weight loss and stool abnormalities like bulky or greasy stools
3) Pain in RUQ and upper stomach lasting 1- 6hrs - Gallbladder and gallstone related
Hence discuss these with your GP and plan further actions
Regards
Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Poorna Chandra K.S (15 hours later)

Dear Dr. XXXXXXX

Thanks for the information. I am curious as to what you mean by a boring pain and also don't understand why such a pain can be pancreas-related even though it appears more in the upper abdomen and hence related to the oesophagus.

I have noticed recently a petrol-like smell to my stool if that is possible but did an MRCP with an abdominal MRI two months ago, which did not pick up anything. What sort of conditions related to the pancreas might give the symptoms of boring pain and not be picked up MRCP and general abdominal MRI?

Thanks.

Answered by Dr. Poorna Chandra K.S (15 hours later)

Hi and thanks for writing back
Any organ which originates from the foregut of the primitive digestive tract - Esophagus, stomach, upper small intestine, gall bladder and pancreas can lead to pain in the upper abdomen.
MRI and MRCP are the best available investigations to look for any structural problem in pancreas and the gall bladder - biliary tree. Hence if it is normal we need not worry about it XXXXXXX your GP and get yourself evaluated and treated for GERD
Regards
Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Poorna Chandra K.S (2 days later)

Dear Dr. XXXXXXX

Thanks again. The issue with my MRI is that apart from the MRCP, I am not sure it looked at the pancreas and my understanding with MRI of the abdomen is that specific organs must be looked at, unlike a CT scan.

Also, I am wondering if the MRCP procedure might itself cause an issue as I am aware than ERCP for example can lead to an inflamed pancreas.

Thankyou.

Answered by Dr. Poorna Chandra K.S (1 hour later)

Hi and thanks for airing your query
MRCP ia a derived sequence obtained from a plain MR abdomen. Hence if MRCP is normal most likely pancreas will be normal
MRCP is a non invasive imaging as compared to ERCP and hence there is no risk of pancreatitis
Regards
Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Poorna Chandra K.S (22 hours later)

Dear Dr. XXXXXXX

Thankyou. Lastly, I am interested as to what conditions of the pancreas and gallbladder could cause a petrol-like smell to the stool, which I seem to detect. Would these also be detected by abdominal MRI with MRCP sequence?

Thanks.

Answered by Dr. Poorna Chandra K.S (55 minutes later)

Hi
"Petrol like smell" of stools is not descibed in medical literature as far as I know. However this could be because of something you ate or rarely because of improper digestion of fat
Get a stool examined for fat globules and if available do a hydrogen breath test.
All structural diseases of the pancreas and gallbladder can be diagnosed by MR
Regards
Dr XXXXXXX

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar