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Overweight,abdominal pain,cramp.belching,sneezing,diarrhea

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Internal Medicine Specialist
Practicing since : 1998
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I am a 50 YO Male slightly overweight but in good health with no diseases. I have high triglycerides (>1200) but do not take meds because of sensitivities to statins.

Last Friday morning I awoke with fairly severe abdominal pain on the left side below the first lower rib and above my hip. The pain seems to be XXXXXXX but radiates towards my back. My first thought on the area of the body was "kidney".. It is similar to having a "side stitch" cramp while exercising. The pain was sensitive to certain body positions and seriously increased momentarily by belching or taking a very XXXXXXX breath such as prior to sneezing. I have no fever, vomiting or jaundice, and otherwise feel fine. I have had one bout of unexplained diarrhea today but that does occasionally happen to me which is why I don't take statins for triglycerides. By the third day the pain subsided mostly when I am static, but still severe when bending over and especially when belching or taking a XXXXXXX breath that fills my lungs. 400 MG of ibuprofen seems to help lessening the pain by 50% when belching/breathing XXXXXXX

I can schedule an appointment with my MD but that will likely take about two weeks. My other alternative would be the ER but I don't really feel bad enough for that unsavory experience... My current plan is to wait this out for a few more days and then go to urgent care or ER if there is no meaningful improvement. What say you?
Posted Tue, 8 May 2012 in Digestion and Bowels
Answered by Dr. Jasvinder Singh 40 minutes later

Thanks for posting your query.

Based on your description, I can think of four possibilities. They are:

1) Muscle strain: This may cause localized tenderness and pain when bending over. It responds to warm compresses and left upper quadrant pain is caused by peptic ulcer disease.

2) The second possibility is of peptic ulcer disease or hiatal hernia. This is a very likely diagnosis for you because there was accompanying diarrhea and the pain increased on belching.

Diagnosis can be confirmed by upper GI endoscopy. Try raising the head of your bed about four inches with blocks. It also might help to avoid eating or drinking for two hours before you lie down. To help control the stomach acid, one should not drink alcohol or drinks with caffeine in them, or eat chocolate or spicy or greasy foods.

Also take some antacid but if the symptoms are severe, then you may need drugs like proton pump inhibitors like Omeprazole which are available under prescription. These drugs will help a lot in your symptoms.

3) The third possibility is of pancreatitis as it may cause upper left abdominal pain which is worse when bending over or sitting. Pancreatic enzymes like serum amylase and lipase should be measured to rule out any pancreatic cause.

4) The last possibility, although less likely is of pleuritic chest pain which is caused by inflammation of pleura and irritation of pleura. This may cause pain which is worse when one bends over or on XXXXXXX inspiration.

I suggest you to consult a physician and get an ultrasound upper left abdomen, pancreatic enzymes, upper GI endoscopy and a chest x-ray done to rule out these causes.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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