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Pulsating abdominal pain, peaks in sync with pulse. History of tongue swelling. Causes for abdominal pain?

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Internal Medicine Specialist
Practicing since : 1998
Answered : 1579 Questions
My 15yo son woke ~40 minutes ago with pulsating bilateral upper abd pain, still present. Pain peaks in sync w/ pulse. He says it's sharp, peaks at 9 on scale of 10. Abd is barely tender, no splinting. I can't palpate any mass (much less a pulsating one as one might w/ AAA).

He had a heavy dinner tonight. Not constipated, no nausea. No ongoing medical condx, except several incidents of tongue swelling over last few months (probably an as-yet-unidentifie allergy, have ruled out HAE and many allergens).

Posted Wed, 18 Apr 2012 in Abdominal Pain
Answered by Dr. Jasvinder Singh 49 minutes later

Thanks for posting your query.

Given the history of bilateral pulsating upper abdominal pain and the severity of the pain along with the history of a heavy dinner, your son may be suffering from gastroesophageal reflux disease or a hiatal hernia in which there is protrusion (or herniation) of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm.

Abdominal aortic aneurysm can also present with such symptoms but this condition is very rare in people below 50 years of age.

It should go away with the right treatment and the following lifestyle measures:

1)     Try raising the head of your son’s bed about four inches with blocks.
2)     Avoid eating or drinking for two hours before lying down.
3)     Avoid caffeinated drinks, alcohol, chocolate, spicy and greasy foods.
4)     Also give him some antacid like Tablet Zantac 150 mg twice a day half an hour before meals . If the symptoms are severe, then you may need drugs like proton pump inhibitors like omeprazole after consulting your doctor.

If the symptoms are severe, then he should consult a gastroenterologist and get an upper GI endoscopy done to rule out any hiatus hernia.

I hope I have answered your query. If you have any additional questions or follow up queries, then please do not hesitate in writing to us.

Please accept my answer in case you have no follow up query.

Wishing you good health.

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