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Severe pain around upper abdomen, difficulty in eating, gassy feeling. Remedy?

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General Surgeon
Practicing since : 2008
Answered : 5376 Questions
Yesterday, I was admitted to ED following my Doctor's orders (as well as having an endometriosis flare up for the last three weeks or so); I was having great difficulty eating as it hurt do much - some of my endo pain is in my appendix area. I found out I had gastritis from stress, and now the doctors are focusing in on scans of my gall bladder and liver. I have been very gassy (belching - not just burping, and passing wind), but the worst thing is the terrible pain in my right upper abdomen. How can I help myself with the gastritis - does acid/alkaline food monitoring work? Any information/advice around the pain around my right upper abdomen?
I have never had digestive problems before in my life
I have attached my discharge form
Posted Sun, 2 Jun 2013 in Digestion and Bowels
Answered by Dr. Grzegorz Stanko 1 hour later

Thank you for the query.

Upper right abdominal pain can be caused by gallstones indeed and scans can be helpful. However it is very common that for such pain, stomach disease is responsible. It can be gastritis (stomach inflammation), peptic ulcer, inflammation due to Helicobacter Pylori infection, etc. With stomach disease you may also suffer from loss of appetite, nausea,vomiting. Further Stress and pain killers intake make stomach problems more possible.
It is very characteristic that with peptic ulcer almost all tests are negative. That is why it is strongly necessary to have it diagnosed. Since endoscopy is an important diagnostic tool to confirm gastritis/peptic ulcer, I would suggest you to consider this test when you plan other tests. During this test, Helicobacter Pylori infection will be checked and if present, should be treated with antibiotics.

In the meanwhile you should avoid coffee, fatty foods, spicy foods, fruit juices, alcohol intake. Last meal should be two hours before sleeping. Specific medications can be started based on endoscopy findings.

Your lower abdominal pain can be caused by endometriosis. This condition causes adhesions creation in the abdominal cavity. This adhesions impede bowel movements. It gives abdominal pain, cramps, bloated abdomen and diarrhea. If you find this can be the reason of your symptoms, some tests should be done. Colonoscopy, abdominal CT with oral contrast (enteroclysis) should be considered at first. Depending on the results and symptoms, diagnostic laparoscopy might be necessary.

Hope this will help. Feel free to ask further questions.

Above answer was peer-reviewed by
Follow-up: Severe pain around upper abdomen, difficulty in eating, gassy feeling. Remedy? 1 hour later
The pain in this area started over my appendix last September when I came off amitryptiline. It kept getting worse everytime I had a period and the days before hand ( and another area to the left of my navel). I have had endo removed in the past.

Could they be two separate issues or do think they are related. Just sitting here typing is uncomfortable on my right side- I have to sit ramrod straight! :)
Answered by Dr. Grzegorz Stanko 2 hours later
Your abdominal situation seems quite complicated. Endometriosis can recur even if it were removed.
Please try to compare your previous endometriosis symptoms with current symptoms (localisation can be different but the type of pain and bowel movement problem can be similar). If it seems similar, endometriosis can be the main reason.
According to your symptoms it seems that you do suffer from two separate issues (stomach problem and endometriosis). But it only seems, the answer can be given after mentioned tests (gastroscopy for stomach problems and colonoscopy + abdominal CT for intestines problem due to endometriosis).

Hope this will help.
Above answer was peer-reviewed by
Follow-up: Severe pain around upper abdomen, difficulty in eating, gassy feeling. Remedy? 47 hours later
I have got out of Hospital this afternoon. The ultrasound showed no abdominal issues, gall bladder fine - it has been put down to stress induced gastritis & gave me mylanta. No endo was sighted in the US but that wasn't unexpected. An elective laproscopy will be scheduled at my next Gynae appt. I do have moderate hemorrhoids, but lately I have been bleeding alot more than ususal, even when the stool is soft. When I talk about blood in the toilet afterwards I mean alot, more than normal hemorrhoid. I may post this as a second question which hopefully you answer. The thing is I didn't tell them about it on the ward today
Answered by Dr. Grzegorz Stanko 2 hours later
Abdominal ultrasound is good test for basic diagnostics and really does not tell anything about stomach, and hardly anything about intestines. That is why endoscopy should be done. Stress caused gastritis is still a stomach disease and can give peptic ulcers. Untreated peptic ulcers can lead to stomach perforation. So this is not a good information.
Laparoscopy is a good idea and its good for you that you will have it soon.

Bleeding from rectum can be caused by hemorrhoids indeed. Such blood is usually bright red, on the surface of the stool or toilet paper. Such blood is not mixed with the stool (this is very important). If your bleeding is ample, it does not have to be bleeding from hemorrhoid. Especially that you have abdominal pain. Hemorrhoids are the last disease which should be diagnosed at your case (this means that there is many more serious diseases which should be ruled out first).
So your doctor should know about such symptom. This is really a serious symptom. And colonoscopy should be done at your case.

If you are absolutely certain that this is only hemorrhoids bleeding, you may try such treatment:
- avoid constipation (increase fiber XXXXXXX products, mineral water intake)
- do not push hard on stool (when pushing on stool, blood pressure in hemorrhoids rises and makes them bigger)
- have sitz baths with Quercus Cortex twice a day
- wash your anus after every stool
- use OTC suppositories for hemorrhoids

Such treatment might help and you should see an improvement in a week or so. But it is advisable for you to visit your doctor once again and mention about this bleeding.

Hope this will help.
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