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Suggest Treatment For Upper Abdominal Pain

Posted on Fri, 24 Jun 2016

Question: I am experiencing pain in my upper abdomen just under the breast area that seems to be both in the front and back. I feel like I have to defecate and throw up at times. Accompanied by these symptoms are cold sweats. I had this around thanksgiving and heart issues were ruled out at the local hospital. The pain returns especially hard after eating and drinking anything

Answered by Dr. Dr. Muhammad Sareer Khalil (31 minutes later)

Brief Answer:
Explained

Detailed Answer:
Hello and Welcome

I appreciate your concern

Just to be sure that I understood your query

If cardiac causes were excluded then the most probable cause includes cholecystitis, GERD/Gastritis and pleurisy. Most likely its related to cholecystitis based on the history that you described.

An ultrasound of the abdomen along with the chest can be advised. The pleural space and diaphragmatic movements can be visualized to rule out any pleural involvement. Evidence of gall stones with signs of cholcystitis would prompt offering a cholecystectomy electively at a later date.

Serum Amylase, lipase and basic metabolic panel including blood sugar, LFTs should also be advised.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

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

Follow up: Dr. Dr. Muhammad Sareer Khalil (3 minutes later)

My gall bladder was removed some years ago....how does that affect your answer

Answered by Dr. Dr. Muhammad Sareer Khalil (7 minutes later)

Brief Answer:
Explained

Detailed Answer:
Hello again

GERD/ Gastritis, Pancreatitis, pleurisy and even a urinary tract stone in the kidneys can be a possibility.

Even though the description doesn't fit any cardiac cause, we like to exclude a cardiac cause anyways by doing a baseline ECG with such a presentation.

The exclusion of gall bladder narrows the differential. This has to be correlated clinically, of course.

For now omeprazole, anti spasmodic like hyoscine butylbromide and metoclopramide like pro kinetic can be advised as part of treatment.

Wishing you best of health

Thanks

Please consult your doctor before deciding on any further course of action.

Dr. M.S. Khalil

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