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What Causes Abdominal Pain With Tenderness And Burping?

Posted on Wed, 25 Jun 2014

Question: Hello, I have had several Gallstones attacks in the past and as of a year ago have one 7mm stone. After breakfast (EGG whites cooked in olive oil, with some cheese and coffee, I left the house. About 30 min later had a double espresso. An hour or so after that I felt bloated and had to come home. I've had some constant full pain and tenderness, burping and have not eaten much (about 9 hours). I have had water, lemon juice, fiber mixed in water only. My pain has dissipated but still feels tender in liver area. I have moved my bowels several times.

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer:
Likely to be due to Cholecystitis

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Dear Sir,

This episode of pain is unlikely to be due to gall bladder or associated stone for following reasons
1. Acute attack of stone or Acute Cholecystitis : Cholecystitis symptoms are unlikely to resolve spontaneously on their own. They usually require use of antibiotics
2. The symptoms are not typical of Cholecystitis: Gall bladder infammation usually causes associated nausea ,vomiting and fever.

The symptoms are likely to be due to acid peptic disease. I would suggest you the following
1. Proton pump inhibitors like Pantoprozole along with Domperidone twice a day. Acid suppression will be helpful
2. Liquid antacid containing Simethicone will be helpful to relieve bloating

If the symptoms persists beyond 12 hours after initiation of treatment , I would suggest you to consult your physician for further clinical assessment to rule out Cholecystitis.

Do get back to me if you need any further assistance, will be glad to assist you.

Take care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Surgeon

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepak Kishore Kaltari (13 hours later)

Thank you Dr. XXXXXXX

Since the episode, I have been having only alkalizing drinks (Wheatgrass, green tea, spring water) and essentially no solid food.

I do feel significantly better and have minimal tenderness.

I am scheduled for bloodwork for Cholesterol on Tuesday, should I have my liver and pancreas checked as well?

About two years ago, an experienced traditional gastroenterologist told me to have the gallbladder removed. I then went to a Chinese medicine doctor and for about six months was receiving acupuncture and stimuation in the gallbladder. Addditionally I was taking Jin Quan Cao (Coin Grass) which is supposed to help keep the gallbladder clean.

Thanks.

Answered by Dr. Deepak Kishore Kaltari (3 minutes later)

Brief Answer:
Ultrasound abdomen is advisable

Detailed Answer:
Hi

Greetings

You will definitely require evaluation of gall bladder and pancreas. I would suggest you to get Ultrasound scan done.
Presence of symptomatic Gall stones is definitely an indication for Surgical intervention. Laparoscopic Cholecystectomy is advisable.
Would suggest you to consult your Physician for further management.

Take Care

Best Regards
Deepak

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

Follow up: Dr. Deepak Kishore Kaltari (21 hours later)

Hi Doc,

I am going to have the following blood tests done tomorrow:

CBC with Differential platelet
Hepatic Function Panel
Amylase
Lipase
Fasting Blood Sugar
Cholesterol

Please advise if you feel I should have any other blood work.

I will consult back with you after I get these results and then schedule with appropriate local doctor after that.

Thanks

Answered by Dr. Deepak Kishore Kaltari (12 minutes later)

Brief Answer:
Also get Ultrasound abdomen

Detailed Answer:
Dear Sir,

Also get Ultrasound abdomen for assessment of Gall bladder and pancrease and to look for features of chronic cholecystitis. Also do get Post prandial blood sugar( sugar level 2 hours after breakfast).

Do get back to me.

Take Care

Regards
Deepak

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

Follow up: Dr. Deepak Kishore Kaltari (49 minutes later)

Hi Doc,

My thought process is that I am going to get this bloodwork done, THEN bring it in to Gastroenterologist or General practicitioner so to save time. While I have no pain now, I do want to make sure it is JUST the gallbladder and nothing else.

Regarding the post prandial blood sugar, I have never done that. Is there a reason to do this on top of the fasting blood sugar? Please advise.

I had general blood work in January and a year ago.

I'm quite sure they will order the ultrasound and we'll go from there.

Thank you!

Answered by Dr. Deepak Kishore Kaltari (4 minutes later)

Brief Answer:
Go ahead

Detailed Answer:
Hi

Its is preferable to get both fasting and post prandial blood sugar estimation. If both the levels are normal Diabetis is completely rule out.
All the blood samples are collected in fasting state( minimum of 8 hours overnight fasting) . After the collection of fasting sample, regular breakfast can be had and 2 hours following which post prandial sugar is estimated.

Remember protocols vary from one physician to other. Your thought process is well planned. Go ahead.

Take care

Regards
Deepak

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

Follow up: Dr. Deepak Kishore Kaltari (10 minutes later)

Hi Doc,

I will add the post prandial sugar estimation test as well.

Thanks!

Answered by Dr. Deepak Kishore Kaltari (2 minutes later)

Brief Answer:
Take Care

Detailed Answer:
Hi
Take Care Sir
Deepak

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