Brief Answer:
Clinical assessement and investigations required.

Detailed Answer:
Hi XXXX! Good morning. I am Dr Shareef answering your query.

Long term use of pain medications cause repeated trauma to the gastric and duodenal mucosa causing gastritis (inflammation of the gastric mucosa) /duodenitis (inflammation of the duodenal mucosa) which when acute might cause sharp pain with or without other manifestations like vomiting, and even bleeding from these sites.

In addition, the status of your pancreas has to be assessed because of your history of consumption of alcoholic beverages which causes inflammation of the pancreas causing destruction of the pancreatic tissue in the long run. This would also give rise to the sharp pain, and with this inflammation of the liver as well could be there because of the alcohol consumption.

If I were your doctor, I would after a clinical examination of your abdomen, would advise you to abstain completely from alcohol and smoking if you do as both these substances would cause damage to the gastrointestinal mucosa making it more vulnerable to the effect of pain killers which you are used to.

Next I would advise you on the dietary front to go for bland diet with more of roughage with fruits and sufficient liquids.

After advising you with some anti spasmodic along with a proton pump inhibitor for a symptomatic relief for the present, I would advise you with some investigations for diagnosing your problem like the following :
*Complete blood count
*Blood sugar both fasting and post prndial
*Liver function tests along with HbsAg and HIV test
*Serum Amylase and Lipase
*Blood urea and serum creatinine
*Routine stool test for ova and cyst, and also for occult blood
*Ultrasound of the abdomen followed by a CT scan if the reports of the ultrasound are inconclusive.

Further management would depend on the results of clinical assessment & reports of investigations. If need be, an endoscopic evaluation of your stomach and intestines by a gastro enterologist might have to be considered. Till that I would continue prescribing you with a proton pump inhibitor, a liquid antacid and advise you to avoid pain killers unless supervised by your treating doctor.

I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.

Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.

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