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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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On Acetaminophen. Pain In Stomach. Have An Eating Disorder. Lost Pounds. Cure For Symptoms?

hi there,
i took a single dose of 3500 mg of acetaminophen five or six days ago. since then, i started experiencing a pain on the right side of my ribcage, radiating to the stomach. it's not so sharp, but it's quite annoying and sometimes wakes me up at night. it also tends to hurt more when i don't eat.

i also have an eating disorder. i've never been diagnosed, but it's clear that something's wrong. i've lost thirty pounds during the summer, but gained back ten since school started because of binging and purging multiple times a day. my bmi is about 18.

i've had an endoscopy two months ago because of an eating disorder related accident where the toothbrush i used to make me purge slipped down my oesophagus. quite an uncommon thing, i know. since then, i seem to have a lot of stomach pains and heartburns.

i was wondering if i should see someone.
please excuse the mistakes i might have done, english isn't my mother tongue.
and thanks for the answer!
Thu, 3 Oct 2013
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General & Family Physician 's  Response
Hello,
Thanks for the query to H.C.M. Forum.
If I were your treating doctor for this case I would up come up with the following advice as,
1 Accidentally you took 3500 mg acetacminphen and stated experiencing pain in the right rib cage.
First of all I want to clear that maximum you can 4000 mg ( 4 gm ) of this drug without side effects, so all these symptoms may be due to gastric trouble .
As in large single dose this may develops acute gastritis and all symptoms developed .
Diagnosis can be confirmed by a physician by physical examination.Take antacid & if severe symptom take proton pump inhibitors.
2 Next reason of your problem is blunt injury in the esophagus due to toothbrush . As this developed esophagitis , this causes heart burn and stomach pain .
Try raising the head of your bed about 4 inches with blocks. It might also help to avoid eating or drinking for 2 hours before you lie down.
To help control the stomach acid, one should not drink alcohol or drinks with caffeine in them or eat chocolates or spicy food or greasy foods.
Also take some antacid but if symptoms are severe then you may need drugs like proton pump inhibitors.
So in my opinion consultation with a physician will be helpful for you.
Good luck. Dr. HET
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General Surgeon Dr. M Y Shareef's  Response
Hi ! I am Dr Shareef answering your query. I am not aware for what condition you took such dosage of acetaminophen. This kind of dosage may cause irritation of the gastric and duodenal mucosa giving rise to duodenitis/gastritis giving rise to such pain. This pain will increase in empty stomach due to non dilution of the acid produced in the stomach and reaching the duodenum. This may be the reason for increased pain in empty stomach when you do not eat and awakening you in nights.

Also large doses of acetaminophen may give rise to some kind of hepatic derangements, and if associated with inflammation of the liver, may cause such symptoms.

Under these circumstances, if I would have been your doctor, I would advise you not to skip your food any time of the day and night, avoid alcoholic and aerated beverages if you do take, avoid fatty and fried spicy food. Also raising the head end of the bed by one or two blocks helps the acid to pass through the duodenum faster, and thus may help in relieving your symptome. Also change in life style like regular exercises and regular routine eating habits instead of binge eating may also help you in this.

On the medicinal side, I would advise you to take proton pump inhibitor with a prokinetic drug and a probiotic for a prolonged duration. As these are prescription drugs, you have to get yourself examined by a doctor to get the essential prescription.

If these measures are not helping you out, then I would go for some routine tests along with a liver function test, and also consider referring you to a gastro-enterologist for an endoscopic examination of your stomach and doudenum. By the way, you have not mentioned the report of your endoscopic examination.

I hope these information will help you out. Wishing you an early recovery. Thanks and good luck.
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Radiologist Dr. Vivek Chail's  Response
Hi,
Thanks for writing in to us.

Taking 4000 mg in a day is allowed but 3500 mg acetaminophen as single dose might cause problems considering your build and BMI with eating disorder. It can cause problems with your stomach (gastritis) and liver.

It is unlikely that you have any toxicity. Many individuals with paracetamol toxicity may have no symptoms at all in the first 24 hours following overdose. Others may initially have nonspecific complaints such as vague abdominal pain and nausea. Since it is 5 days up its nothing serious but you may have to consult your doctor if the pain worsens.

Taking treatment for eating disorder is necessary.

Hope this helps
I find this answer helpful
General & Family Physician Dr. Namala Bharadwaj's  Response
hello dear
thanks for your query at HCM
pain might be due to acid problem that is caused by this drug acetaminophen
take tab pantoprazole twice daily before meals it will decrease acid and decrease your pain too.
for eating disorder you have to consult psychiatrist and take medication accordingly,
regards
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On Acetaminophen. Pain In Stomach. Have An Eating Disorder. Lost Pounds. Cure For Symptoms?

Hello, Thanks for the query to H.C.M. Forum. If I were your treating doctor for this case I would up come up with the following advice as, 1 Accidentally you took 3500 mg acetacminphen and stated experiencing pain in the right rib cage. First of all I want to clear that maximum you can 4000 mg ( 4 gm ) of this drug without side effects, so all these symptoms may be due to gastric trouble . As in large single dose this may develops acute gastritis and all symptoms developed . Diagnosis can be confirmed by a physician by physical examination.Take antacid & if severe symptom take proton pump inhibitors. 2 Next reason of your problem is blunt injury in the esophagus due to toothbrush . As this developed esophagitis , this causes heart burn and stomach pain . Try raising the head of your bed about 4 inches with blocks. It might also help to avoid eating or drinking for 2 hours before you lie down. To help control the stomach acid, one should not drink alcohol or drinks with caffeine in them or eat chocolates or spicy food or greasy foods. Also take some antacid but if symptoms are severe then you may need drugs like proton pump inhibitors. So in my opinion consultation with a physician will be helpful for you. Good luck. Dr. HET