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Dr. Andrew Rynne

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Can alcohol cause severe pain and inflammation of the stomach?

Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2074 Questions

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Posted on Tue, 9 Oct 2018 in Digestion and Bowels
Question: Hi, 33yo male, physically fit, non-smoker, alcohol consumption in moderation, 182cm/75kg/14% body fat. ~14 years ago started noticing occasional discomfort/mild blunt pain in the area under right rib cage (area of lower liver edge). Since then underwent multiple diagnostic procedures due to other symptoms (endoscopies - colonoscopy, gastroduoendoscopy, ultrasound of all internal organs) which lead to diagnosis of Crohn's which was later disproven and IBD diagnosis changed to IBS. None of these diagnostic procedures found anything related to discomfort under right rib cage. Repeated endoscopies, ultrasound evaluatuon in January 2017. No pathologies, the only notice was "concentrated bile". During the last few years several cases of unusual bleeding induced by mild brushing of teeth from tongue, gums the day after unusually high alcohol consumption (~8-10 alcohol units) (subjectively - more blood than saliva), almost no other alcohol toxicity symptoms. Such bleeding lasts 1 day. This year discomfort under right rib cage is more often noticed, more expressed. Liver functional tests AST, ALT, GGT, billirubin, Alkaline phosphotase - all within norm. What could be the cause of this discomfort/pain?
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:

Gastritis can be caused due to alcohol.

Detailed Answer:

Hello,

Most likely cause of pain is alcohol induced gastritis. Gastritis causes severe inflammation of the stomach and hence cause pain. This pain is due to inflammation caused by acid produced
Bleeding can be because of deficiency of vitamin C.

So get your vitamin C level checked up.

Take an over the counter Omeprazole twice daily. Its a proton pump inhibitor and would reduce production of acid in the stomach.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 55 minutes later
Thank you for your response. As I have mentioned, I had a gastroduoendoscopy performed, even with biopsies from healthy tissue, mucose is absolutely healthy, no einflamarion or erosions. Plus, I have occassional limited alcohol and very rarely (up to 2 times per year I have moderate amount - 6 alcohol units or so). So it must be something else.
doctor
Answered by Dr. Ramesh Kumar 30 minutes later
Brief Answer:

follow up.

Detailed Answer:

Hello,

Inflammation is of two types acute and chronic.

Acute inflammation is often missed by planned tests done on you and therefore usual strategy in such cases is to see symptomatic relief.

Have you ever tried any PPI for a week or two please reply.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 2 days later
I have talked to doctor. Due to symptoms (type of pain, also that I can feel it even after fasting), location of discomfort, the fact that it has been lasting 14 years, and I had endoscopies done, gastritis is absolutely ruled out.
doctor
Answered by Dr. Ramesh Kumar 5 hours later
Brief Answer:

Follow up answer.

Detailed Answer:

Hello,

As per the information given by you, almost all tests related to gastrointestinal system are absolutely normal.

Most of the times there are two most common causes of discomfort in the area you are referring to:-
The first one is gastric and second one is cardiac.

You have till date ruled out all gastric causes. But if we come to a cardiac cause, none of the basic tests like echo or treadmill tests is done.

Therefore I would recommend you to go for a treadmill test and 2d echo pain related to a cardiac cause can often mimic gastric pain in origin.

How are your anxiety levels?
What about your sleep cycle?
Any issues related to anxiety or sleep?

However 14 years are too long a time so if everything turns up to be normal we would start you on medication based approach where we would give some trials with anti-inflammatory, deworming and anti-anxiety drugs and see if you respond to them.

Hope you can understand that reaching a diagnosis is not that easy in your case.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Ramesh Kumar 7 days later
Dr. XXXXXXX I fully understand it is not easy and simple, that is why I came to this website. I appreciate your dedication and efforts. I am somewhat prone to anxiety, but I have not related anxiety situation with this condition. Plus, I have quite low-stress job (with occassional stress periods) and I have had periods of very low anxiety, including vacation, yet still had this discomfort. As for my sleep - I usually sleep for about 7 hours, sometimes less, sometimes I have an opportun seeity to sleep longer - 8 or even 9 hours for full recovery. In this society, I would subjectively rate my sleep with a solid 8 out of 10 mark :) Thank you!
doctor
Answered by Dr. Ramesh Kumar 10 minutes later
Brief Answer:

Follow up suggestions.

Detailed Answer:

Hello,

Then have you undergone any of the tests related to cardiology like 2d echo or stress test?

Because after excluding a gastric or anxiety related cause it could be cardiac cause.

Hope I have answered your query. Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Ramesh Kumar 6 hours later
Apologies for missing to respond to these. Yes, I had veloergogram (load ECG) done with perfect results. Heart echo - have not done that for quite some time. Can it still be heart issues if I never have any discomfort in chest area and I have normal ECG (regular and load ECG)? Thank you!
doctor
Answered by Dr. Ramesh Kumar 13 hours later
Brief Answer:

Follow up answer.

Detailed Answer:

Hello,

ECG is just a baseline test when i comes to cardiology with a very low sensitivity(In lay mans term its an over hyped test).

As Problem is persisting I would suggest you go for two tests of cardiology namely 2d echo and stress test. If both of them are normal then we could exclude cardiac cause also.

Hope I have answered your query.

Take care

Regards,
Dr Ramesh Kumar, Gastroenterologist
Above answer was peer-reviewed by : Dr. Kampana
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