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Have upper abdominal pain. Feel discomfort around diner. Diagnosed with Gastroparesis. Take Protonix

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General Surgeon
Practicing since : 2002
Answered : 3190 Questions
I have upper abdominal pain that worsens as the day goes on. I am pretty much fine while sleeing and up until afternoon. In afternoon I may start some discomfort that increases around dinner time. It seems to get worse after dinner. Here is the weird part. If I am standing up in the evening, basically before or after dinner, I feel just very mild discomfort. However, if I sit in a rocker/recliner (just sitting back in it or actually reclining) in the evening the pain gets worse very quickly and stays pretty bad until I stand up again. Then, very quickly it just goes back to very mild discomfort until I get back in the recliner. Sitting upright or leaning forward while sitting, rather than even slightly reclining, seems to give me significant relief as well. When pain is pretty bad I will feel pulsating in my upper abdomen as well. Three years ago I was diagnosed with Gastroparesis which seemed to resolve over a few months. I also have a mild hiatel hernia. I also will feel on rare occasions an almost tightness in my lower chest and/or some shortness of breath. This should not be heart related as I see a cardiologist for A-Fib and have my heart tested quite often. I even went to the ER with the chest symptoms a year or so ago and after running a bunch of tests they said the tightness/shortness of breath was not heart related. I take one Protonix a day. I am an almost daily drinker of alchohol.

Please help. Thank You!

Posted Wed, 30 Oct 2013 in Abdominal Pain
Answered by Dr. Deepak Kishore Kaltari 2 hours later
Brief Answer:
Possibility of Pancreatitis

Detailed Answer:
Welcome to Healthcare-magic
Greetings of the day

Continuous pain/discomfort in abdomen with positional alteration especially leaning forward, along with the history of alcohol intake daily, i would consider the Possibility of Chronic Pancreatitis. Chronic Pancreatitis may have chest symptoms too.

I would suggest you to get Ultrasound Abdomen and Magnetic Resonance Cholangiopancreatography(MRCP) and Liver Function test done. It will also provide information about any associated Alcoholic Liver or Gall Bladders diseases which probably may be a differential diagnosis.

Apart from above investigations to be done for confirmation of Diagnosis and further management, i would strongly advise you complete abstinence from alcohol that shall definitely provide you much needed relief.

Seek advise of a Medical Gastro-enterologist with your scan and MRCP reports for further treatment.

Hope your queries regarding pain in abdomen has been clarified.

Do take care
Wishing you pain free healthy life ahead.

Dr Deepak Kishore Kaltari
Above answer was peer-reviewed by
Follow-up: Have upper abdominal pain. Feel discomfort around diner. Diagnosed with Gastroparesis. Take Protonix 25 hours later
This past XXXXXXX 18th I had a blood draw and a complete physical. The blood draw covered all the liver enzymes and the tests were all normal. Would issues regarding Pancreatitis have come up in that blood test or is that too long ago? I was having similar symptoms back then but not with the regularity that I have been having recently.
Answered by Dr. Deepak Kishore Kaltari 11 hours later
Brief Answer:
Blood report may be normal in chronic pancreatitis

Detailed Answer:
Greetings of the day

Blood reports and biochemical test may be normal in Chronic Pancreatitis. Diagnosis is made by clinical history and Confirmation by Radiological investigation like Ultrasound abdomen and MRCP. Ultrasound is a simple screening test which is easily available.

I hope I have clarified your doubt.

Do take good care of your Health.
Wishing you a healthy life.
Above answer was peer-reviewed by
Follow-up: Have upper abdominal pain. Feel discomfort around diner. Diagnosed with Gastroparesis. Take Protonix 2 days later
I will stop bothering you after this one. A few quick questions that hopefully you can answer quickly. How serious is this? How is pancreatitis treated? Why chronic and not acute? In addition to no alchohol, is there anything else I can do (diet, etc.) as some type of home treatment until I see my doctor? If the pain issue goes away do to no alchohol etc., I assume I still should see my doctor? You said abstaining from alchohol should provide relief. How long should this take? Should I ever drink alchohol again?
Thank you for your patience in dealing with me.
Answered by Dr. Deepak Kishore Kaltari 19 minutes later
Brief Answer:
Life long Abstinence from Alcohol

Detailed Answer:
Greetings of the day

Acute Pancreatitis usually present with severe pain and there is elevation in enzyme level in acute cases. Chronic Pancreatitis is like a slow smoldering inflammation of Pancreas in which acute episode do occur. It causes slow destruction of Pancreas.

Abstinence of alcohol should be life long. It also causes acid peptic disease. As the damage due to alcohol has occurred over years and degree of damage needs Radiological assessment. If you completely abstain from Alcohol it will prevent further damage and allow Pancreas to recover to certain extent.
Consume a diet low in fat and high in fibre. Treatment of chronic pancreatitis is mainly symptoms directed treatment.

It is advisable to see your physician and have further work up for confirmation of diagnosis.

It was my pleasure assisting you.
Do get back to me if you have further queries.

Take care
Dr Kaltari
Above answer was peer-reviewed by
Follow-up: Have upper abdominal pain. Feel discomfort around diner. Diagnosed with Gastroparesis. Take Protonix 20 minutes later
I just want clarification on approximately how long of alcohol abstinence before I should see pain relief and are there any over the counter meds I can take to help deal with pain in the meantime.
Thank you again. I will set an appointment with my doctor.
Answered by Dr. Deepak Kishore Kaltari 27 minutes later
Brief Answer:
1 to 2 months

Detailed Answer:
Greetings of the day
It will take anywhere around one to two months depending on severity of damage. You can take Diclofenac sodium for time being for relief of pain.
Wishing you a healthy life
Take care
Above answer was peer-reviewed by
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