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Dr. Andrew Rynne

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Have upper abdominal pain and mild ketones in urine. How to get rid of pain?

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Dr. Chakravarthy Mazumdar

General & Family Physician

Practicing since :2004

Answered : 1778 Questions

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Posted on Wed, 11 Dec 2013 in Abdominal Pain
Question: 40 yr old female having sharp upper abdominal pain that comes and goes and showing mild ketones in urine. Last glucose test was a month ago normal. What can cause this?
doctor
Answered by Dr. Chakravarthy Mazumdar 6 days later
Brief Answer: Investigate further Detailed Answer: Hi, Since the blood sugar was normal, I would investigate it further with Ultrasound scan / CT scan abdomen which ever is available immediately. For a 40 yr old female there are multiple reasons for a temporary abdominal pain. The important possibilities that need to be ruled out are gall stones, fatty liver, Gastritis, Pelvic lesions. Let me know if you have these results.
Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Chakravarthy Mazumdar 3 hours later
I had an ultrasound and chest cta which checked stomach because it said inda-abdominal organs unremarkable. Ultrasound looked for gallstones which came back normal. Endoscopy a year ago normal. Does gastritis show in an endoscopy?
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Answered by Dr. Chakravarthy Mazumdar 10 minutes later
Brief Answer: Gastritis show on endoscopy Detailed Answer: Is the pain related to menstural periods? How long does that stay? Is it upper or middle or lower one third of the abdomen? is it left or right side? What increases the pain and what reduces the pain? I am happy that the major things are ruled out. It comes now to the pelvic problems .
Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Chakravarthy Mazumdar 35 minutes later
The pain comes and goes in the upper left quadrant. Radiates to my chest and causes thight sqeezing in throat, jaw, shoulder but ive been to emerg to rule out heart problems. Had every cardiac test other than a catheder which all show normal other than impaired LV relaxation. I have ankylosing spondylitis.
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Answered by Dr. Chakravarthy Mazumdar 19 minutes later
Brief Answer: Rheumatologist opinion Detailed Answer: The pain does not sound to be cardiac in nature. It sounds to be muscular in nature. May be associated with ankylosing spondylitis. Were some muscle problems ruled out by your doctor like myositis, Rheumatalgia etc. Get blood counts and ESR done first with the help of your primary care doctor. If they are raised ask for a referral to Rheumatologist.
Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Chakravarthy Mazumdar 2 minutes later
All blood work is perfect. Even RA factor. This feels more like a chronic radiating gas pain. I have a rheumatologist, shhe says i have grade 2, not bad.
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Answered by Dr. Chakravarthy Mazumdar 4 minutes later
Brief Answer: Antacids. Detailed Answer: If it is gas pain, you should be doing good with a month's course of antacids. You can go in for Ranitidine group of medicines or Pantaprazole. Did you explore this?
Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Chakravarthy Mazumdar 2 minutes later
I have some rabaprazole to start but im scared to take it cuz i have heart palpitations. Is it safe?
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Answered by Dr. Chakravarthy Mazumdar 5 minutes later
Brief Answer: Prilosec Detailed Answer: You can start with Prilosec OTC, 20 mg. You can start this half an hour before breakfast and dinner, twice a day for two weeks. This is easy to procure than Rabeprazole. This is available over the counter as well. I somehow feel that you have other problem that is adding to the stress. Elimination is the key. Your problem can be termed as Non Ulcer dyspepsia. You need to work with your doctor to eliminate it.
Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Chakravarthy Mazumdar 1 minute later
In canada too?
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Answered by Dr. Chakravarthy Mazumdar 6 minutes later
Brief Answer: Not sure Detailed Answer: Oops. I am not sure about canada. You can enquire at pharmacy if any PPI is available as OTC. Omeprazole is available in US with the brand PRILOSEC OTC. If you cannot get Priolosec (Omeprazole) then you can start with Rabeprazole for said days. Fill this with your GP the next time.
Above answer was peer-reviewed by : Dr. Aparna Kohli
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