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Suggest remedy for intermittent stomach pain

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Posted on Wed, 30 Sep 2015
Question: I have been feeling stomach pain (above the waistline and below the rib cage for about 10 days now. It is off and on throughout the day and seems to not hurt when I wake up in the morning but becomes worse as the day goes on. Another symptom is I have no energy. I usually workout at a gym 3 days a week and golf and surf on the weekend but the last 2 weekends I have not had the energy to do these activities, as if my body is fighting something. Today I sat at a BBQ with no activity for 3 hours and came home and was exhausted even thought I slept 8 hours last night.
doctor
Answered by Dr. Mukund Savaskar (1 hour later)
Brief Answer:
Stomach Pain with Debility /Under Invetigation

Detailed Answer:
Provisional Impression-Stomach Pain with Debility /Under Investigation
Hi,Dear thanks for your query to My Virtual Clinic at HCM.

I studied your query in all the details put forth by you.
Your issues are reviewed with your query for the last attack in july when you consulted at HCM .

After studying in context of this and the last query, I feel that it would be nice if you update following areas as follows-
Which side of rib cage this stomach pain is there?I s this pain related with your work activity and with your diet intake?
What type pain is it? Is it burning/or dull ache /or mild cutting pain with colic with it?
How frequently you smoke/ drink alcohol, beer/ and have spicy fried non-veg food?
What is your day's work schedule and diet schedule?
How frequently you take tea/coffee in a day?

I understood your life style which is very hectic and stressful for your age.
Any past history of any medical illness and any medications for that in the past or in present?
Any past CT/USG studies with its reports? Please update them.
Update any past tests from GI (Gastro-intestinal) endoscopist and any reports when the gallbladder removal was done?
Why your gall bladder was removed, was it for gall stones or Cholecystitis?

Awaiting further query and more information as asked above, so as to help you out from the missed diagnosis since July 15 attack.

Regards,
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical Specialist

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Mukund Savaskar (38 hours later)
Here are my answers to your questions:

After studying in context of this and the last query, I feel that it would be nice if you update following areas as follows- I believe the symptoms from the last query are unrelated to this query, last time it was suspected to be skeletal or back/nerve related. I had 2 visits to a chiropractor and the symptoms went away.

Which side of rib cage this stomach pain is there? The pain is in the area above my waist line and below my rib cage, mostly in the middle but I feel it on the left and right sides below the front of my rib cage.

Is this pain related with your work activity and with your diet intake? I have an office job and it doesn't seem to be work related, the pain is there at work, at home, when I go to bed, pretty consistently. It seems a little worse after I eat a meal but the pain is there all the time.

What type pain is it? Is it burning/or dull ache /or mild cutting pain with colic with it? It is an ache or pain that is maybe a 5 or 6 on a scale from 1 to 10.

How frequently you smoke/ drink alcohol, beer/ and have spicy fried non-veg food? I do not smoke. I drink alcohol about 3 nights a week, typically 1-3 beers. I don't eat a lot of spicy food, I have Thai food or XXXXXXX food about once every 2 months, other than that most of my diet is not very spicy.

What is your day's work schedule and diet schedule? I work Monday - Friday from 7:30am to 6:00pm in an office environment sitting at a desk mostly. I eat breakfast at 6:30am usually yogurt, banana, and cranberry juice, I eat lunch at noon, usually a sandwich, or something similar, and I eat dinner about 7:30pm usually pasta or fish or beef or a variety of foods.

How frequently you take tea/coffee in a day? I typically drink 3 cups of XXXXXXX Grey black tea a day usually in the morning.

I understood your life style which is very hectic and stressful for your age.
Any past history of any medical illness and any medications for that in the past or in present?
I haven't had any major medical illnesses and i have never had to take medications for an extended period of time. I had a sinus infection at the end of July and took a 10 day prescription of Augmentin antibiotic to get rid of the infection (July 25 - Aug 5th). I take Advil (Ibuprofen about 2-3 times a week if I get a headache or have muscle soreness after working out or after I have been drinking alcohol (beer) to prevent getting a headache.

Any past CT/USG studies with its reports? Please update them. - No

Update any past tests from GI (Gastro-intestinal) endoscopist and any reports when the gallbladder removal was done? These tests were not done.

Why your gall bladder was removed, was it for gall stones or Cholecystitis? I had gall stones which caused a gall bladder attack 3 times in a 6 month period and each time it was a gall stone blocking the duct leaving the gall bladder and the Gastroenterologist I saw recommended removing the gall bladder which was done, that was in 2008.

Awaiting further query and more information as asked above, so as to help you out from the missed diagnosis since July 15 attack.
doctor
Answered by Dr. Mukund Savaskar (9 hours later)
Brief Answer:
Acute On Chronic Gastritis with Unrelieve Stomach Pain with Debility

Detailed Answer:
Provisional Impression- Acute On Chronic Gastritis with Urelieved Stomach Pain with Debility.

Hi,Thanks for the updates.

My clinical Impressions after review of the last reply-

Dear,It seems to be a case of Acute On Chronic Gastritis,
and that's why you did not get the relief after lemon juice and hydration.

Stomach pains in the mid line and on right /left side,are due to-
Acute on Chronic Gastritis and which increases with gastric intakes as the day goes by.
Debility observed by you lately, is due to-
the chronic build up of the stress and lack of intake,as observed by you lately in BBQ

Prima Facie your's is the case of Stress/lifestyle induced Acute on Chronic Gastritis,with a history of gall bladder removal lately.

Would advise to meticulously follow the following suggestion-

-Bland diet/low volume non spicy meals
-Reduce on your tea/coffee for next 3 weeks
- Rest from your surfing and gym working and partying/alcohol(beer) from 3 times a week- to one times ONLY.
-8 hrs sleep without alcohol(beer)/
-Don't Self medicate with pain killer Advil,without guidance from your doctor.
-Tab Proton-D - 1 at 6 pm, under guidance from your family doctor.

-Lab tests suggested-
Stool for Occult
Stool for Ova/Cyst/Protozoa-by concentration method
Complete Blood Test,
Blood Sugar/ Lipid/Liver/ Profiles
-REVIEW after 3 weeks by direct Premium Followup query to ME specifically.

Hope I replied your query in full totality to give you relief in next 2-3 weeks time.
Will appreciate your hiting thanks and writing real review comments for those needy Patient visitors like you at HCM, if you are satisfied by this reply.

Wishing you fast recovery from long complex stomach pains and debility.
Good Day!!

Regards,

Dr.Savaskar M.N. XXXXXXX Surgical Specialist.
M.S.Genl-CVTS


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3607 Questions

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Suggest remedy for intermittent stomach pain

Brief Answer: Stomach Pain with Debility /Under Invetigation Detailed Answer: Provisional Impression-Stomach Pain with Debility /Under Investigation Hi,Dear thanks for your query to My Virtual Clinic at HCM. I studied your query in all the details put forth by you. Your issues are reviewed with your query for the last attack in july when you consulted at HCM . After studying in context of this and the last query, I feel that it would be nice if you update following areas as follows- Which side of rib cage this stomach pain is there?I s this pain related with your work activity and with your diet intake? What type pain is it? Is it burning/or dull ache /or mild cutting pain with colic with it? How frequently you smoke/ drink alcohol, beer/ and have spicy fried non-veg food? What is your day's work schedule and diet schedule? How frequently you take tea/coffee in a day? I understood your life style which is very hectic and stressful for your age. Any past history of any medical illness and any medications for that in the past or in present? Any past CT/USG studies with its reports? Please update them. Update any past tests from GI (Gastro-intestinal) endoscopist and any reports when the gallbladder removal was done? Why your gall bladder was removed, was it for gall stones or Cholecystitis? Awaiting further query and more information as asked above, so as to help you out from the missed diagnosis since July 15 attack. Regards, Dr.Savaskar M.N. M.S.Genl-CVTS XXXXXXX Surgical Specialist