Suggest treatment for duodenal ulcers
Gallbladder, duodenal, acid reflux, vascular problems may cause it
the fact that you've had a normal ultrasound scan is very much against the diagnosis of a gallbladder problem. Duodenal ulcers may cause pain but the negative endoscopy (although it was last year) is also against it. Since you have acid reflux disease, a repeat endoscopy wouldn't go amiss.
Vascular problems may cause pain to the abdomen and chest. Occluded coronary arteries may cause chest pain that radiates to the abdomen and may indeed start after meals. Abdominal blood vessels can also be affected and cause ischemia to parts of the gastrointestinal system. Ischemia can present with pain and perhaps other symptoms or signs like gastrointestinal bleeding, diarrhea etc.
Untreated acid reflux may cause esophagitis, which may present with chest pain that may radiate to the abdomen. Acid reflux is more likely to cause symptoms immediately after a heavy meal, rather than two hours later.
Finally, nervous system problems may delay gastric emptying (gastroparesis). Such problems are usually caused by diabetes, abdominal surgery, drugs etc
So in conclusion, there are various possibilities. The main ones have to be excluded with a new ultrasound scan, endoscopy and cardiovascular assessment.
Contact me again, if you'd like more information about this condition.
I still believe you should carry on with the assessment I've suggested
thanks for the input!
Your diet seems to be as healthy as it can be, so I suppose it shouldn't be part of your problem. The aforementioned tests are important to exclude the most common causes. You haven't mentioned anything about your pancreas but I should ask this: have you even had pancreatitis? Chronic pancreatitis may sometimes present with intermittent pain. A CT scan of the abdomen should be sufficient to exclude that, although the sensitivity of this test for chronic pancreatitis is not perfect. I would suggest proceeding to the first tests I've mentioned before doing the CT.
If the tests are negative (or perhaps even before doing the tests) you can try a practical approach with metoclopramide administration (if you can find it in the USA) or any similar prokinetic drug. This drug speeds up stomach emptying and may cause some relief in cases of gastroparesis.
I hope you find my advices helpful!
If you have more questions, please contact me again.
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