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Suggest Treatment For Severe Abdominal Pain With Nausea And Vomiting
Question: Hi, I've been having severe abdominal pain with nausea and vomiting. I have abdominal pain every day when I wake up and usually after few hours it goes away but lots of times it does not and it gets worse and worse to the point where I can't walk and usually I am taken to ER at that point, I've had every test done that doctors could come up with, together with CT scans, x rays, ultrasound etc. This has been hurting me for about 8 yrs now and I really don't know what to do any more and my doctor seems to given up on me as well. Even ER staff thinks that I go there just for drugs since nothing can help me with pain except dilaudid. They did place me on a care plan so now the'll hold me at the ER for 5-8hrs without giving me anything for pain and sending me home like that where I go thru all that again and again. I think they told me that I have Cyclic vomiting syndrome which I do not believe. I had several upper and lower endoscopies done as well and all looked normal. I really don't know what to do any more at this point all I know it is living hell every single day and my whole life revolves around my gut. Can someone please help?
Brief Answer:
Give detailed history in chronology.
Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Male/39 - severe abdominal pain with nausea and vomiting - more than 8 years - pain every day on waking up - usually goes away after a few hours - but does not a lots of time - worsen that you are taken to ER - staff thinks that you go for Dilaudid, the only medicine that helps you - have been told this to be cyclic vomiting syndrome - all the tests normal - no records with you - read the history carefully....
I can understand the agony you must have been going through.
Since your Doctors have given up on you, I would like to assist you.
In most of the cases the detailed history in chronology can help us to get a diagnosis.
Please provide me the history of 8 years in chronology from the day you had the first attack.
- What was the incidence that the pain in abdomen started?
- Had the pain been so severe that disturbs sleeps?
- What comes first - the pain, nausea, vomiting or anything else?
- Type of pain: burning/cutting/ throbbing/pinching or so?
- Hoe does the pain is felt in the morning when the attack starts- how does it progress?
- Site of pain?
- Any radiation of the pain to other place?
- Any bloating?
- Any aggravating factor?
- Any relieving factors?
- How much relief with Dilaudid?
- Does the passing of gases/feces reduce the pain?
- Any other information which you feel relevant or irrelevant?
Awaiting for your feedback in details.
Give detailed history in chronology.
Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Male/39 - severe abdominal pain with nausea and vomiting - more than 8 years - pain every day on waking up - usually goes away after a few hours - but does not a lots of time - worsen that you are taken to ER - staff thinks that you go for Dilaudid, the only medicine that helps you - have been told this to be cyclic vomiting syndrome - all the tests normal - no records with you - read the history carefully....
I can understand the agony you must have been going through.
Since your Doctors have given up on you, I would like to assist you.
In most of the cases the detailed history in chronology can help us to get a diagnosis.
Please provide me the history of 8 years in chronology from the day you had the first attack.
- What was the incidence that the pain in abdomen started?
- Had the pain been so severe that disturbs sleeps?
- What comes first - the pain, nausea, vomiting or anything else?
- Type of pain: burning/cutting/ throbbing/pinching or so?
- Hoe does the pain is felt in the morning when the attack starts- how does it progress?
- Site of pain?
- Any radiation of the pain to other place?
- Any bloating?
- Any aggravating factor?
- Any relieving factors?
- How much relief with Dilaudid?
- Does the passing of gases/feces reduce the pain?
- Any other information which you feel relevant or irrelevant?
Awaiting for your feedback in details.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
First time I had this happen to me was while I was in the college and working full time, I also had a wife and two kids at that time. I was under so much stress that finally one morning I woke up and felt nauseaus and when I came to work I was trying to eat breakfast and that is when I got so sick and started vomiting and could not stop, my friend drove me to ER. After that episode I did not have another one for probably 10 months and then it came again. After that it was more and more often. 2 years ago I was so sick that I made 26 trips to ER and still seeing my other doctors who did not know what to do with me. I had several upper and lower endoscopies done, several CT scans also several x rays where everything came back normal, I was hospitalized twice, one time for colitis and 2nd time for vomiting which doctors could not stop and they would not treat me with Dilauded.
Going few years back I was waking up soaking wet from sweat and I had acid coming back into my throat so in the morning I would have a hard time talking how much my throat was burned.
I don't have acid any more but I still wake up all in sweat on some occasions.
If I get my episode there is no sleep on laying down or walking or anything it is so uncomfortable that you cant fine any position that would give you some comfort.
Pain is all over my stomach and it feels like everything in my belly is getting swollen and it just hurts everywhere.
It is a combination of burning and throbbing pain.
Pain does not radiate anywhere else except my belly.
I read online that hot showers help so I've been doing that a lot. I mave a water so hot that is almost unbearable to be under then I try to slow my breathing down and that helps for a few minutes, so everytime now I have a episode I take anywhere from 20-30 showers hoping that it will pass. If it doesn't then my wife will take to ER, but in ER they will not treat me with Dilaudid since they placed me on a care list and they will not treat me with narcotics even though nothing else helps. They will keep me in ER for 5-6 hours giving me whatever medicine they can come up but not narcotic and then they send me home in the same shape I was when I came in, so I try to do whatever I can to stay out of ER. I don't do drugs of any kind and I don't drink, I smoke half a pack of cigarets a day. I drink lots of tea, and I ma using probiotics,
My late doctor who passed away last year was finally starting to see what I am going thru and he was actually doing some research on my condition but he had a heart attack and died.
Dilaudid for some reason works within minutes , I don't know why but if they treat me with it I can go home within 10 minutes like I was never sick.
Other thing to note is that I get very tired before getting sick, so when I start feeling like that I kind of know it's coming but trying to rest it just doesn't work for some reason it takes me a lot of time to recharge my body.
Normally everyday in the morning pain starts first, then nausea and then I have to go to bathroom, first stool is normal but second one is watery.At that point pain will ease up but I still have nausea, and if I don't get better within first hour then 90% chance I will end up in hospital and I really hate going to ER, I have a feeling they all think I am a junkie and that I am there just for drugs. If some one could go thru what I go when I have episode they would see what that does to a human body, I get so exhausted that I can barely walk and it is getting worse and worse every time. But none seems to want to really find out what is the cause
I hope this somewhat explains what I am going thru. and I thank you very much!
Fell free to ask any other questions you might have. Oh and so far this year I had 4 trips to ER and that was after I suffered at home for about 6 hours since I know how I am gonna be treated in ER.
right now I take following medications: Amitrptyline,clonazepam,prochlorperazine,mirtazapine
Going few years back I was waking up soaking wet from sweat and I had acid coming back into my throat so in the morning I would have a hard time talking how much my throat was burned.
I don't have acid any more but I still wake up all in sweat on some occasions.
If I get my episode there is no sleep on laying down or walking or anything it is so uncomfortable that you cant fine any position that would give you some comfort.
Pain is all over my stomach and it feels like everything in my belly is getting swollen and it just hurts everywhere.
It is a combination of burning and throbbing pain.
Pain does not radiate anywhere else except my belly.
I read online that hot showers help so I've been doing that a lot. I mave a water so hot that is almost unbearable to be under then I try to slow my breathing down and that helps for a few minutes, so everytime now I have a episode I take anywhere from 20-30 showers hoping that it will pass. If it doesn't then my wife will take to ER, but in ER they will not treat me with Dilaudid since they placed me on a care list and they will not treat me with narcotics even though nothing else helps. They will keep me in ER for 5-6 hours giving me whatever medicine they can come up but not narcotic and then they send me home in the same shape I was when I came in, so I try to do whatever I can to stay out of ER. I don't do drugs of any kind and I don't drink, I smoke half a pack of cigarets a day. I drink lots of tea, and I ma using probiotics,
My late doctor who passed away last year was finally starting to see what I am going thru and he was actually doing some research on my condition but he had a heart attack and died.
Dilaudid for some reason works within minutes , I don't know why but if they treat me with it I can go home within 10 minutes like I was never sick.
Other thing to note is that I get very tired before getting sick, so when I start feeling like that I kind of know it's coming but trying to rest it just doesn't work for some reason it takes me a lot of time to recharge my body.
Normally everyday in the morning pain starts first, then nausea and then I have to go to bathroom, first stool is normal but second one is watery.At that point pain will ease up but I still have nausea, and if I don't get better within first hour then 90% chance I will end up in hospital and I really hate going to ER, I have a feeling they all think I am a junkie and that I am there just for drugs. If some one could go thru what I go when I have episode they would see what that does to a human body, I get so exhausted that I can barely walk and it is getting worse and worse every time. But none seems to want to really find out what is the cause
I hope this somewhat explains what I am going thru. and I thank you very much!
Fell free to ask any other questions you might have. Oh and so far this year I had 4 trips to ER and that was after I suffered at home for about 6 hours since I know how I am gonna be treated in ER.
right now I take following medications: Amitrptyline,clonazepam,prochlorperazine,mirtazapine
Brief Answer:
Observe, remember to correlate, stop instigating factors and give feedback.
Detailed Answer:
Thanks for an elucidate history, this helps.
- One of the dictum of Pain in abdomen is:
If all the investigations are normal, this may be IBS that is irritable bowel syndrome. Since your history has started with stress there is more likelihood of being suffering IBS.
- Secondly, there are some conditions that are better investigated further or tried with treatments on empirical basis o see whether effective or not.
To name a few are abdominal epilepsy, usually seen in children.
- Since someone has mentioned you about cyclic vomiting an MRI of the brain and the thoraco-lumbar spine are needed to rule out the central or peripheral causes.
- The medications you are on: Amitriptyline, clonazepam, prochlorperazine, mirtazapine should help if hte cause is psychological alone or need modulation of medicines or dosages, as most of these need increase as per the necessity, but needs a prescription of your Doctor under his guidance.
- Since Diluadid helps you so much, they should treat you with it. Again you have to discuss with your Doctors, someone may help you with this. Dilaudid (hydromorphone) is an opioid pain medication. An opioid is sometimes called a narcotic. Dilaudid is used to treat moderate to severe pain. This is the worry that your Doctors do not want to give you more.
- Alternative therapies: Try these like naturopathy, meditation, acupressure, acupuncture, yoga and anything that you know reduces your stress and anxiety.
I am hopeful that if you can control your stress and anxiety, you will be symptom-free for longer duration, lesser severity and have a great life.
- Since it is you that you are suffering and that you know what causes you the stress and anxiety you can take all the care to avoid all the factors that instigate or enhance your problems.
- Also watch for the foods, beverages, or any other such factors that instigate or enhance your problems and you have to strictly stop these, for example watch for milk and milk products, meat and other things that have high protein values, or have additives and preservatives as these can cause the similar problems.
So read all these carefully, follow the instructions and give me the feedback of your observations and the results of modulations that you will do with immediate effect.
Waiting to hear from you about the observations, following instructions and its results.
Observe, remember to correlate, stop instigating factors and give feedback.
Detailed Answer:
Thanks for an elucidate history, this helps.
- One of the dictum of Pain in abdomen is:
If all the investigations are normal, this may be IBS that is irritable bowel syndrome. Since your history has started with stress there is more likelihood of being suffering IBS.
- Secondly, there are some conditions that are better investigated further or tried with treatments on empirical basis o see whether effective or not.
To name a few are abdominal epilepsy, usually seen in children.
- Since someone has mentioned you about cyclic vomiting an MRI of the brain and the thoraco-lumbar spine are needed to rule out the central or peripheral causes.
- The medications you are on: Amitriptyline, clonazepam, prochlorperazine, mirtazapine should help if hte cause is psychological alone or need modulation of medicines or dosages, as most of these need increase as per the necessity, but needs a prescription of your Doctor under his guidance.
- Since Diluadid helps you so much, they should treat you with it. Again you have to discuss with your Doctors, someone may help you with this. Dilaudid (hydromorphone) is an opioid pain medication. An opioid is sometimes called a narcotic. Dilaudid is used to treat moderate to severe pain. This is the worry that your Doctors do not want to give you more.
- Alternative therapies: Try these like naturopathy, meditation, acupressure, acupuncture, yoga and anything that you know reduces your stress and anxiety.
I am hopeful that if you can control your stress and anxiety, you will be symptom-free for longer duration, lesser severity and have a great life.
- Since it is you that you are suffering and that you know what causes you the stress and anxiety you can take all the care to avoid all the factors that instigate or enhance your problems.
- Also watch for the foods, beverages, or any other such factors that instigate or enhance your problems and you have to strictly stop these, for example watch for milk and milk products, meat and other things that have high protein values, or have additives and preservatives as these can cause the similar problems.
So read all these carefully, follow the instructions and give me the feedback of your observations and the results of modulations that you will do with immediate effect.
Waiting to hear from you about the observations, following instructions and its results.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Answered by
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