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What causes chronic upper abdominal pain followed by loss of consciousness?

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Posted on Mon, 14 Jul 2014
Question: My husband ,for the past 4 years , has suffered from chronic upper abdominal pain , which intermittently turns severe acute upper abdo pain, so severe at times he collapses and goes unconscious, I call an ambulance, by the time the ambulance arrives which is usually between 15 to 20 mins, he regains consciousness and even though he feels a bit "washed out", the pain dies back to chronic type. he had a nephrectomy 8 years ago for cancer, and 3 years ago a cholecystectomy and an ercp and a stone removed from the bile duct, recently had another ercp but showed nil.he continually has had scans , ultrasounds , ct scans , gastroscopys you name it he has had them, also he has been admitted to hospital durinthis time with 3 partial small bowel obstructions,treated with ryles tubes and nil orallyfor three days meanwhile at times his bloods are only average most of the time , his LFTS, rise to very high levels at times and his ferritin remains quite high most of the time. haemachromotosis test negative. weight loss is about 18 kgs over last 12 months , although he was told to lose 10 to 12 kgs but he continues to lose it not by choice. T he specialist we have been seeing lately has ordered him tegrotol tabs as he thinks it maybe nerve ending pain , what do you think , as he feels he lives in fear, that the pain gets so bad he willcollapse again and not recover, which seems to happen every 6 to 8 weeks but may be a shorter time between. Do you have any answers or suggestions ?? I forgot to mention he was sent to a vascular specialist , who ordered an abdo angiogram which showed 1 abdo artery was 60 % blocked and 2 were 40% blocked but not bad enough to have surgery ! who and where should we go next.
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Answered by Dr. Chobufo Ditah (2 hours later)
Brief Answer:
Talk to the vascular specialists!

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about these symptoms that your husband has been experiencing. From extensive testing, partially blocked arteries have been identified. His symptoms seem suggestive of intestinal angina. This is similar to what goes on in the heart when there is a blocked vessel. During digestion, intestines need more blood supply just like the heart does during physical exercise. If this amount of nutrients cannot be guaranteed by the blood supply network at any time, the client would present with severe abdominal pains that mimics exactly what goes on in a classical heart attack. How soon this pain sets in depends on the affected part and when it is at its peak of action in the digestion process. With this pain, symptoms would most likely not appear exacerbate should he go without eating. Because of the relief he gets by avoiding food, his food intake would be reduced and he would for sure unintentional continue to drop weight. How much food does your husband eats? Has it changed over the years?

In the face of severe difficulties, I will like to see the known abnormalities addressed first. Partially blocked vessels have been identified and should be corrected. It requires nothing more than putting a stent in place and that would be all. This would be my ultimate suggestion if none of his current medications help with this.

How has been been feeling on tegretol? Hope a lot better but nerve pain would be a constant about the same intensity pain and not pain with intermittent exacerbation that sends the whole entourage panicking. Can I have a full report of the LFT and iron studies?

In all, this sounds like intestinal angina. Talk to his doctors about this and hear what they say.

I hope this helps. I wish you well. Thank you so much for using our services and do feel free to ask for more information and clarifications if need be.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6318 Questions

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What causes chronic upper abdominal pain followed by loss of consciousness?

Brief Answer: Talk to the vascular specialists! Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about these symptoms that your husband has been experiencing. From extensive testing, partially blocked arteries have been identified. His symptoms seem suggestive of intestinal angina. This is similar to what goes on in the heart when there is a blocked vessel. During digestion, intestines need more blood supply just like the heart does during physical exercise. If this amount of nutrients cannot be guaranteed by the blood supply network at any time, the client would present with severe abdominal pains that mimics exactly what goes on in a classical heart attack. How soon this pain sets in depends on the affected part and when it is at its peak of action in the digestion process. With this pain, symptoms would most likely not appear exacerbate should he go without eating. Because of the relief he gets by avoiding food, his food intake would be reduced and he would for sure unintentional continue to drop weight. How much food does your husband eats? Has it changed over the years? In the face of severe difficulties, I will like to see the known abnormalities addressed first. Partially blocked vessels have been identified and should be corrected. It requires nothing more than putting a stent in place and that would be all. This would be my ultimate suggestion if none of his current medications help with this. How has been been feeling on tegretol? Hope a lot better but nerve pain would be a constant about the same intensity pain and not pain with intermittent exacerbation that sends the whole entourage panicking. Can I have a full report of the LFT and iron studies? In all, this sounds like intestinal angina. Talk to his doctors about this and hear what they say. I hope this helps. I wish you well. Thank you so much for using our services and do feel free to ask for more information and clarifications if need be.