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What causes persistent stomach ache and fatigue?

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Posted on Wed, 16 May 2018
Question: I have a persistent stomachache. I also have fatigue after I eat and have to lay down for 15 minutes and sleep. I have just survived pancreatic cancer. I take TUMS but it does not help. I am on no medication. I have high A1c at6.5 but am watch what I eat and am going to the gym or walking a mile each day.
thanks in advance for your response.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Please give details and post actual reports.

Detailed Answer:
Hi.
Thanks for your query.
Noted the history.
Please give additional information for me to assist you better:
In which area of the abdomen that you have persistent stomach ache?
Any referred pain?
What was the treatment given for Pancreatic cancer? And when?
Is Pantoprazole helping in relieving the symptoms?
Feedback to these questions will help me to assist you better.
Awaiting.
With Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (2 hours later)
Thanks for this information request
Stomach ache occurs all the time below the end of the sternum -- top of stomach.
I did have a similar pain before but more intense and endoscopy procedure was done which only revealed a cyst which was drained. After that procedure, I felt better and no pain. That particular doctor prescribed Pantoprazole to be taken two times a day. I backed off the recommendation because I felt no pain. I took the medication every other day until the pain returned but the pantoprazole did not alleviate the pain. I do not believe that there is any referred pain. Not sure. Treatment for Pancreatic cancer: surgery (Oct, 2016), distal pancreatic surgery.. removed 40%, margins were clear but one lymph node of 11 contained cancer, so I underwent 6 months of chemo. The recent PET scan (Nov. 2017) revealed NO cancer cells. Recently saw my surgeon and mentioned the cyst which he thought was not the cause of my pain. He suggested taking TUMS; however, TUMS does not seem to help much. The Pantoprazole does nothing for pain; the surgeon suggested that pantoprazole can stop working when the body builds a tolerance for it. My fatigue does not occur after every meal. I try to be active. Activity seems to decrease the pain but then fatique sets in about 30 minutes after exercising. thanks for your help
doctor
Answered by Dr. T Chandrakant (9 hours later)
Brief Answer:
As explained below.

Detailed Answer:
Thanks for your detailed feedback.
Since tums and Pantoprazole is not helping in relieving the symptoms of pain in upper abdomen below sternum, we have to find the probable cause which may be as follows to mention a few common ones I can think about as per the history you have provided:
Fibro-myalgia in the area of pain.
Post-pancreatectomy referred pain.
Pain due to inflammation in xiphisternum.
Small epigastric hernia with obliterated fat only.

My thoughts:
CT scan of the abdomen and abdominal wall along with detailed clinical evaluation, review upper GI Endoscopy and other necessary investigations can help to find the exact cause.
Please discuss these issues with your Surgeon.
Taking a second opinion of another Surgeon helps sometimes.

I hope this answer helps you.l
Please give feedback.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19230 Questions

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What causes persistent stomach ache and fatigue?

Brief Answer: Please give details and post actual reports. Detailed Answer: Hi. Thanks for your query. Noted the history. Please give additional information for me to assist you better: In which area of the abdomen that you have persistent stomach ache? Any referred pain? What was the treatment given for Pancreatic cancer? And when? Is Pantoprazole helping in relieving the symptoms? Feedback to these questions will help me to assist you better. Awaiting. With Regards.