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What Causes Recurring Abdominal Pain And Nausea?

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Posted on Fri, 11 Jul 2014
Question: HI MY NAME IS XXXXXXX AND MY PROBLEM IS SEVERE NAUSEA AND UPPER ABDOMINAL PAIN FOR 5 YEARS, MY NAUSEA IS SO BAD WHEN I WAKE UP AND SOMETIMES LASTS ALL DAY, HAVE HAD EGDS, CT SCANS, BLOODWORK, EXPLORATORY SURGERY, I HAVE NO GALLBLADDER, BEEN TO MANY DRS. THAT CANT FIGURE OUT THE PROBLEM, I TAKE PROMETHAZINE, ZOFRAN, DYCYCLOMINE, ZANAX, GINGER ROOT, THEY DONT SEEM TO HELP ANYMORE, THYROID BLOODWORK WAS NORMAL, LAST EGD SHOWED YEAST I ESOPHAGUS AND INTESTINES, CT OF HEAD WAS NORMAL, SMALL BOWEL FOLLOW NORMAL, GASTRIC EMPTYING NORMAL, I AM VERY FRUSTRATED THIS HAS TAKEN OVER MY LIFE
doctor
Answered by Dr. Dr. Prasad J (10 hours later)
Brief Answer:
Add antiulcer drugs...

Detailed Answer:
Dear XXXXXXX

I empathize with you. I can see you been suffering a lot without answers for the last 5 years. Honestly, I am perplexed too. In most cases of recurring abdominal pain and nausea +/- vomiting, I look forward to the results of EGG and ultrasound scans which unfortunately are essentially normal in your case. In this situation, few things that I would suggest your doctor are:
1. To include acid lowering drugs (antiulcer drugs) along with antiemetic drugs. Since you have esophageal candidiasis the doctors should treat it with antifungal first before implementing antiulcer drugs.
2. Consider possibility of H.pylori infection. Urease breathe test, serological tests +/- biopsy may be needed.
3. If these are episodic symptoms, rare possibilities such as abdominal migraine to be considered. They are managed using a different line of treatment with antidepressant drugs.

It may be worthwhile to take a second opinion with competent gastroenterologist. In the interim, healthy diet and lifestyle implementation is absolutely important. I guess you already know the diet and life style measures.

Hope I have been of some help.

Wish you good luck!!

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (12 hours later)
THANK YOU SO MUCH FOR ANSWERING ME, WHAT IS ANTIEMETIC DRUGS? IM ON 100MG OF ZOLOFT DAILY AND HYPYLORI IS NEGATIVE, CTS NEGATIVE, CELIAC NEGATIVE, I NEVER VOMIT, I JUST HAVE SEVERE NAUSEA EVERDAY FROM THE TIME I WAKE UP PLUS THE CENTER UPPER ABDOMINAL PAIN, I HAVE SEEN SEVERAL GASTRO DRS WITH NO HELP. I AM DESPARATE I FEEL LIKE I HAVE NO LIFE. ZOFRAN AND PROMETHAZINE DONT HELP MUCH ANY MORE. IS THERE ANY OTHER TESTS THAT MIGHT SHOW SOMETHING? I TAKE VICODIN SOMETIMES FOR ABDOMINAL PAIN. WHAT IS ABDOMINAL MIGRAINE, HOW WOULD THAT SHOW UP, JUST HAD EGD 3 WEEKS AGO. WHAT ARE SEROLOGICAL TESTS? THANK YOU FOR TRYING TO HELP ME LOOK FORWARD TO HEARING FROM YOU XXXXXXX COLE
doctor
Answered by Dr. Dr. Prasad J (10 hours later)
Brief Answer:
Medicine + lifestyle change + gastro follow up...

Detailed Answer:
Hello XXXXXXX

Let me first answer your specific concerns.

1. Antiemetic drugs are class of medicines that are used to treat vomiting and nausea. You are 2 different variety - promethazine and zofran (ondansetron).
2. Besides urease breathe test that tests for H.pylori, there are blood tests that tests for antibodies against H.pylori. Those tests are broadly known as serological tests. I guess your doctors have included all these tests before ruling out H.pylori.
3. As I said in my earlier reply, I look for reports of ultrasound and endoscopy to provide clues. If none is found, I refer them to gastroenterologist. However I feel your treating doctors have performed all available tests. If you wish that an expert should go through those tests and remark / suggest the next step, you may try top specialists on this forum. They are available on Ask A Specialist.
4. Abdominal migraine is a rare type of condition similar to migraine headaches. Here some neurotransmitter disturbance leads to sudden onset abdominal pain with nausea and vomiting. These are episodic symptoms which occur randomly, lasts for hours to days. In between two episodes patient may remain asymptomatic. If you feel your symptoms matches this description, you can talk about it with your treating doctor. A neurologist help may be needed in that case.

In a nutshell, I have got the following options to you:
1. As you been investigated extensively you may ask a competent gastroenterologist XXXXXXX or online to review them independently and provide an opinion whether or not you need more tests.
2. Be strict with diet and life style. Eating smaller meals frequently with less spices will make lot of differences.
3. Try the antiulcer drug with the antiemetics. But make sure your treating doctor takes care of esophageal candidiasis.
4. If symptoms closely match abdominal migraine, ask for a neurologist referrral.

I have tried my best to address this concern. Hope it's of some help to you.

Wish you good luck!!
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Prasad J

General & Family Physician

Practicing since :2005

Answered : 3708 Questions

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What Causes Recurring Abdominal Pain And Nausea?

Brief Answer: Add antiulcer drugs... Detailed Answer: Dear XXXXXXX I empathize with you. I can see you been suffering a lot without answers for the last 5 years. Honestly, I am perplexed too. In most cases of recurring abdominal pain and nausea +/- vomiting, I look forward to the results of EGG and ultrasound scans which unfortunately are essentially normal in your case. In this situation, few things that I would suggest your doctor are: 1. To include acid lowering drugs (antiulcer drugs) along with antiemetic drugs. Since you have esophageal candidiasis the doctors should treat it with antifungal first before implementing antiulcer drugs. 2. Consider possibility of H.pylori infection. Urease breathe test, serological tests +/- biopsy may be needed. 3. If these are episodic symptoms, rare possibilities such as abdominal migraine to be considered. They are managed using a different line of treatment with antidepressant drugs. It may be worthwhile to take a second opinion with competent gastroenterologist. In the interim, healthy diet and lifestyle implementation is absolutely important. I guess you already know the diet and life style measures. Hope I have been of some help. Wish you good luck!! Regards