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What Causes Severe Abdominal Pain And Vomiting?

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Posted on Wed, 8 Oct 2014
Question: My brother in law has been experiencing severe abdominal pain and vomiting. Was taken to the ER where blood tests and X-rays were taken but no diagnosis was given, told to follow up with his physician. These espsides began several months ago, originally was told he has an inflamed pancreas. He has since been watching his diet EXTREMELY closely, rare if any alcohol. The most recent episodes have come out of nowhere. I thought maybe his gallbladder but was told at the ER it was 'fine'. Any suggestions?
doctor
Answered by Dr. T Chandrakant (14 minutes later)
Brief Answer:
Chronic Pancreatitis.

Detailed Answer:
Hi.
From the history you have provided this looks to be due to Chronic pancreatitis.
NO alcohol at all.
It is good that He is watching his diet strictly.
The pancreatitis attack comes like this only, sudden and acute.

He can follow with his Physician as advised. He may be advised Pancreatic enzyme supplements to be taken with food, no alcohol at all, further investigations as would be advised by His Physician.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (16 minutes later)
Is there any reason something didnt show up in his blood work? What is treatment? Another doctor after his first attach told him it wasnt his pancreaus (sp?) should this have been detected before now?
doctor
Answered by Dr. T Chandrakant (11 minutes later)
Brief Answer:
Gastroenterologist's opinion and investigations

Detailed Answer:
Blood work may not show much of importance in every case and may not really be relied as we see in many cases.

To have a definite diagnosis he needs to undergo CT scan / MRCP / Upper GI endoscopy an so on.

The treatment will depend upon the findings on clinical examination by a Gastroenterologist / Findings on the investigations.
He should try to seek an opinion of a Gastroenterologist.

It will be difficult to comment on what other Doctor has said, was he a Gatroenterologist? Has He given an opinion or insight about the possible diagnosis ?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (7 minutes later)
Yes, a Gastroenterologist. Simply told to stay away from fatty foods. He has watched his diet so closely, in my and my sisters (his wife) opinion has lost too much weight. Now after the last two episodes afraid to eat.
doctor
Answered by Dr. T Chandrakant (1 minute later)
Brief Answer:
Any investigations?

Detailed Answer:
What were the investigations done ?
Loosing weight is a serious matter unless proved otherwise.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (8 minutes later)
Blood tests, ultra sound of gall bladder ducts (no blockages). First set if blood tests showed enzymes, second set showed none. MRI showed nothing significant. Gastro doctor did zero tests, just told to stay away from fatty foods. The most recent pain was in his lower abdomin, the belly button area, felt like an extreme tight squeezing, with vomiting.
doctor
Answered by Dr. T Chandrakant (16 minutes later)
Brief Answer:
Further evaluation is needed

Detailed Answer:
First set if blood tests showed enzymes >> were they elevated ? Can you please elaborate.

It is true that pancreatitis may not cause pain in the lower abdomen unless it has leaked, but the case is very serious then.

The most recent pain in his lower abdomen, the belly button area, which felt like an ''' extreme tight squeezing''' >> this indicated an intestinal problem. Squeezing is classical of intestinal spasm and the vomiting can be due to reflex process as is accompanied with abdominal pain of any reason or die to an intestinal problem. He is also loosing weight.
I hope he is not diabetic.

How is he now ? What are the other symptoms or problems is he facing ?

If you are not satisfied with the present Gastroenterologist you can certainly go for another opinion of another Specialist.

I think He needs further evaluation.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (8 minutes later)
Enzymes were elevated, told it was from inflammed pancreus. Nothing else. Not diabetic, no other symptoms. Approximately one hour after eating is now when the attacks ome on.c
doctor
Answered by Dr. T Chandrakant (14 minutes later)
Brief Answer:
MRCP / CT scan is better

Detailed Answer:
They must be amylase and lipase. they are elevated on the first attack and may not be elevated in case of further attacks. They are indicative of Pancreatitis.

A good MRCP / CT scan can help diagnosis of pancreas problems and of other structures as a direct finding or suggestive of a particular disease. This is better than the ultrasonography.

Good to know he is not diabetic.
Any change of bowel habits like constipation or loose motions?

I would suggest to have a second opinion. A good detailed history, clinical examination and investigations should take us to a proper diagnosis. Once this is made, then only a specific treatment can be carried .



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (4 minutes later)
I appreciate all your insight. If i find out about his bowels, i will send a follow-up.
doctor
Answered by Dr. T Chandrakant (2 minutes later)
Brief Answer:
most welcome !

Detailed Answer:
Thanks for your appreciation.
I would be happy to know the reports and be of assistance, whenever you feel for it.

( You may please rate this answer , if you like. )
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (30 minutes later)
Just found out, no changes in his bowel movements or texture
doctor
Answered by Dr. T Chandrakant (9 minutes later)
Brief Answer:
This is good.

Detailed Answer:
Thanks for feedback.
This is a good news.
Please carry on as suggested.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

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

General Surgeon

Practicing since :1984

Answered : 19779 Questions

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What Causes Severe Abdominal Pain And Vomiting?

Brief Answer: Chronic Pancreatitis. Detailed Answer: Hi. From the history you have provided this looks to be due to Chronic pancreatitis. NO alcohol at all. It is good that He is watching his diet strictly. The pancreatitis attack comes like this only, sudden and acute. He can follow with his Physician as advised. He may be advised Pancreatic enzyme supplements to be taken with food, no alcohol at all, further investigations as would be advised by His Physician.