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What is the reason for recurring excruciating stomach pain?

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General & Family Physician
Practicing since : 2003
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Approximately 5 years ago, I started getting these terrible abdominal muscle spasms. My husband & I had gone out to dinner one nite (for steak - no alcohol). At the conclusion of the meal, I could feel some cramping, but figured it was just gas from eating such a large meal. By the time we got out to the car, I thot I was having a heart attack. The pain was excruciating! It was travelling in waves, up & down my abdomen & straight thru to my back. I thot it was a 1-time thing, but then it started happening more often. No rhyme or reason to it, but the majority of the time, it happens at nite. When it begins, the pain is only stong enough to wake me up but within minutes it escalates to a 8-10. At first, my attacks were very random, coming maybe every 4-5 months, but as time went on, they started coming more frequently. Now, I'm having at least 1-2 episodes a month. Tonite, I was taking a nap (around 7pm). I woke up to take a drink of water (not ice water, just room temp.) & within 10 mins., I could already feel the dull ache that proceeds a full-blown attack. And sure enough, I woke up with horrible stomach & back pain (at the top middle part of my stomach, right below my sternum - very XXXXXXX pain, the pain is so bad you can't breath or lie down). The pain is always there, but it goes in waves of how strong it is (between 8-10, never going below an 8). My husband had some pain meds. (percodan) that works miracles when I take it, but they are now gone. Just as an end note, in-between attacks, I have no stomach pain, no heartburn, no digestive problems, no nothing. I am in relatively good shape, eat balanced meals, & exercise regularly. I've charted my food intake, sleep, & stress levels & can find no connections.

I'm thinking either biliary colic or SOD?
Sun, 6 May 2012 in Abdominal Pain
Answered by Dr. Deepak Anvekar 49 minutes later

Thanks for your query.

The description of your symptoms are very typical and indicate the possibility of you having gall bladder inflammation (Cholecystitis) that occurs most commonly because of an obstruction of the cystic duct from cholelithiasis (Gall bladder stones). Stones may temporarily obstruct the cystic duct or pass through into the common bile duct, leading to symptomatic biliary colic.

The way forward would be to get a few blood tests (including Liver function tests) and a ultrasound (Liver and Gall ‎bladder). This would confirm the diagnosis.

Once the ultrasound confirms the presence of gall stones and associated inflammation of the gall bladder, then Laparoscopic cholecystectomy might be the choice of treatment. Surgery is the best option in your case since you have had multiple attacks and the frequency of pain attacks have increased now.

You might consider consulting your primary physician or a gastroenterologist who after a physical ‎examination may initiate necessary interventions. ‎

It is good that you have a healthy active lifestyle and are doing regular exercises to keep fit.

Here are a few points which might help you to manage the pain conservatively until the surgery is planned.

‎1) Avoid mental stress and practice stress relief measures like meditation, yoga, breathing exercises, etc.
‎2) Avoid eating high fat and oil containing foods.
‎3. Be on a gall stone specific diet. (Described below)‎
‎4) Lifestyle and Dietary habit changes: Paying attention to regular meals on time; Avoid ‎excessive food and/or drink at one meal. By eating right, one can avoid formation of gallstones ‎and also flush out the existing ones.‎

Important aspects of a Gallstone diet that you might consider following: ‎

‎1. First and foremost drink plenty of water.‎
‎2. A diet XXXXXXX in water soluble fibers (found in fruits and vegetables). ‎
The inclusion of at least 3-4 servings of vegetables a day and two to four servings of fruit each ‎day is a must in a gallstone diet. Include fruits like - Dried fruits (dates, apricots, prunes, raisins); ‎raspberries, blackberries, strawberries, blueberries, and oranges. Include more of vegetables like ‎beans, corn, and broccoli.‎

‎3. Include a lot of whole grain bread, corn XXXXXXX cereals, buns, muffins, XXXXXXX flakes, whole wheat ‎cereals, whole grain pasta, and brown rice in your daily diet. ‎
Whole grains - help to flush out gallstones; also enhance the digestive system.

‎4. To avoid risk of developing more gallstones, make sure you stay away from red meat, fried ‎and fatty food items, onions, alcohol, and eggs. Staying away from heavy proteins like cheese, ‎butter, and whole milk is also a good idea.‎

I hope you find the information given here helpful.‎

I shall be available for any follow up questions that you might be having.‎


Dr. Anvekar.
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