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Forum Name: Gastroenterology Topics

Question: extremely severe abdominal pains


 nor24 - Wed Sep 01, 2004 11:20 pm

hi,
i have had some extreme abdominal issues on and off since 1991 (1991, 94,98,99,03), but have no idea what it might be. It starts when i get a "red bell pepper" tasting belch, then my stomach becomes extremely painful right above my navel. i then vomit, which smells like fecal matter. i cannot eat anything during the pain, not even teeny-tiny bits, and i cannot drink anything..sucking on ice cubes keeps my mouth hydrated, but if i swallow, i vomit. anything i put in my mouth immediately comes back up. this pain lasts for about 2-3 days, so i get extremely dehydrated and have some hallucinations. since i vomit, i cannot take any oral medication to dull the pain, but supposatories makes it a teeny bit better. it hurts standing up, sitting or laying down....everything hurts! i have been to the doctor plenty of times, but i have yet to make it there in the middle of an attack b/c i am in so much pain i cannot move. i have had a ct scan (nothing), gastroscopy (nothing), some other tests that i can't remember what were (nothing). i was referred to a food allergy specialist who told me i was allergic to almost everything, so i changed my diet, but that didn't help either. i haven't had an attack in a little over a year, but would like to find out what this might be, if you have any suggestions, i would be extremely grateful!
Thank you
 Dr. Tamer Fouad - Fri Feb 10, 2006 7:12 am

User avatar Hello,

When investigating abdominal pain, it is important for the physician to first exclude any serious causes. Those at high risk include, patients above the age of 50 years, those with dysphagia, anorexia with weight loss or persistent vomiting; in addition to those with a palpable mass or those with evidence of GIT hemorrhage (melena, anemia or hypotension) and those presenting with a board-like abdomen. For those cases immediate surgery (laparotomy) or endoscopy may be needed.

Location is most easily categorized on the basis of embryologic origin. Pain located between the xiphoid process and the umbilicus originates in the foregut, which includes the distal esophagus, stomach, proximal duodenum, biliary tree, pancreas, and liver (although conditions of the liver usually do not cause chronic abdominal pain).

The epigastrium is area of central abdomen lying just below the sternum. Common causes are peritonitis, pancreatitis, GI obstruction, gall bladder disease and peptic ulcer and ruptured aortic aneurysm. Other causes include inflammatory bowel syndrome, gastric cancer, referred pain (from a myocardial infarction, pleural disease or spinal disease) and psychosomatic diseases.

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