Persistent Upper Abdominal Pain: Causes and Solutions - Gastroenterology and Hepatology

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Persistent upper abdominal pain can be a challenging symptom to navigate, especially when it occurs frequently and lasts for several hours, as you described. The location of your pain near the xiphoid process (the lower part of the sternum) and its occurrence after meals suggest a few potential causes that could be contributing to your discomfort.

One common cause of upper abdominal pain, particularly after eating, is gastritis or gastric ulcers. Gastritis is the inflammation of the stomach lining, which can be triggered by factors such as excessive alcohol consumption, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), or infections like Helicobacter pylori. Gastric ulcers, on the other hand, are sores that develop on the lining of the stomach and can cause significant pain, especially after meals when the stomach is active in digestion.

Another possibility is that you may be experiencing symptoms of gallbladder disease, such as gallstones or cholecystitis. Gallstones can block the bile ducts, leading to pain that often occurs after eating fatty meals. Cholecystitis, which is the inflammation of the gallbladder, can also present with similar symptoms, including pain in the upper abdomen, nausea, and sometimes fever.

Your mention of sticky stools could indicate a malabsorption issue, which might be related to pancreatic insufficiency or bile duct obstruction. The pancreas produces enzymes necessary for digestion, and if it is not functioning properly, it can lead to undigested food in the stool, resulting in a sticky consistency.

The fact that your pain has persisted for nearly a month without improvement is concerning and warrants further investigation. While it is possible for gastritis or ulcers to cause prolonged discomfort, the presence of additional symptoms such as sticky stools and the relief you find from warm water suggests that there may be more complex underlying issues at play.

In terms of management, it is crucial to consult with a healthcare professional who can perform a thorough evaluation. This may include blood tests, imaging studies such as an ultrasound or CT scan, and possibly an endoscopy to visualize the stomach and duodenum directly. These tests can help identify any structural abnormalities, infections, or other gastrointestinal conditions that may be contributing to your symptoms.

In the meantime, dietary modifications can be beneficial. Avoiding spicy, fatty, or acidic foods may help reduce irritation in the stomach. Eating smaller, more frequent meals instead of larger ones can also alleviate pressure on the digestive system. Additionally, staying hydrated and avoiding caffeine and alcohol can further support digestive health.

If your symptoms are related to gastritis or ulcers, your doctor may prescribe medications such as proton pump inhibitors (PPIs) or H2 blockers to reduce stomach acid and promote healing. If gallbladder disease is suspected, surgical intervention may be necessary.

In summary, persistent upper abdominal pain can arise from various gastrointestinal issues, including gastritis, ulcers, gallbladder disease, or malabsorption syndromes. Given the duration and nature of your symptoms, it is essential to seek medical attention for a comprehensive evaluation and appropriate treatment. Early intervention can lead to better outcomes and relief from your discomfort.