Upper Abdominal Pain: Causes, Symptoms, and When to Seek Help

Q: Upper Abdominal Pain: Causes, Symptoms, and When to Seek Help

Hello： Based on the location you described, it is likely a gastrointestinal issue, particularly related to the stomach. <br>If you have already avoided irritant foods, including caffeinated beverages, and there is still no improvement, it may be necessary to consult a pediatric g

Upper abdominal pain

Three weeks ago (during midterm exam week), I started experiencing bloating and some pain in my upper abdomen.
Over the past three weeks, I have seen four doctors.
The first doctor performed a physical examination and auscultation, diagnosing me with indigestion, bloating, and gastroenteritis, although I did not have symptoms of vomiting or diarrhea, just some indigestion.
Since I live in a dormitory, I went home and visited a doctor at a local hospital.
The doctor had me undergo an X-ray, which confirmed that I had intestinal bloating and indigestion, but I still felt uncomfortable.
A couple of days later, I returned to the same hospital and saw a different doctor who diagnosed me with the same symptoms and advised me to avoid fried and irritating foods.
The fourth doctor, whom I saw this Wednesday, noted that I was experiencing intermittent pain near my ribs and suggested it might be nerve-related.
He also mentioned that I had bloating and that I had lost weight.
I am unsure why I have lost weight; previously, I often consumed fried foods and meat while rarely eating vegetables and fruits, and I frequently drank sugary beverages.
However, over the past month, I have started to increase my intake of vegetables and fruits and replaced sugary drinks with water, which has led to noticeable weight loss.
My classmates have remarked that I look noticeably thinner.
Is this weight loss concerning? Currently, my abdominal symptoms include intermittent pain in the upper abdomen and left hypochondriac region, occasional bloating, and a slight feeling of nausea in the morning (which I suspect may be related to oral odor).
What could be the cause of these symptoms? I am a bit worried.
It has been three weeks, and I am considering going to a larger hospital for further examination.
Would they use an endoscopy or ultrasound?

Rita, 10~19 year old female. Ask Date: 2017/05/05

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Based on the location you described, it is likely a gastrointestinal issue, particularly related to the stomach.
If you have already avoided irritant foods, including caffeinated beverages, and there is still no improvement, it may be necessary to consult a pediatric gastroenterologist.
It is advisable not to switch doctors frequently; seeing the same physician will provide a clearer understanding of what medications have been ineffective and what potential issues may be present, as well as what tests might need to be arranged.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2017/05/05

More Info

Upper abdominal pain can be a complex issue, as it can stem from various causes, ranging from benign to serious conditions. Given your symptoms of bloating, intermittent pain in the upper abdomen and left upper quadrant, nausea, and recent weight loss, it's essential to consider several potential underlying issues.

Possible Causes of Upper Abdominal Pain
1. Gastrointestinal Disorders:
- Gastritis or Peptic Ulcer Disease: Inflammation of the stomach lining or ulcers can cause pain, bloating, and nausea. These conditions can be exacerbated by certain foods, stress, and lifestyle choices.

- Gastroesophageal Reflux Disease (GERD): This condition can lead to discomfort in the upper abdomen due to acid reflux, which may also cause nausea and a sensation of bloating.

- Irritable Bowel Syndrome (IBS): This functional gastrointestinal disorder can cause bloating, abdominal pain, and changes in bowel habits. Stress and dietary changes often influence symptoms.

2. Pancreatic Issues:
- Pancreatitis: Inflammation of the pancreas can lead to severe abdominal pain, often radiating to the back. It can be acute or chronic and is commonly associated with gallstones or alcohol use.

3. Biliary Tract Disorders:
- Cholecystitis or Gallstones: Pain in the upper right abdomen, especially after eating fatty meals, can indicate gallbladder issues. This can also lead to nausea and vomiting.

4. Musculoskeletal Issues:
- Costochondritis or Muscle Strain: Pain that feels sharp and is localized can sometimes be due to inflammation of the cartilage connecting the ribs or muscle strain, especially if you have engaged in physical activity or stress.

5. Weight Loss Concerns:
- Unintentional weight loss, especially when combined with gastrointestinal symptoms, can be concerning. It may indicate a more serious underlying condition such as malignancy or chronic disease.

When to Seek Further Help
Given that you have seen multiple doctors and have not found relief, it may be time to pursue further diagnostic testing. A gastroenterologist can provide specialized care and may recommend:
- Upper Endoscopy (Gastroscopy): This procedure allows direct visualization of the esophagus, stomach, and duodenum, and can help diagnose conditions like gastritis, ulcers, or tumors.

- Abdominal Ultrasound: This imaging test can help assess the gallbladder, liver, pancreas, and kidneys for any abnormalities.

- CT Scan: If necessary, a CT scan can provide a more detailed view of the abdominal organs and help identify issues that may not be visible on an ultrasound.

Lifestyle Modifications
In addition to seeking medical advice, consider the following lifestyle changes that may help alleviate your symptoms:
- Dietary Adjustments: Continue to focus on a balanced diet rich in fruits, vegetables, and whole grains while avoiding fried and spicy foods. Eating smaller, more frequent meals can also help.

- Hydration: Ensure you are drinking enough water, as dehydration can exacerbate gastrointestinal issues.

- Stress Management: Since stress can significantly impact gastrointestinal health, consider incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises.

Conclusion
Your symptoms warrant further investigation, especially considering the weight loss and persistent discomfort. It’s crucial to communicate your concerns clearly with your healthcare provider and advocate for the necessary tests to rule out serious conditions. Remember, early diagnosis and treatment can significantly improve outcomes for many gastrointestinal disorders.

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