Upper Abdominal Pain and Lower Abdominal Discomfort

Upper abdominal pain and lower abdominal discomfort?

Hello, doctor! I have been experiencing upper abdominal pain for over two weeks.
Sometimes I can't eat, while other times I can eat normally, but I feel very full and bloated after just a small amount, so I only dare to eat congee.
I've lost 2 kilograms in weight.
I have seen three doctors and had an endoscopy, which showed no ulcers, only excessive stomach acid and a bit of gastroesophageal reflux.
However, after taking medication, the upper abdominal pain persists.
I would like to ask the doctor what could be the cause?
I also have discomfort in my lower abdomen and have been experiencing constipation recently.
When I saw the doctor, they said it was intestinal gas and prescribed a stool softener.
Now, I can only have a bowel movement with the stool softener, and I find it easy to pass gas.
My stools are softer but not watery.
For the past few days, I have also felt a stinging sensation in my anus after using the restroom.
Despite taking medication, there has been no significant improvement in the dull pain, which is worse at night.
Last night into this morning, I had a dull pain in my abdomen and couldn't have a bowel movement, which made me break out in a cold sweat.

I would like to ask the doctor if I need to have a colonoscopy, or if this could be irritable bowel syndrome, or if I should see a gynecologist? Thank you.

Miao Miao, 20~29 year old female. Ask Date: 2018/07/23

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Hello, Miss Miao Miao.
If your condition does not improve after taking medication, you can request your outpatient physician to arrange for a colonoscopy.
It is also advisable to undergo an evaluation in the gynecological department.
You can schedule appointments with both the gastroenterology and gynecology departments together.

Changhua Hospital cares about your health.

Reply Date: 2018/07/23

More Info

Upper abdominal pain and lower abdominal discomfort can stem from a variety of causes, and understanding the underlying issues is crucial for effective treatment. Based on your description, it appears that you have been experiencing persistent upper abdominal pain for over two weeks, along with symptoms of bloating, early satiety, and changes in bowel habits, including constipation and discomfort during bowel movements.
Given that you have already undergone an endoscopy, which ruled out ulcers but indicated excessive stomach acid and mild gastroesophageal reflux disease (GERD), it is important to consider other potential causes for your symptoms. Conditions such as gastritis, functional dyspepsia, or even gallbladder issues could contribute to your upper abdominal pain. Additionally, the sensation of fullness and bloating may suggest a functional gastrointestinal disorder, such as irritable bowel syndrome (IBS), which can manifest with both upper and lower abdominal symptoms.

The lower abdominal discomfort and constipation you are experiencing could be related to a few factors. The use of softeners indicates that there may be a significant issue with bowel motility. Bloating and gas can often accompany constipation, leading to discomfort and a feeling of fullness. The fact that you are experiencing pain during bowel movements, along with a burning sensation, may suggest anal fissures or hemorrhoids, which can occur due to straining during constipation.

Your symptoms of increased discomfort at night and the sensation of cold sweats could indicate a more serious underlying condition, especially if they are accompanied by significant changes in your weight and appetite. It is essential to monitor these symptoms closely.
Regarding your question about whether a colonoscopy is necessary, it may be warranted given your ongoing symptoms, especially if they do not improve with conservative management. A colonoscopy can help rule out any structural issues within the colon, such as polyps or inflammatory bowel disease, and can provide a clearer picture of your gastrointestinal health.
Additionally, considering your symptoms, it may also be beneficial to consult with a gastroenterologist who specializes in functional gastrointestinal disorders. They can provide a more comprehensive evaluation and may recommend further testing, such as imaging studies or motility tests, to assess how well your digestive system is functioning.

In summary, while your upper abdominal pain may be linked to acid-related disorders, the lower abdominal discomfort and constipation could suggest a functional issue or structural problem that warrants further investigation. It is crucial to continue working closely with your healthcare providers to explore these symptoms thoroughly. If your symptoms worsen or new symptoms arise, do not hesitate to seek immediate medical attention.

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