Severe Left Upper Abdominal Pain at Night: Causes and Solutions - Surgery

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Severe left upper abdominal pain, especially when it occurs at night, can be quite distressing and may have various underlying causes. Given the complexity of abdominal pain and the fact that your family member has a history of gastrointestinal issues, it is essential to consider multiple factors that could contribute to this pain.

Firstly, the left upper quadrant of the abdomen houses several important organs, including the stomach, spleen, pancreas, and parts of the colon. Pain in this area can arise from issues related to any of these organs. For instance, conditions such as gastritis, peptic ulcers, or even pancreatitis can manifest as left upper abdominal pain. Although your family member has been diagnosed with a history of gastric ulcers and is on medication, it is crucial to note that ulcers can recur, and sometimes they may not fully heal, leading to intermittent pain.

Another possibility is that the pain could be related to the spleen. Splenic issues, such as splenomegaly (enlargement of the spleen) or splenic infarction, can cause significant discomfort. Additionally, referred pain from the diaphragm or other structures can sometimes present as abdominal pain, particularly if there is irritation or inflammation.

The timing of the pain is also noteworthy. If the pain consistently occurs at night, it could be associated with the body's circadian rhythms, which can affect gastrointestinal motility and acid secretion. For example, increased acid production at night can exacerbate conditions like gastroesophageal reflux disease (GERD) or peptic ulcers, leading to pain when lying down.

Furthermore, the fact that the pain sometimes correlates with eating suggests that it could be related to food intake. Certain foods can trigger pain in individuals with sensitive stomachs or those prone to gastritis or ulcers. Keeping a food diary to track what is eaten before the onset of pain may help identify potential triggers.

Given that your family member has undergone both gastroscopy and colonoscopy without significant findings, it may be beneficial to consider other diagnostic avenues. Imaging studies such as an abdominal ultrasound or CT scan could provide additional insights into the abdominal organs and help rule out conditions like pancreatitis, splenic issues, or even vascular problems.

Additionally, it may be worthwhile to consult with a gastroenterologist who specializes in functional gastrointestinal disorders. Conditions like irritable bowel syndrome (IBS) or functional dyspepsia can sometimes cause significant discomfort without clear structural abnormalities. These conditions can be challenging to diagnose but may respond well to dietary modifications, stress management, and specific medications aimed at alleviating symptoms.

In summary, while the pain your family member is experiencing could be related to their history of gastric ulcers, it is essential to consider a broader range of potential causes. A thorough evaluation by a healthcare professional, possibly including imaging studies and a detailed review of dietary habits, could provide valuable insights. It is crucial to address this issue promptly, especially since the pain is severe enough to require analgesics for relief. Seeking a second opinion or further evaluation at a specialized center may also be beneficial in managing this complex situation.