Persistent Abdominal Pain: Causes and Solutions for Seniors

Experiencing abdominal pain every day?

Hello doctor, my father is 68 years old and experiences persistent abdominal pain every day.
The pain is intermittent, especially at night when lying down, making it difficult for him to sleep.
He has to get up and walk around to alleviate the pain.
He has tried taking antacids, but there has been no improvement.
He still tends to eat foods like "Xinfeng Mingshi" and "Ruoyuan Tablets." It should not be gastroesophageal reflux disease (GERD) since he does not experience heartburn.
This has been ongoing for three to four years, and despite seeing doctors, no cause has been identified.
I would like to ask what the issue might be or what methods could help improve his condition.
Thank you.

Dongdong, 30~39 year old female. Ask Date: 2020/03/13

Dr. Chen Shidian reply Gastroenterology and Hepatology

Please visit the gastroenterology outpatient clinic for an examination.

Reply Date: 2020/03/13

More Info

Persistent abdominal pain in seniors can be a complex issue, often requiring a thorough understanding of various potential causes and appropriate management strategies. Given your father's age and the chronic nature of his symptoms, it is essential to consider a wide range of possibilities.

Potential Causes of Persistent Abdominal Pain
1. Gastrointestinal Disorders: Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or diverticulitis can lead to chronic abdominal pain. These conditions may not always present with clear symptoms, making diagnosis challenging.

2. Peptic Ulcers: Although your father does not report symptoms of acid reflux, peptic ulcers can still cause significant discomfort. They may not always present with classic symptoms, especially in older adults.

3. Gallbladder Issues: Gallstones or cholecystitis can cause intermittent pain, particularly after meals. This pain can sometimes radiate to the back or shoulder.

4. Pancreatic Disorders: Chronic pancreatitis or pancreatic cancer can manifest as persistent abdominal pain, especially in older adults. Symptoms may include weight loss and changes in appetite.

5. Renal Issues: Kidney stones or infections can also lead to abdominal pain. The pain may be more pronounced when lying down, as the position can affect kidney drainage.

6. Musculoskeletal Pain: Sometimes, what feels like abdominal pain may actually originate from musculoskeletal issues, especially in older adults who may have degenerative changes in the spine or surrounding muscles.

7. Psychological Factors: Anxiety and depression can manifest as physical symptoms, including abdominal pain. Chronic pain can also lead to increased anxiety, creating a cycle that is difficult to break.

Diagnostic Approach
Given that your father has already seen a physician without a definitive diagnosis, it may be beneficial to pursue further evaluation. Here are some recommendations:
- Comprehensive Evaluation: A gastroenterologist can conduct a thorough assessment, including blood tests, imaging studies (like an abdominal ultrasound or CT scan), and possibly an endoscopy to visualize the gastrointestinal tract.

- Dietary Review: Keeping a food diary may help identify any dietary triggers. Certain foods can exacerbate gastrointestinal symptoms, and avoiding these may provide relief.

- Medication Review: It’s important to review all medications your father is taking, including over-the-counter medications. Some medications can cause gastrointestinal side effects.

- Psychological Assessment: If no physical cause is identified, a referral to a mental health professional may be warranted to explore any underlying anxiety or depression that could be contributing to his symptoms.

Management Strategies
1. Dietary Modifications: Encourage a diet rich in fiber, low in fat, and avoid known irritants such as spicy foods, caffeine, and alcohol. Eating smaller, more frequent meals may also help.

2. Hydration: Ensure adequate fluid intake, especially if there are any signs of dehydration or if he is experiencing diarrhea.

3. Pain Management: Over-the-counter pain relievers may help, but it’s crucial to consult with a physician before starting any new medication.

4. Physical Activity: Gentle exercise, such as walking, can help improve gastrointestinal motility and reduce discomfort.

5. Stress Management: Techniques such as mindfulness, yoga, or meditation can help manage stress and may alleviate some of the pain if it has a psychological component.

6. Follow-Up: Regular follow-up with healthcare providers is essential to monitor symptoms and adjust treatment as necessary.

Conclusion
Persistent abdominal pain in seniors can stem from a variety of causes, and a comprehensive approach is necessary for effective management. It is crucial to work closely with healthcare providers to explore all potential avenues for diagnosis and treatment. Encouraging your father to maintain a healthy lifestyle, manage stress, and adhere to medical advice can significantly improve his quality of life.

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