Persistent Abdominal Pain: Causes and Next Steps - Gastroenterology and Hepatology

Abdominal discomfort lasting for three to four months?

Hello doctor, I usually experience abdominal pain that lasts no longer than 3 to 6 seconds, similar to a sudden punch.
However, the location varies; sometimes it's between my stomach and chest, sometimes in the left upper abdomen, at times on either side of my navel, and occasionally in the lower abdomen.
When I squat and then stand up, my abdomen feels bloated, and the pain can persist for several days.
I also experience belching and bloating after drinking water, which lasts for a long time.
I feel irritable, and my stomach feels distended.
After burping, I feel some relief.
I had a colonoscopy in August, an endoscopy in September, an abdominal ultrasound, and a test for Helicobacter pylori.
In December, I underwent an electrocardiogram, chest X-ray, and blood tests, all of which showed no issues.
My bowel movements are normal, with no constipation or abnormal color, and my urination is also normal, with no unusual odor.
I pass gas regularly without any foul smell.
In August, September, and October, I went to a batting practice facility to lose weight, and in November and December, I swam in a pool for weight loss.
My weight is 115.5 pounds, and my height is 174 cm.

Doctor: 1.
Is this abdominal pain similar to neuropathic pain or muscular pain? 2.
Which specialty should I consult next? Or should I just relax, lose weight, and hope the pain improves?

Xiao Feng, 20~29 year old female. Ask Date: 2022/12/06

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is likely not a gastrointestinal issue.
It is recommended to adopt a healthy diet for weight loss, avoid intense exercise during pain, and warm up before exercising to prevent strains.

Reply Date: 2022/12/06

More Info

Persistent abdominal pain can be a complex issue, and understanding its potential causes is crucial for effective management. Based on your description, it seems that you are experiencing intermittent pain in various locations within your abdomen, along with symptoms such as bloating, gas, and discomfort that can last for several days. You've also undergone a series of diagnostic tests, including colonoscopy, gastroscopy, abdominal ultrasound, and blood tests, all of which have returned normal results.

Possible Causes of Your Symptoms
1. Functional Gastrointestinal Disorders: Given the nature of your symptoms, one possibility is a functional gastrointestinal disorder, such as Irritable Bowel Syndrome (IBS). IBS can cause abdominal pain, bloating, and changes in bowel habits without any identifiable structural abnormalities. Stress and anxiety can exacerbate these symptoms, leading to a cycle of discomfort.

2. Musculoskeletal Pain: The description of your pain feeling like a punch and its variability in location may suggest a musculoskeletal origin. Muscle strain or tension in the abdominal wall can cause localized pain that may mimic internal organ pain. Activities like swimming or hitting practice could potentially lead to such strains.

3. Gastroesophageal Reflux Disease (GERD): The sensation of bloating and belching after drinking water could indicate GERD, where stomach acid flows back into the esophagus, causing discomfort. This condition can also lead to referred pain in the upper abdomen or chest.

4. Visceral Pain: The nature of visceral pain can be quite different from somatic pain. It often feels vague and can be difficult to localize. Conditions affecting the internal organs, such as gastritis or peptic ulcers, could also be considered, although your previous tests did not indicate these issues.

5. Psychosomatic Factors: Given your mention of anxiety and irritability, it’s worth considering that psychological factors can significantly impact physical health. Anxiety can manifest as gastrointestinal symptoms, and managing stress through relaxation techniques, therapy, or lifestyle changes may help alleviate some of your discomfort.

Next Steps
1. Consult a Gastroenterologist: Since you have already undergone extensive testing, it may be beneficial to follow up with a gastroenterologist who specializes in functional gastrointestinal disorders. They can provide insights into managing conditions like IBS or GERD and may recommend dietary changes or medications to help alleviate your symptoms.

2. Consider a Pain Management Specialist: If musculoskeletal pain is suspected, a visit to a pain management specialist or a physical therapist could be beneficial. They can assess your posture, movement patterns, and any potential muscle imbalances contributing to your pain.

3. Psychological Support: Given the role of anxiety in your symptoms, consulting a mental health professional may also be helpful. Cognitive-behavioral therapy (CBT) or mindfulness techniques can help manage anxiety and its physical manifestations.

4. Lifestyle Modifications: Continue focusing on a healthy lifestyle, including regular exercise, a balanced diet, and adequate hydration. Stress management techniques, such as yoga or meditation, can also be effective in reducing symptoms related to anxiety and gastrointestinal discomfort.

5. Keep a Symptom Diary: Documenting your symptoms, dietary habits, and stress levels can provide valuable insights for your healthcare provider. This information can help identify potential triggers and patterns related to your abdominal pain.

Conclusion
Persistent abdominal pain can arise from various causes, and it often requires a multidisciplinary approach for effective management. By consulting with the appropriate specialists and considering both physical and psychological factors, you can work towards finding relief from your symptoms. Remember, it's essential to communicate openly with your healthcare providers about your experiences and concerns to tailor a treatment plan that best suits your needs.

Similar Q&A

Persistent Abdominal Discomfort: Seeking Answers for Ongoing Pain

Dear Doctor: I have been experiencing abdominal discomfort for about a week. I visited a doctor who prescribed me medications for intestinal regulation, digestion, and antispasmodics, but they have not alleviated my discomfort. Most of the pain is in my lower abdomen; sometimes i...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello, based on your age and description, the possible causes of abdominal pain and abnormal bowel movements include irritable bowel syndrome and gastroenteritis. It is advisable to pay attention to your dietary habits, eat light meals, and increase your fluid intake. Avoid spicy...

Understanding Chronic Abdominal Pain: Possible Causes and Next Steps

Hello, doctor. For the past six months, I have frequently experienced abdominal bloating and pain accompanied by cold sweats, nausea, dizziness, and a feeling of wanting to vomit. The pain is not localized and can be felt from below the ribs to below the navel, often with a sensa...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Please discuss with a gastroenterologist and implement dietary control along with moderate exercise to reduce stress. An ultrasound examination may also be considered.

Understanding Persistent Abdominal Pain: Causes and Solutions

Hello Director Chen, Since February of this year, I have been experiencing intermittent pain in my left abdomen (approximately 3 to 5 centimeters from my navel), along with a feeling of overall abdominal bloating, which is very uncomfortable. In April, I consulted a gastroentero...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Hello Zhao Nianyu: You can visit the gastroenterology department to confirm the related symptoms and treatment (including small intestine and large intestine) in order to understand the cause and provide symptomatic treatment. Wishing you a speedy recovery, Chen Shidian.

Persistent Abdominal Pain for Over a Month: Seeking Answers

Hello doctor, I have been experiencing abdominal pain for over a month. I have undergone examinations in gynecology, gastroenterology, and orthopedics, and everything came back normal. The tests I have had include a Pap smear, vaginal ultrasound, abdominal ultrasound, urinalysis,...

Dr. Xiao Yongxun reply Family Medicine
Dear Ms. Ake: 1. Abdominal pain is inherently challenging in clinical practice due to the wide range of organs and systems involved. 2. Taking upper abdominal pain or discomfort as an example, common diagnoses include gastric ulcers or gastritis, duodenal ulcers or duodenitis, ...