Morning Upper Abdominal Pain: When to Seek Medical Advice?

Upper abdominal pain upon waking up?

Hello, doctor.
Last Thursday after work, I felt achy and weak all over.
I thought it was just due to being tired from work, so I went home, took a shower, and went to bed.
However, I woke up in the middle of the night with stomach pain and diarrhea (watery stools).
In the morning, I still felt achy and weak, and after having breakfast, I continued to rest, experiencing another episode of diarrhea.
After waking up, the achiness was gone.
I had a light dinner and replenished with electrolyte drinks.
The next day, I still had watery stools that were yellowish (twice).
The following day, I no longer had diarrhea, but I also did not have a normal bowel movement.
For the next two days, I had stomach pain, but it became difficult to pass stool, resulting in only a small amount of thick, pasty stool, and I noticed some mucus when wiping.
The day before yesterday, I woke up with pain in the lower left abdomen and was unable to have a bowel movement.
The pain eventually subsided.
Yesterday and today, I woke up with pain in the upper abdomen (both sides), and I am unsure if it is rib pain or internal pain.
I was able to pass a small amount of stool, which was more formed than in previous days, but the upper abdominal pain persisted, although it subsided after a while.
Today, I also woke up with upper abdominal pain.
After using the bathroom and lying back down, the pain continued, but it disappeared after I sat up for about 1 hour and 20 minutes.
Last night happened to be the first day of my menstrual period.
In the past, I would experience menstrual cramps on the first day for half a day, but this time I did not.
I would like to ask which specialty I should consult.
Thank you.

Chen, 30~39 year old female. Ask Date: 2023/08/17

Dr. Ye Qianyu reply Family Medicine

Hello! It is recommended that you visit a gastroenterology and hepatology clinic.

Reply Date: 2023/08/17

More Info

Based on the symptoms you've described, it seems that you are experiencing a combination of gastrointestinal distress and abdominal pain that fluctuates throughout the day. The fact that you have had episodes of diarrhea, followed by changes in your bowel movements, and now upper abdominal pain suggests that there may be an underlying gastrointestinal issue that needs to be addressed.

Given your history of symptoms, it would be advisable to consult a gastroenterologist. This specialist focuses on disorders of the digestive system, which includes the stomach, intestines, liver, and other related organs. The gastroenterologist can perform a thorough evaluation, which may include a physical examination, blood tests, imaging studies, and possibly endoscopic procedures to get a clearer picture of what might be causing your symptoms.

Your symptoms of upper abdominal pain, particularly when you wake up, could be indicative of several conditions. One possibility is gastritis, which is inflammation of the stomach lining that can cause pain and discomfort, especially after eating. Another potential issue could be related to gallbladder function, particularly if the pain is located in the upper right quadrant of your abdomen. Gallstones or cholecystitis (inflammation of the gallbladder) can lead to significant pain and digestive issues.

Additionally, the fact that you experienced diarrhea followed by constipation and changes in the consistency of your stool could suggest a condition known as irritable bowel syndrome (IBS). IBS is characterized by a mix of symptoms including abdominal pain, bloating, and changes in bowel habits. Stress and dietary factors often exacerbate IBS symptoms, so it may be worth considering any recent changes in your lifestyle or diet that could be contributing to your discomfort.

It's also important to consider the timing of your symptoms in relation to your menstrual cycle. Since you mentioned that you are on your period, hormonal fluctuations can also affect gastrointestinal function and may lead to symptoms such as bloating, cramping, and changes in bowel habits. However, given the persistence and nature of your abdominal pain, it is crucial to rule out any serious underlying conditions.

In summary, I recommend that you seek an appointment with a gastroenterologist to discuss your symptoms in detail. They may suggest diagnostic tests such as an abdominal ultrasound, CT scan, or endoscopy to investigate further. In the meantime, keep a food diary to track what you eat and any symptoms that arise, as this can provide valuable information to your healthcare provider. Additionally, staying hydrated and maintaining a balanced diet may help alleviate some of your symptoms. If your symptoms worsen or you experience severe pain, fever, or blood in your stool, seek medical attention immediately.

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