Severe Stomach Pain: Causes and Treatment Options - Gastroenterology and Hepatology

Severe stomach pain and pain in the left side of the abdomen?

I have severe pain in the middle under my rib cage (where the stomach is located), and it is persistent.
I endured the pain all night without any relief.
In the morning, I went to the emergency room, where I had an X-ray and an endoscopy.
The doctor said there was nothing wrong and diagnosed me with gastritis, prescribing pain relief medication for me to take at home.
After taking the medication and applying heat, I felt a bit better (though the pain was still mild).
I initially thought everything was fine, but that evening, after eating a little bit of vegetables (mostly just a bite), the pain returned.
I got anxious and ended up doing an enema twice.
Despite my efforts with heat therapy, the pain became severe again, spreading to my stomach and the entire left side of my abdomen (burning and dull pain), causing me to roll on the floor in agony.
I was taken back to the emergency room, where the doctor administered pain relief through an IV, but it was still ineffective.
They suspected an ectopic pregnancy and referred me to gynecology, but the examination showed nothing wrong.
Later, I was prescribed medication for peptic ulcers, anti-inflammatory drugs, and gas relief to take at home.

That evening, my menstrual period started (but there was no menstrual pain), and the severe pain in my stomach and left abdomen returned.
I was really struggling with the pain.
I was sent to the emergency room for the third time, and this doctor was very thorough, using ultrasound to examine my stomach and the left side of my abdomen, explaining that there were no issues.
An X-ray was also done because I initially thought it might be a bowel obstruction, but the doctor said the situation with fecal impaction was manageable, and I was able to use the restroom afterward.
After resting in the hospital, the doctor gave me pain relief through an IV and medication to stimulate my gastrointestinal motility.
I was able to pass some gas and felt a bit better (though there was still some pain).
The doctor confirmed that my internal organs were fine, but there was some bloating in my large intestine, small intestine, and stomach, which was causing the pain.

After feeling a bit better, I returned home with prescriptions for pain relief, medications for peptic ulcers, gas relief, gastroesophageal reflux disease, gastric ulcers, and chronic gastritis.
On the first day back, I felt much better and the pain was less intense (but today, it has started again...
right now, I am experiencing pain in my stomach and the entire left side of my abdomen).
It has been 9 days since the onset of this condition, and I am really struggling and confused.
Can simple bloating really cause such severe pain for such a long time? I would like to ask if anyone knows if there could be another underlying issue.
Please help me; I am really at my wit's end with this severe, persistent pain, and pain relief medications are ineffective.
It is now the 10th day, and I am unsure if this is truly just bloating.
Please help!

Tao Ya-Lin, 20~29 year old female. Ask Date: 2010/07/03

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, based on the symptoms, the likelihood of stomach pain is the highest.
Sometimes gastric cramps can indeed be very painful.
If treatment does not improve the condition, a colon examination may be considered.
Dr.
Chen Chih-Feng, Taoyuan Hospital, Department of Health.

Reply Date: 2010/07/03

More Info

I'm sorry to hear about the severe stomach pain you're experiencing. Based on your description, it sounds like you've been through a lot in terms of medical evaluations and treatments. Let's break down the potential causes of your symptoms and discuss some treatment options.

Understanding Your Symptoms
1. Location and Nature of Pain: You mentioned that the pain is located under your ribs, primarily in the area of the stomach, and that it has been persistent and severe. This type of pain can be associated with various gastrointestinal issues, including gastritis, peptic ulcers, or even functional gastrointestinal disorders like irritable bowel syndrome (IBS).

2. Associated Symptoms: The fact that you experience burning and dull pain, along with episodes of bloating and discomfort after eating, suggests that there may be an underlying issue related to your stomach's ability to handle food or produce acid. The presence of gas and bloating can also indicate that your digestive system is not functioning optimally.

3. Medical Evaluations: You've undergone several tests, including X-rays and an endoscopy, which have ruled out serious conditions like organ obstruction or significant structural issues. However, the persistence of your symptoms indicates that there may be a functional or inflammatory component that needs to be addressed.

Potential Causes
1. Gastritis or Peptic Ulcer Disease: These conditions can cause significant pain and discomfort, especially after eating. If the mucosal lining of the stomach is inflamed or if there are ulcers present, it can lead to severe pain, particularly when the stomach is empty or after consuming certain foods.

2. Gastroesophageal Reflux Disease (GERD): This condition can cause pain that mimics heartburn but can also lead to discomfort in the upper abdomen. The fact that you feel better when lying down may suggest that your symptoms are related to acid reflux.

3. Functional Dyspepsia: This is a common condition characterized by chronic pain or discomfort in the upper abdomen without any identifiable cause. It can be exacerbated by stress, diet, and lifestyle factors.

4. Bowel Issues: Given your mention of constipation and bloating, it's possible that there are issues related to bowel motility or even a functional bowel disorder.

Treatment Options
1. Medications: It seems you have been prescribed medications for pain relief, anti-inflammatory purposes, and to reduce gastric acid. It's important to follow your doctor's instructions regarding these medications. Proton pump inhibitors (PPIs) like Omeprazole can be effective for reducing stomach acid and promoting healing of the stomach lining.

2. Dietary Adjustments: Consider keeping a food diary to identify any specific foods that may trigger your symptoms. Generally, a bland diet that avoids spicy, acidic, or fatty foods can help. Eating smaller, more frequent meals may also alleviate symptoms.

3. Hydration and Fiber: Ensure you are drinking enough water and consuming adequate fiber to help with bowel regularity. This can alleviate some of the bloating and discomfort associated with constipation.

4. Stress Management: Stress can exacerbate gastrointestinal symptoms. Techniques such as mindfulness, yoga, or gentle exercise may help reduce stress levels and improve your overall digestive health.

5. Follow-Up Care: Since your symptoms have persisted for an extended period, it is crucial to maintain open communication with your healthcare provider. If your current treatment plan is not effective, further evaluation may be necessary, including possible imaging studies or referrals to a gastroenterologist for specialized care.

Conclusion
Severe and persistent stomach pain can be distressing, and it's important to address both the physical and emotional aspects of your health. While dietary changes and medications can provide relief, ongoing communication with your healthcare provider is essential to ensure that any underlying issues are properly managed. If your symptoms continue to worsen or if you experience new symptoms, seeking immediate medical attention is advisable. Remember, your health is paramount, and you deserve to find relief from your discomfort.

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