Persistent Abdominal Pain: Seeking Further Diagnosis and Relief - Internal Medicine

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I'm sorry to hear about your persistent abdominal pain and the discomfort you're experiencing. It sounds like you've been through quite a bit already with various medical consultations and treatments. Given your symptoms and the lack of improvement, it’s important to explore further diagnostic options to identify the underlying cause of your pain.

Based on your description, the pain you are experiencing is located in the area just below your ribs, which could involve several organs, including the stomach, liver, pancreas, and even parts of the intestines. The fact that the pain worsens at night and improves when you sit up could suggest a few possibilities, including gastrointestinal issues such as gastritis, peptic ulcers, or even gallbladder problems. Additionally, the sensation of a swollen throat and blood taste could indicate a more systemic issue or a reaction to medication, which should be evaluated promptly.

Since you've already undergone an ultrasound and have not found any significant issues, it may be time to consider more advanced imaging studies. A CT scan of the abdomen could provide a more detailed view of the internal organs and help identify any abnormalities that might not be visible on an ultrasound. Furthermore, if there is a suspicion of gastrointestinal reflux disease (GERD) or other esophageal issues, an upper endoscopy (EGD) might be warranted to directly visualize the esophagus and stomach lining.

In addition to imaging studies, it might be beneficial to consult with a gastroenterologist if you haven't already. They specialize in digestive system disorders and can provide a more focused evaluation of your symptoms. They may also consider conducting tests for H. pylori infection, which can cause gastritis and ulcers, or other gastrointestinal conditions that could lead to your symptoms.

Moreover, given your mention of throat swelling and a metallic taste, it’s crucial to consider whether these symptoms could be related to medication side effects or an allergic reaction. If you are taking any new medications, discuss these with your healthcare provider to determine if they could be contributing to your symptoms.

Lastly, if your symptoms continue to escalate or if you experience any new symptoms such as fever, significant weight loss, or changes in bowel habits, it’s essential to seek immediate medical attention. Persistent abdominal pain can sometimes indicate a more serious condition that requires urgent care.

In summary, I recommend the following steps:
1. Discuss the possibility of a CT scan or upper endoscopy with your healthcare provider.

2. Consider a referral to a gastroenterologist for specialized evaluation.

3. Review any medications you are currently taking with your doctor to rule out side effects.

4. Monitor your symptoms closely and seek immediate care if they worsen.

Your health is paramount, and persistent symptoms should never be ignored. It's important to advocate for yourself and ensure that you receive the thorough evaluation you deserve.