Upper abdo pain

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Hi All, after some thoughts/ experiences please.

For the past 6 months I have been experiencing near constant nausea worse about 1 hour after eating, on an empty stomach and first thing in the morning, regular vomitting (about twice a week), never any 'coffee grounds' or blood in it, constant abdominal bloating (upper), increased belching, regular bouts of acid reflux (the pain isnt too bad, but i get regular acid taste in my throat and a bad taste a smell that goes with it), generalised upper abdo pains and feeling really tired all the time.

As a bit of background i was diagnosed with IBS 10 years ago, so it is always difficult to say if bowels are different, but I would say they have been more frequent and loose, and sometimes smell more discusting than usual.

I have been going back and forward to my GP about this since February. Initially he upped my dose of omeprazole to 40mg a day thinking it was just the acid reflux flairing up (I was already on 20mg a day which I had been on for a couple of years). That didnt help much, so I went back and he checked me for HPylori (which was negative) refered me for an abdo ultrasound, which showed a slightly fatty liver, which he doesnt think would cause the symptoms, but not a lot else. 

He also referred me for a gastroscopy, but after 2 months of waiting without hearing a date for this I chased it with my GP to find out the hospital had rejected the referal but not bothered to let me or the GP know. After further chasing it appears the consultant in their infinate wisdom feel I am too young to need a gastroscopy (I am 31).

Ok, so getting to the point...

I feel like I'm going round in circles. I've had various blood tests, which has shown on 1 occassion I was anaemic, but that was treated with iron (which really did screw up my stomach while I was taking it!!) and seems ok now, but MCVs and MCHs are still on the low side, and my feritin sores are on the lower end of normal, plus my lymphocytes are raised, but looking back they always are slightly. Also on the most recent test my CRP was raised slightly. My GP has yet to comment on these. I feel he's going to ask me at my next appointment where he wants me to go from here, and I just don't know! So a few questions:

1) has anyone around 31 or less had a gastroscopy in the past? I'm just curious!

2) Has anyone else experienced simular symptoms and actually gotten anywhere?

3) Any suggestions of where to go from here!!

4) I keep wondering about coeliacs or Crohns, I dont think of my bowel pains are that bad, but do have quite a high pain tollerance having put up with a pretty painful anal fissure for 5 years... Do these symptoms strike a chord for either of these?

Sorry for the really long message, i'm just getting so fed up with it all and just want to know why I feel so rubbish all the time!

Any thoughts/advice greatly appreciated.

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10 Replies

  • Posted

    Of course you are not too young for gastroscopy. When my 14 yr old daughter had to had one (due to constant nausea, vomiting, abdominal cramping without any reason found in blood, urine, stool, breath tests, MRI), there were 2 and 5 year old children going in for one, too....

    Please also think of gastroparesis, it can be very easily, pain free tested via gastric emptying study. If food stays too long in the stomach, one gets nausea and vomits. This can be due to many different reasons, even diabetes is one. (Have you checked your blood glucose)

    Please also think of being put into the IBS draw maybe to quickly without enough tests done prior (IBS, which is an exclusion and history diagnose only, a name, if nothing can be found, but severe diseases for sure excluded, but has prime symptoms of 'feeling better after defecation, change in bowel frequency or form, ongoing over 12 weeks'),

    some suffer other problems actually and were not tested for or false neg at first and only test.

    Get tested for Helicobacter pylori, for celiac (please be on gluten diet, otherwise false neg test result blood antibody or biopsie test, the blood genetic test is great for exclusion, but being positive on the other hand does not mean to have the gene switched on), for fructose, sorbitol, lactose malabsorbtion (breath or biopsie, later is better, measures the enzymes in tissue, not just a metabolite)

    Yes, a gastroscopy at least seems very routine test to be done here in your case to get started.

    And yes, my daughter was rejected 3 times at hospital for being not urgent enough, not dying from the symptoms, no inflammation, no appendicitis, just left in agony, in pain without answer, sent home.

     

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    • Posted

      Thanks for your reply, makes me feel a bit better that I'm not over reacting at thinking 31 isn't too young for a test!

      Not sure how long gasroparathesis lasts but when I'm sick sometimes first thing in the morning after just having a drink there's no food from the night before left, so I know it's gone by then, but not sure if it could just be sluggish... Recent glucose level was fine (5.4).

      From the IBS point of view I actually usually feel worse after emptying my bowel, so even that doesn't quite fit! I had an hpylori test, which was negative, but I've recently read that being on omeprazole being an inhibitor can give false negatives, so now I'm paranoid even that might have been wrong!

      Will speak to my gp about the other tests then. I've not cut out gluten yet for that exact reason, I keep getting told by friends 'well why don't you try cutting out gluten', who when I tell them if I cut it out they can't test for it I think they just think I'm being awkward!

      I'll try hassling my gp for the scope, I think he's as bemused by it all as I am. He's quite good and knows I'm not someone who's there every other week with a problem, and generally avoid him as much as possible!! So I think he at least is taking me seriously, he just hasn't mentioned any tests for coeliacs etc. If they reject the scope again I might try asking to be referred to another hospital, see if someone else might take it seriously.

      Thanks again for your reply/advice.

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    • Posted

      Hi Vickya,

      Sorry to say, but it should be standard question by pathology staff, if you were taking any 2 antagonist usuallyantibiotics or antiacids prior a breath test.

      You need to have 4 weeks break of antibiotics or antibacterials prior test.

      You need to have 2 weeks break H2-antagonist and PPI (protone pump inhibitor) like Omeprazole prior test. (H2-antagonist is 9hours during fasting enough, but cannot hurt to stop much earlier)

      the breath test is immensely accurate, the test itself, but the preparation can do something or some condition:

      I give you a list:

      False NEGATIVE H.pylori test results:  

      - if done too soon after antibiotics, acid suppression therapy  

      - if one has a rapid gastric emptying (post surgery)

      False POSITIVE

      - if non-fasting

      - if achlorhydria, gastric atrophy

      I think you need to repeat the breath test.

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    • Posted

      Oh 'great', my cursor hopped around, got stuck and sent. After reset it seems to work again, hope you still could understand first line.

      " should ask, if you were taking any H2-antagonist, antibiotics or antiacids prior a breath test."

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    • Posted

      Stool and breath test are two completely different methods.

      In a breath test the swallowed carbon-labelled-urea gets metabolised by H.pylori's urease to produce labelled carbon dioxide, which via absorbtion in blood stream gets exhaled in breath.

      Hence we don't want to disturb the H.pylori in number or its metabolism prior test with antibiotics or antiacids.

      A stool test looks for a DIRECT ANTIGEN (H.pylory bacteria itself being the antigen provider, the proteins on its surface), not for metabolism of the bacteria. Dead or alive, it has its antigen, no metabolism needed.

      HpSA (Helicobacter pylory Stool Antigen) is an immuno assay.

      None of breath or stool tests are 100% sensitive and specific.

      This is hardly ever the case with any infection test anyway!, so no fault there.

      It ranks around 90% +/-  for both, stool and breath test.

      So:

      NO, your PPI did not influence the result of the H.pylori STOOL test.  

      There were studies done about this concern. (if I paste in the link here, it might get deleted, I shall try seperately in case interested)

      But YES, it is possible (very little % though) to be false negative....as it always is with infection lab tests. 

      If you are negative in a one off stool test, and typical symptoms persist, you can be re-tested, maybe with a different test please.

      The Gold standard diagnosis for H.pylori is unfortunately INVASIVE and COSTLY,

      a biopsie of the stomach and two tests in it positive: Histology (stain, look through microscope) and rapid urease

      (or culture positive. (Culture mostly only done, if first antibiotic lot did not work to eradicate bacteria and antibiotics needed to be tested on bacteria directly to see, what they don't like))

      All the best!

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  • Posted

    I had an endoscopy in my twenties despite my doctor telling me I was too young.  Although I was having severe heartburn nothing was found.  It was suggested I might have a weak oesophagus sphincter and I was prescribed omeprazole which helped.  Surgery was suggested but I have bad reactions to general anaesthetic and I also was ill with depression within hours after the sedation and it took three weeks to clear up.  The acid is a lot better than it used to be but I still have bouts of it and take over the counter antacids to control it.
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    • Posted

      That sounds rubbish, but sounds like you're a bit stuck if you have reactions to general anaesthetics! Glad it's mostly better though. What dose of omeprazole are you on just out of curiosity?
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    • Posted

      At the time I was taking two daily on the lowest dose. I forget how many miligrams exactly because it was some time ago.  However, I now just take Gaviscon rather than bothering the doctor for prescriptions and it helps.

      I've always had reactions such as vomiting, and depression after general anaethesia along with anxiety.  Even local dental anaesthetics cause me trouble if they contain adrenaline.  So I have to tell the dentist to exclude it.  This means I have to have several injections because adrenaline free ones take longer to work.

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