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Boyfriends chronic upper abdomen pain

My boyfriend has been living with severe, chronic stomach pain since he was 16 and he is now 20. It subsides in his upper-left abdomen and he says he sometimes feels it in his esophagus. His symptoms that I am aware of include unintended weight loss, pain when eating, pain when he doesn't eat, pain in the morning after just waking up (he usually needs to drink something right away), pain if he's too active. He has gone through all of the GI tests including such procedures as CT scans, MRIS, colonoscopys, and was even looked at for MALS disease(not thorougly) and many more. Time after time results have come back with no diagnosis and at such an early age he is given up hope and doesn't want to further pursue any other options. He is very insecure and very depressed, not to mention he is bi-polar and you wouldn't imagine the toll this puts on him. Currently, he is on a 15 mg dose of methadone which he takes once a day to help subside his pain which has helped him greatly. But this only masks his pain and it's time that we need to find some answers for the cause. I wish I could give more information but due to his sensitivy on the topic I have to space out my questions. Also, he says that he has lower back pain but is caused from his job from bending over and picking up heavy weights. Thanks for any insight.
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replied November 17th, 2010

Welcome to the ehealthforum and I am glad to help you out. The likely possibilities of the pain in the stomach area along with the nausea are acute gastritis or a peptic ulcer. If the ulcer is present in the stomach, the pain gets worsened on eating and if the ulcer is in the duodenum (1st part of the intestine), then the pain gets worsened if fasting and the patient gets relief from the pain on eating. The confirmation of the diagnosis is possible only on endoscopy.

The treatment consists of antacids, drugs which inhibit the acid production like omeprazole, pantoprazole etc. Other possibilities which can have a similar presentation are a stone in the gall bladder (diagnosed by an ultrasound) or acute pancreatitis for which one needs to do a CT scan and the serum amylase/lipase are elevated. I’ll suggest you to consult a gastroenterologist for the confirmation of the diagnosis.

I sincerely hope this information helps. Take care.

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