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A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 14936
Experience:  Board Certified NP, MS, RN. Private practice & hospitalist
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Ive been having upper epigastric pain for weeks! Had abdominal

Customer Question

I've been having upper epigastric pain for weeks! Had abdominal ultrasound and X-ray along with blood work all normal. What can this be? Dr said stress?
Submitted: 1 year ago.
Category: Health
Expert:  911Doctor replied 1 year ago.

911Doctor :

Welcome, My answers are for educational purposes only. Remember please, that we do not get paid if you do not click 'accept' / give positive ratings!

911Doctor :

stress can cause many syjptoms... this is possibly the cause.

911Doctor :

an Xray is generally worthless for abdominal pain complaints

911Doctor :

the ultrasound, i hope, was of your gallbladder, and if so that is good to have had because it takes gallstones mostly off the list.

911Doctor :

is the pain constant?

911Doctor :

are you on any medicines?

Customer : Pain intermittent but constant for hours
Customer : Taking ranitidine
911Doctor :

any relief with the ranitidine? also, where is the pain exactly and do you have nausea or vomiting with it?

Customer : I've been examined multiple times at walk in clinic they say noyhing ranitidine not doing much... No nausea and vomiting just a symphony coming from tummy
911Doctor :

so at this point a walk in clinic is not going to be able to help as it seems that the obvious causes have been ruled out.

Customer : Pain mainly around my umbilical region
911Doctor :

for how long have you been experiencing this?

911Doctor :

okay... around the umbilicus.... thanks.

911Doctor :

standing by .

Customer : Yes and urgent care sent me home after blood work X-ray and ultrasound:(
Customer : It's been three weeks on and off....
911Doctor :

that was not a mistake on their part... ranitidine treats reflux and since they looked for dangerous causes of your pain and didn't find any that's the most they can do.

911Doctor :

to see how hard it is to get to the bottom of abdominal pain please see

911Doctor :

THIS ARTICLE

Customer : So what do I do? Go with the stess theory?
911Doctor :

the botXXXXX XXXXXne is this. if the ranitidine is not helping and you have had this for more than ten days or so it is likely you will need to be seen by a Gastroenterologist.

911Doctor :

I think that the 'stress' theory is a diagnosis of exclusion, meaning, once ALL other possible causes are ruled out then we can maybe blame this on stress

911Doctor :

things that have not been done that may need to be done...

911Doctor :

CT Scan of abdomen and pelvie

911Doctor :

'

911Doctor :

'pelvis'

911Doctor :

and possible an endoscopy

911Doctor :

wher ethe GI doctor looks inside your stomach with a camera to check for ulcers and similar conditions.

Customer : Or start freaking that it's serious?
911Doctor :

i definintely would not just wait on this but would be very aggressive in getting a diagnosis

911Doctor :

no

911Doctor :

that's what I'm telling you

911Doctor :

chronic abdominal pain, which seems to be what you have at this point, is VERY difficult to assess

911Doctor :

and well beyond the scope of a walk-in clinic

911Doctor :

it's time to get with an expert

911Doctor :

and that would be a gastroenterologist.

911Doctor :

if you look at that link you will see thirty or forty possible causes

911Doctor :

and there are lots more

911Doctor :

since reflux and gallbladder disease are probably not the cause at this point

911Doctor :

it's going to take some more specific testing to get the answer and the fix.

911Doctor :

standing by

Customer : Well looking at aortic anyeurism as one fors
911Doctor :

your pain and your age pretty much take aneurysm off the list

Customer : Help:( I had upper gi series last year and lower nothing showed all was normal
911Doctor :

again, that is helpful, but was a year ago

911Doctor :

so it is of no value to you in your current situation

911Doctor :

standing by

Customer : So do I rush myself to ER or have faith in waiting for dr to get on this?
911Doctor :

the ER will likely be of no help because you do not have surgical abdominal pain, meaning, this is a chronic and not acute problem. they will likely simply refer you back to your doctor.

911Doctor :

you need to press for a referral to a GI doctor.

911Doctor :

this is a guess, but is quite common in women of your age, and difficult to diganose, but is manageable and is diagnosed by a GI doctor.

911Doctor :

standing by.

Customer : So relax a little in that it's nothing life threatening at present? And can I take more than 300 mg of ranitidine - they've also prescribed dicatel but I'm weary of medications
911Doctor :

i would not increase the ranitidine

911Doctor :

the dicatel is usually prescribed for irritable bowel syndrome

911Doctor :

and is not used in the US

911Doctor :

but there would be little harm in trying it, AND, it will either work or it will not. either way, it iill help your doctor to get to the real answer if you have tried this medicine.

911Doctor :

standing by

Customer : Ok as long as I know rushing to the ER is pointless I assume I'll just battle through
911Doctor :

I do not see a reason to go to the ER. Rather, pick up the phone and call your doctor and tell him/her that your abdominal pain is still there and ask for an appointment. you need to be referred to a GI doctor, or, your doctor may do more testing before the referral.

911Doctor :

stadning by

911Doctor :

do you have any more questiosn for me?

911Doctor :

the point is that your workup is not complete, and more needs to be done. you need to push for this to happen. in the mantime i would take your medicine and not increase the ranitidine. does this make sense?

911Doctor :

I do not see you in the chat. I am going to switch to the Q and A format to facilitate this discussion. If your question has been adequately answered I do so appreciate positive feedback. If you have further questions or desire clarification simply type your response in the box below and click ‘reply’ and I will be back with you as soon as I can.


Should you need my assistance in the future simply start your question with ‘for 911doc only’.


Thank you

Expert:  911Doctor replied 1 year ago.
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Expert:  Camille-Mod replied 1 year ago.

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Expert:  A. Schuyler, NP replied 1 year ago.

Hello,

Thanks for using Just Answer. My name is XXXXX XXXXX I will do whatever I can to answer your question.

 

Was there something not answered in your original question that you still need help with?

 

 

Best regards,

 

Schuyler

 

Customer: replied 1 year ago.
I'm having shoulder blade pain accompanied by lower back pain and tightness in chest.. Vitals are fine... Muscular or anxiety?
Expert:  A. Schuyler, NP replied 1 year ago.

Given all that you discussed with 911 Doctor, it is probably anxiety. However, no one can provide a diagnosis online. It is not only impossible, it is illegal.

Anxiety can cause muscle tighness and spasm resulting in pain. Have you consulted a psychiatrist about the possibility of anxiety causing the physical symptoms you are having?

Controlling the anxiety with cognitive behavioral therapy (CBT) and/or drugs can help with the painful symptoms if that is determined to be the diagnosis.

Best regards,

Schuyler

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A. Schuyler, NP
A. Schuyler, NP
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14936 Satisfied Customers
Board Certified NP, MS, RN. Private practice & hospitalist