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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
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Experience:  MD
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I have been experiencing sporadic mild pain throughout my

Customer Question

I have been experiencing sporadic mild pain throughout my abdomen. Sometimes it is in my upper right abdomen, sometimes centered in the middle below the sternum and often in the upper left abdomen, as it is today. Today it triggers pain in the upper left abdomen, when I yawn.
My urine is normal and not painful. My bowel movements are regular and normal. I have no nausea or fever. I do not have a loss of apetite and have lost no weight.
I experienced a similar problem about 4 years ago. At that time, I went through several tests, including colonoscopy, endoscopy, cat scan, and gallbladder scan. The results revealed that I have diverticulitis and a disfunctional gall bladder. In addition, I have GERD and some erosion of the LES. I have been on Omezrapole for several years.
Submitted: 6 months ago.
Category: Medical
Expert:  Dr Basu replied 6 months ago.

Hi there,
This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.

Intestinal gas problem can cause such random pain at different areas commonly. Diverticular disease and dysfunctional gallbladder can cause such problem. Food may not digest well resulting in excessive bacterial action in the intestine producing gas and intestinal colic.
Excess bacterial overgrowth in the small intestine known as SIBO syndrome.
This is not usually diagnosed by the colonoscopy.
Small intestinal aspirate can be sent for bacterial count.
Carbohydrate breath test ( D xylose) is a simple test to diagnose this condition.
But, the treatment is much easier.
A 14 day course of Rifaximine improves the symptoms dramatically.

You should consider following low fermentable sugar diet ( FODMAP diet) to reduce your symptoms.
Please go to this link for detailed information:
http://stanfordhealthcare.org/content/dam/SHC/for-patients-component/programs-services/clinical-nutrition-services/docs/pdf-lowfodmapdiet.pdf

Please also include prebiotics like Inulin daily to keep your colon acidic which prevent gas producing bacteria.
Also take a probiotic ( lactobacilli, bifidobacterium) daily to restore intestinal microbial balance.
Culturelle 30 Counts twice daily should be fine.
Please consider taking Simethicone ( GasX) strips before each meal and activated charcoal tablets to reduce gas formation.

Best wishes,
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Customer: replied 6 months ago.
One more question, please. Of course, Pancreas problems come to my immediately - worst case scenario, right? Does this sound Pancreas related? Also, if it were gas, wouldn't it be causing bloating or belching?
Expert:  Dr Basu replied 6 months ago.

Chronic pancreatitis can interfere with the food digestion. That is also possible. Stool fat estimation, CT scan with contrast should be considered as part of evaluation.
Digestive enzyme supplementation with meals will help in that case.
Best wishes