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Non pregnant wife with severe abdominal pain after eating grapes

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My wife has had severe abdominal pain, intermittently over the past 3 days. It is severe enough to keep her awake at night. Not pregnant. We have tried: Immodium AD, Tylenol, Aleve, Pepto Bismol, Gas-EX, Milk of Magnesia, and Tums. None of these have provided any relief of symptoms. Some vomiting on occasion. No bloody stools, no diarrhea, no vomiting blood. No previous history. No previous medical conditions or surgery. 32 y/o Black female that is normally healthy.


Category: Gastroenterologist, Medical

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Category: Family Physician-GP
Dr. Mayank Bhargava is online now

Expert:  Dr. Mayank Bhargava replied 4 Days.

Hi,
Welcome to Doctor Spring Forum.

Let me know the associated details along with mentioned.
Does she has fever/ yellow discoloration of eyes and urine/ excessive gargling
sound/abdominal bloating ?
Do you have acidic belching/ retrosternal burning pain/ sour water coming in mouth?
Do you have foul smelling sticky stools?
Do you have increased frequency of defecation?
What is the type of abdominal pain?
What are the relieving and aggravating factor of abdominal pain?

With the available described details, there could be possibility of acute bacterial
gastroenteritis/ cholecystitis/ pancreatitis or renal stones.
There appears to be least possibility of peptic ulcer disease as she is not getting relief
with milk of magnesia, gasex, Pepto Bismol.
Acute bacterial gastroenteritis could be associated with severe spasmodic abdominal pain with
increased frequency of defecation. Amount of stool passed could be small.

You should consult with internal medicine specialist/ gastroenterologist and should go for
thorough check up.

You should also go for complete blood count, serum amylase and lipase, liver function test,
blood sugar. thyroid function test, urine routine microscopy, ultrasound imaging and x ray
abdomen on preliminary basis.
Requirement of endoscopy will be decided after all these investigations.

Treatment depends on exact diagnosis.
She should take proton pump inhibitors, antacids, and tramadol in written prescription from a
local doctor.

You should also take soft diet along with yogurt.
Avoid tomatoes, citrus fruits, coffee, chocolates, excessive tea.

Take care,
Let me know your other queries.
Get well soon,
Dr. Mayank Bhargava


Patient replied :

Please see answers to your questions below.

Does she has fever/ yellow discoloration of eyes and urine/ excessive gargling
sound/abdominal bloating ? No fever, does have frequent urination, no discoloration of eyes, no bloating of abdomen, no gargling sound.

Do you have acidic belching/ retrosternal burning pain/ sour water coming in mouth? None of these.

Do you have foul smelling sticky stools? Stool is normal consistency/color.

Do you have increased frequency of defecation? No, normal frequency.

What is the type of abdominal pain? Generalized from mid-sternum throughout abdomen. Pain briefly goes away for a few seconds each hour, but is otherwise persistent at a 10/10.

What are the relieving and aggravating factor of abdominal pain? Nothing has relieved the pain as of yet. Pain started on Saturday. Went away on its own Monday evening. Came back at 1100hrs on Tuesday and has remained since.

We thought pain was associated with some grapes we had purchased at the store as eating grapes has been the only association with the pain starting. Otherwise, it is random onset.


Anything you recommend OTC? We do not have Health Insurance, so a consult with Gastro or at a Family Doctor is out of the question. We could go to ER, but would prefer low-cost remedies OTC. Do you think something like Prilosec OTC could help relieve symptoms?


Expert:  Dr. Mayank Bhargava replied 3 Days.

Hello,

I am afraid your will have to go the ER, unless the pain is settled now. The pain could be due to a condition called Acute Pancreatitis. This affects the pancreas and may lead of to long term problems later. So it is not wise to postpone the diagnosis and further care if needed.

It is less likely to be related to the grapes. Grapes can cause ulcer pain, but ulcer pain are mostly continuous pain. Other causes like Uterteic and Kidney stones, Gallbladder problems also needs to be ruled out

AVOID all the medications you have mentioned in the first query. They indeed can aggravate the pain. You can take Prilosce OTC. Take it twice daily (not once as in the package insert) before food. Avoid any other natural remedies, OTC pain medication and alcohol.

Hope this helps
Please feel free to ask followup queries.


Dr. Mayank Bhargava
Category: Family Physician-GP
Experience: 
Fellowship: Gastroenterology, Chotiram Hospital & Research centre, Indore, 2009
Residency: General Medicine, Rajasthan University Jaipur, 2008
Medical School:  MBBS, Rajasthan University Jaipur, 2004
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