Epigastric Pain Essay

GERD is a digestive disorder that affects the lower esophageal sphincter. When the lower esophageal sphincter gets weak, the acid backed up in the esophagus causing pain and discomfort. Heart burn is a common symptom of gastroesophageal reflux disease (GERD), and it is caused by the irritation of the stomach acid (DeBruyne & Pinna, 2012). This can create a burning discomfort in the upper abdomen.

When gallstones are suspected to be the cause of symptoms, the doctor is likely to do an ultrasound exam or CT Scan, the most sensitive and specific test for gallstones. Other exams that may be performed are a Cholescintigraphy a.k.a. HIDA (hepatobiliary iminodiactec acid) Scan, ERCP (endoscopic retrograde cholangiopancreatography), and blood tests.

I knew the severe symptoms that I had were not characteristic of gallbladder disease. Particularly not in the beginning, when there was only a very small amount of gallbladder sludge. The very elevated liver enzymes I had were also a mystery because they also do not occur when there is gallbladder sludge alone. They can occur when there is sludge blocking a duct, but there never appeared to be any obstructed ducts in either of the ultrasounds I had during that

Mr. Johnson’s reason for driving himself to the emergency room and the symptoms he is experiencing in conjunction with test, and lab results led me to this conclusion. Johnson noticed pain from his epigastric region, radiating to the right shoulder and scapular region. During his emergency room physical exam the physician noted, palpation of the epigastric region demonstrated tenderness with guarding, an above normal body temperature, increased blood pressure, as well as an increased heart rate. The increase in body temperature can be linked to a gallbladder infection. The pain Mr. Johnson is feeling radiating to the

(3) Medical management therapies (such as ongoing stretching exercises, physical therapy, NSAIDs, and muscle relaxants) have failed to control the pain;

According to XX, common causes of epigastric tenderness include; gastritis, esophagitis, esophageal spasms, epigastric hernia, GERD, peptic ulcer disease, with or without bleeding, pancreatitis and hiatal hernia. A gastric ulcer is an ulceration or breakdown in the stomach or duodenal lining. The symptoms of a gastric ulcer include dull and burning recurrent abdominal pain in the epigastric region which can be exacerbated by food. Antacids or milk may relieve the pain. In the additional history, it states that the patient describes his pain as burning. The epigastric pain is relieved by eating, especially drinking milk, but returns two hours after eating. In this case scenario, food intake, especially milk is a relieving factor, not an exacerbating factor. The patient history states he denies early satiety, anorexia or weight loss. He states he has had dyspepsia in the past, but his present symptoms are much worse. The factors that damage the gastric mucosal barrier include use of non-steroidal anti-inflammatory drugs (NSAIDs), cigarette smoking, glucocorticoids, H. Pylori, alcohol consumption and stress. The patient states he has been taking an NSAID (Tylenol) for two months due to a knee injury. He smokes a pack a day, drinking three mixed drinks a day and has increased stress due to a recent job change. .So, he has many exacerbating factors for the development of a gastric or duodenal ulcer. The bacteria Helicobacter

The gallbladder is located under the right lobe of the liver. It stores bile that produced by the liver until it releases into the duodenum to expedite absorption of fats, fat-soluble vitamins, minerals which is part of the digestive system. According to Jorden’s symptoms such as mild pain in midepigastric region, radiating to the right upper quadrant of the abdomen and right subscapular are, as his nurse, I could acknowledge the reasons cause all that symptoms are due to cholesterol problem. It’s a major constituent of gallstone which is one of the gallbladder disorders. Patient who experience it will be in a high risk of inflamed gallbladder due to a big heavy consumption of high-fat meal. And also because the gallbladder is located under

Pain in the central nervous system is a complex process that has been studied by many researchers. Pain is controlled by certain pathways in the CNS. One of these paths is descending serotonergic system (Millan, 2002). This route originated from the nucleus raphe Magnus (NRM). The main function of the NRM is mostly pain mediation; in fact it sends projections to the dorsal horn of the spinal cord to directly inhibit pain (Haines et al., 2013).

I enjoyed reading your thorough and informative post. To add to it, mesenteric panniculitis is another differential diagnosis for epigastric pain in adults as a result of inflammatory process affecting the fatty tissue at the root of the mesentery. Most patients with mesenteric panniculitis do not show symptoms, however, those with symptoms are experience abdominal pain usually localized in the central region or on the upper quadrants, and abdominal mass. The diagnosis testing include CT scan and histological examination. The abdominal CT findings show an increase in mesenteric fat density which can be due to the infiltration of the mesentery by fluid or fibrous tissue, or due to infiltration by inflammatory cells as in acute

Cholecystectomy, the gold standard for cholelithiasis, until the institution of laparoscopic cholecystectomy.[92] Cholecystectomy requires hospital stay , and has death rate of less than one percent.[93,94] Disadvantages to open cholecystectomy are the resulting pain and weeks of disability.[97] A patient who has had abdominal surgery a number of times may not be a appropriate candidate for Laparoscopic cholecystectomy because of broad adhesions around the gallbladder.[26] Patients who are therapeutically too unstable to undergo open cholecystectomy are also not a good candidate for Laparoscopic cholecystectomy either. The estimation and treatment of the stones in the common bile duct can be carried out by endoscopic retrograde cholangiopancreatography

1. Abdominal pain, often centered on the bottom right, but the pain can sometimes be more widespread

Refer patient to Emergency Room for abdominal ultrasound- Acute cholecystitis is a serious condition that requires instant medical treatment in the hospital. Treatment for this condition includes pain medicine, IV fluids, and occasionally antibiotics.

Thirty five year old accountant presented to his physician with a steady burning pain just right of the midline of the abdominal region in an area from 1 to 4 inches above the “ belly button”. The pain was followed by meals (1- 3 hours after). He had several episodes of vomiting, which included blood. The patient had no fever, the patient appeared fine. He had no evidence of weightloss.He showed a slight rebound tenderness in the upper abdomen.An occult blood test revealed the presence of blood.

Acute cholecystitis is the acute inflammation of the gall bladder, which is most commonly caused by gall stones [1]. Gall stones affect about 10% of the western population [2]. Asymptomatic gall stones are present in more than 80% of the patients and among the patients of symptomatic gall stones only 1-3% develop acute cholecystitis [1], [3]. Hence acute cholecystitis is considered the most common severe complication of gall stones [3]. Ascariasis- a major cause of biliary disease also results in acute cholecystitis b/c the cystic duct obstruction caused by the helminth causes an inflammatory process to start [4]. Acute cholecystitis is diagnosed on the basis of clinical features and ultrasonography [1]. Literature gives two opinions regarding the surgical treatment of acute cholecystitis- first is the early surgery within few days

Over the years, with the more experience in Laparoscopic Cholecystectomy has resulted in an increasing number of authors reporting that Laparoscopic Cholecystectomy can be performed safely in cirrhotic patients.18