These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Stomach Problems
Question: I often get sharp pains in my upper abdomen which seem to begin most commonly (although not always) when I go several hours without eating. The only remedy seems to be to lie down and sip water. My doctor prescribed Zantac, which I’ve been taking for about 4 months, but it hasn’t really helped. Any ideas?
Answer: Upper abdominal pain is a commonly experienced symptom, and is among the more frequent reasons for patients to see their physicians. Although there are many possible underlying causes of upper abdominal pain and discomfort, the specifics of the pain and any other symptoms may at times suggest which cause(s) is, or are more likely. For example, does the pain travel to any other part of the body, such as the back, or other parts of the abdomen? Is the pain associated with fever, chills, nausea, vomiting, diarrhea, or bloating? How severe, how often, and the quality of the pain are also important factors. Have you experienced any bleeding with your bowel movements, or pain with passing urine or stool? Do you experience abdominal symptoms after eating, or trouble with slow passage of food after swallowing? Have you experienced any weight changes?
In addition, knowledge of any medications you are currently taking, as well as any other medical problems you may have, may also be helpful in determining potential causes for the pain. Is there any history of pancreas or liver disease, gall bladder disease or stones, kidney disease or stones, prior surgery involving the abdomen, ulcer disease, “heartburn”, or intolerance of spicy foods, caffeine, or dairy products?
A thorough history and physical examination are therefore very important in the evaluation of a patient suffering from upper abdominal pain. Your physician has prescribed, and you have been taking Zantac for the past 4 months. This medication is known as an H2 blocker, which means it blocks one of the mechanisms by which the stomach produces acid. In turn this reduces acid production in the stomach, and has been shown to improve symptoms from ulcer disease, heartburn due to reflux of stomach acid into the esophagus, as well as stomach irritation from excess acid production, which may be due to dietary factors, physical or emotional stress, or other medical conditions.
If you have not experienced improvement in your symptoms after 4 months of Zantac therapy, you should see your doctor. In addition to considering other medications which are available, a discussion with your physician regarding what further testing he or she feels is warranted (be it blood work, radiologic (x-ray) evaluation, or further physical testing), may be beneficial. As always, close and regular follow-up with your doctor is key in determining whether any therapy has an effect.
