Help to diagnose me! Stomach pain.

[perpetuallypregnant]

Before anyone tells me to - I’ve been to see gastroenterologist and she’s just signed me off with dietary advice.
I have no gall bladder (removed over 10 years ago)
I am early 40’s and otherwise healthy, normal weight and a vegetarian. Don’t drink much or smoke.
I get chronic stomach aches under my ribs. It started about 2 years ago and if I press down in the centre it’s so tender. I went to a and e once, it was so bad. Like a gnawing ache. I’ve had an ultrasound, bloods and an endoscopy all of which were normal. Not celiac either.
I was on Omeprazole for over a year. It helped a bit I think but gave me diarrhoea (I have IBS) so I’ve stopped it. It’s not supposed to be long term anyway and I know it’s linked with vitamin deficiencies and other issues. I don’t get heartburn especially often and the pain doesn’t seem linked with any particular food and can be after food or when I haven’t eaten.
Dr suggested FODMAP which I’ve tried before for IBS and am happy to try again but im
still concerned in case they’re missing something. It’s so sore and I’m terrified of a bad attack which leave me lying in agony for hours. It can’t be normal?
I’ve lost some weight recently but I’ve been trying and if I overeat I gain it again so I’m not worried about it.
It doesn’t get worse if I eat fatty foods in fact salads make it worse.

Anyone else dealt with this? Do I just live with the Omeprazole and take supplements?

Sorry to hear you're going through this. I'm going through something similar. Have you had a Faecal Cal Protectin test? This is used in part to diagnose Crohn's and Inflammatory Bowel Disease but a high result can also be triggered by an infection or parastites.

You said you've had an endoscopy - was it just a colonoscopy? You can have Crohn's in your small intestine causing these kinds of symptoms and I'm told an MRI is needed to see this. If your gastro didn't request it, you could maybe ask your GP to do the FCP test and see what the numbers show? Another relevant test is Faecal elastase to check if you have pancreatic insufficiency. I'm guessing you've probably had all these already?

You might try something like peppermint oil (Colpermin) in the meantime to see if this soothes things a little. I'm taking one at night before bed and a probiotic in the morning at the moment and that seems to help, also peppermint tea. Minimal caffeine, alcohol and spicy food also seem to help (all the fun stuff!) Good luck.

What type of endoscopy? Gastroscopy ? Colonoscopy? Sigmoidoscopy?

As soon as you said salad was a problem my first thought was Crohn's or ulcerative colitis.

I would go to A&E every single time until you get the investigations that you need. It will be something diagnosable, but if they manage to control the pain they’ll send you home.
Can you ask to be transferred to a different hospital for investigation? The hospital 1 mile from me took 9 months to put me on their list for GB surgery after multiple episodes. I went to a different Hospital when I was taken ill at work one day and they booked me in for surgery without any fuss and were much more thorough!

It does sound like Crohn's or IBD. I would push for more tests. I only suggested the FCP test as if it's high (greater than 500) it's definitely not allergy or IBS and points to Crohn's or IBD. It's quick, cheap and easy to do so your GP shouldn't have any problem with doing it.

Are the pain attacks constant or episodic? How long does the pain last?

Do you still get bad cramps,diarrhoea,rushing to the toilet? Bile etc

So much of this yes.
sorry it was a gastroscope into my stomach and they said it looked healthy. Never had a colonoscopy despite being diagnosed with IBS in my teens.

Episodic definitely. It reaches a crescendo and then settles down. Usually over a few hours. They can be mild and irritating (like one I’ve been having today) or agonising - this doesn’t happen too often but when it does I can’t do anything.

Weirdly never had this although my CRP has always been normal which implies minimum inflammation.
I may request this. I take probiotics, drink kéfir, eat sauerkraut, went vegan, tried gluten free…
nothing makes it completely disappear.

You can't be diagnosed with IBS without a colonoscopy. It's a diagnosis of exclusion - that means inflammatory bowel disease has to be excluded first and that can only be done with a camera test and biopsies.

Go back to your GP. You should have had a colonoscopy years ago.

Abdominal migraine?

So can Crohns manifest in upper gasto pain? Wouldn’t the gastroscope show something?
Thanks for that, I’ll request a colonoscopy.

Have you been tested for H pylori? Possibly peptic ulcer?

Tested and checked with the scope as thats what they thought it was.

Crohn's can affect your entire digestive tract. Partial bowel obstructions in your small or large intestine can cause referred pain through your entire body.

For example, if you were having repeated partial obstructions due to inflammation or scarring in your small intestine that would cause pain and discomfort to back up through the upper part of your digestive system.

It's negligent that they've sent you away with an IBS diagnosis without properly investigating for IBD.

So no, a gastroscopy wouldn't pick that up if the pain was referring from further down your system.

Are you sure it's not costochondritis? That's inflammation between your ribs. Sometimes feels like it's behind though. I suffer with it and it can be super tender when touched.

Thanks User that’s interesting. I feel like my GP thinks I’m a hypochondriac and they keep telling me my pain and diarrhoea are caused by anxiety and IBS.
So when I then see a gastro and she says the same thing I wonder if they’re right and I’m just supposed to put up with it.
I’ll go back and ask for a colonoscopy.

My husband has excruciating pain in his stomach on a fairly regular basis. Every two months or so lasting up to 5 days only at night. He vomits too during these episodes. Been to a and e, had so many tests can't find anything.

I think it maybe stomach migraines, more common in children than adults but definitely something worth investigating.

I had a dull ache (only occasional sharp pains) on the upper right under my ribs. Also lots of diarrhoea and urgency. My calprotectin was higher than normal but no IBD. I was eventually diagnosed with pancreatic insufficiency. Most people struggle with fatty foods, but actually it’s things like salad or fermented foods like kimchi or sauerkraut that can cause mine to kick off. There is also something called small bowel bacterial overgrowth (SIBO), which has a lot of overlap (many people have both).

Google Bile Acid Malabsorption and read up about it. I got this after having my gallbladder out. Took 10 years for diagnosis as a lot of medical people haven't even heard of it. I had been told just ibs over the years but knew it was something more.

Is the pain left or right side