Epigastric Pain Case Study

Epigastric pain is felt in the middle of the upper abdomen, mostly between the ribs and the bellybutton. Epigastric pain may be mild of severe as the case may be. It is noted that the pain may radiate to other parts of the body (Micromedex, 2016). Signs and symptoms depends on what is causing the pain. Some of the differential diagnoses for epigastric pain include; Cholecystitis, pancreatitis and peptic ulcer (Leik, 2014)

Cholecystitis- This is one of the reasons why people get epigastric pain. It is an inflammation of the gallbladder. The gallbladder helps to breakdown the fat that are consumed, and also helps to remove certain chemicals from the body. Cholecystitis can be severe with an acute onset or mild attacks which could be chronic.

This is an open sore in the lining of the stomach, intestine or esophagus. Peptic ulcers have different names depending on their location. Such as gastric ulcer which are ulcers in the stomach. Duodenal ulcers are those found in the small intestine, while those found in the esophagus are known as ulcers of the esophagus. Duodenal ulcers are more prevalent that gastric ulcers. While gastric ulcers are found to be more maliglinant than duodenal ulcers. The most common cause of both duodenal and gastric ulcers are H-pylori (Leik, 2014). People with peptic ulcer complain of episodic epigastric pain and burning, which may be short or long term. The signs and symptoms of peptic ulcers are burning sensation or pain in the upper abdominal region, nausea, vomiting, burping and bleeding, which could cause bloody stool. This pain may happen one to three hours after food consumption or when the stomach is empty. The pain may be worse at night or happen intermittently for weeks. It is noted that the peptic ulcer pain may be relieved with food or when antacid is taken. The diagnostic tests for peptic ulcer are blood test to check for H- pylori, stool sample is sent to the laboratory to see if there is blood in the stool, urea breath test is done to check for H- pylori, an upper endoscopy is done to check if there is any problem with the digestive system, upper GI x-ray is obtained to check the pictures of the stomach and intestines (Micromedex, 2016). The treatment for peptic ulcer also depends on the cause. If H-pylori is identified, triple therapy is indicated, which is Biaxin, amoxicillin and proton pump inhibitor (PPI)for 6-8 weeks in order to allow the ulcers to heal. Quadruple therapy may also be indicated, which are, Bismuth Subsalicylate, Flagyl, tetracycline and proton pump inhibitor (PPI) for 4- 6 weeks or longer (Leik, 2014). However, if the condition is not caused by H- pylori, lifestyle changes is recommended,