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December 17, 2010 4:07 PM   Subscribe

I'm having trouble figuring out how to handle my stomach pain, please help me.

Hi friends. Thanks for coming to my rescue.

I am mid-exam-period. I have three major projects that I need to complete over the next four days, and I no longer have enough time to do everything that I need to do, so I am pretty stressed out and this makes it very hard for me to make decisions relating to time management.

My problem is this. I have noticed that over the last few years, I tend to feel sick to my stomach when I am anxious or stressed. That's obviously going on right now, so I have been dismissing my stomach pain, which is usually something like feeling nauseous or bloated after eating. In the last few days it's been waking me up at night (also not useful during exams). Today I have been feeling it continuously since it woke me up a few times in the night. It feels kind of like pressure, kind of like gas, and sometimes radiates to my back or jaw. I'm worried that it might be an ulcer. I took a Pepcid but it did not help at all.

I don't know what to do. Here are the options I have thought of:

1) Ignore it until after exams. This is complicated by the fact that I am going to visit with my parents for the holidays and I am not sure I will be able to see a doctor there because I am on my school's student health plan, and leaving NYC will probably make using it harder.

2) Try to go see a doctor tomorrow or Monday. I am not sure how much time this would take up. And if there isn't anything they can do for me to give me immediate relief, then it seems like a bad plan.

I haven't thought of any other ideas. Should I try a different medicine, or taking more than one Pepcid at a time? Is there food that is reliably "gentler" than the pasta I had for lunch?

I would also appreciate any tips on powering through physical pain to do work that requires a lot of mental focus.

Thanks in advance for your advice. I am sorry if this is a silly question, I am feeling a bit overwhelmed and there's no one but me to take care of me so I'm just trying to do my best.
posted by prefpara to Health & Fitness (24 answers total) 2 users marked this as a favorite
Prilosec. OTC at a drugstore near you. Might want to stock up at Costco when you are home though, its spendy.
posted by fshgrl at 4:14 PM on December 17, 2010

Yogurt, and maybe try a PPI (proton pump inhibitor) instead of an anti-acid. Prilosec for example...

Since you mention you'd like to see a doctor however, you should definitely do that anyway. It could be something simply related to stress, or something else with which you can begin treatment. In any case, the added stress definitely isn't helping, and you should probably not pass up the opportunity to get good advice from a medical professional.
posted by samsara at 4:15 PM on December 17, 2010

Best answer: Have you tried just taking some Pepto Bismol? I wouldn't take too much, or for too long a period of time, but it's more of an "all-purpose" stomach pain medicine than pepcid is.

And stress can cause stomach pain that's just stress, not necessarily an ulcer (the stress-causes-ulcers thing is mostly a myth). Not that you shouldn't try to see a doctor anyway, but stress+stomach pain does not necessarily = ulcer.
posted by brainmouse at 4:16 PM on December 17, 2010

Are you drinking a lot of coffee in an attempt to stay awake and focused? If so, that can cause a lot of stomach discomfort. Slow down on that and maybe drink some ginger tea instead? Ginger can be helpful at calming the stomach.
posted by joan_holloway at 4:21 PM on December 17, 2010 [1 favorite]

If there is any chance it might be gas, try drinking a hot drink (something that won't bother your stomach, maybe green tea or even just hot water with honey) and using a hot water bottle/warming pad against your abdomen or lower back. To relax muscles, try a hot bath or shower. Try varying your body position, since being stuck in one position can create muscle stiffness and let gas get trapped.

If it doesn't get better I would try to see your campus health person tomorrow or at the soonest opportunity. (It's probably stress, but get it checked anyway.) Bring some work with you to the waiting room, your appoinment may not take long and you'll be able to use the time effectively up to the appointment itself.

General tips for exams and stressful times:

-Do not think about where you "should be" in the projects by now. Live in the now. Figure out how much time you realistically have to devote to each project (24 hrs per, minus time for food/sleep/etc, call it 15 hours per project.), and what are the most important tasks to accomplish for each project. Suppose there are 5 most important tasks -- you have 3 hours to accomplish each task. Ok. You can do a lot in 3 hours.

-Eat regularly; for me, protein-rich foods are especially important to maintain focus.

-Sleep at least some, ideally get 6+ hours in each 24 hr period. Sleep helps your brain cement what you studied in you memory, as well as recharging you for what's ahead. It is not wasted time.

-Showering, and brief exercise (eg brisk walk around the outside of your dorm, or around the block) are good for waking up and clearing your head

-Try to break your tasks into discrete units that can be accomplished in 45 minutes or so, then take a 10-15 min break.
posted by LobsterMitten at 4:27 PM on December 17, 2010 [1 favorite]

IANAD or YD; this sounds like precisely what occurred to me a few months back. Pepto didn't help, nor Tums, nor Zantac nor Prilosec. The worst part is that the pain worsened considerably at night, so I would have a bad night, then feel about 30-50% better in the daytime. I saw my GP, who prescribed Nexium, but I began the course too late - that very night at 2am I had to go to the ER because of stomach pain. There they administered many expensive tests (ct scan, Upper gi scan), and (thankfully) gave me morphine for the pain. Testing turned up nothing, and the pain resolved after several days of nexium & a very bland diet (toast/tea only). I tell this tale only as a warning to not wait too long as a trip to the ER can be costly & time-consuming, obviously a concern right now with exams. Though my issue was not diagnosed, I have a history of ulcers, and a gastroenterologist on follow-up opined that it was probably gastritis or an ulcerative condition.
posted by dreamphone at 4:31 PM on December 17, 2010

I would definitely try to see a doctor sooner rather than later, especially since you have an earlier question from March about persistent nausea after eating. If you really can't get to a doctor before exams are over, then at least make some calls to find out specifically what coverage you have and precisely how to go about seeing someone over vacation.

In the meantime, I agree with the suggestion of trying an OTC proton-pump inhibitor like Prilosec to see if that helps as well. It might be a little pricier than the Pepcid, but don't let that put you off.

Avoid caffeine, alcohol, and nicotine like the plague if you normally ingest any of them. They can all cause major stomach discomfort. If you really have to have some caffeine to get through exams, at least switch to tea.

Good luck. Please do see a doctor at some point soon (and don't dismiss it as "just stress" and therefore not of real concern), since this seems to be an ongoing problem for you. There are a lot of things it could be, ranging from the not-so-serious to quite serious, but the sooner you find out the sooner you can start managing it for real.

Good luck. And this is not a silly question at all!
posted by scody at 4:33 PM on December 17, 2010 [1 favorite]

oops, that should be: "If you really have to have some caffeine to get through exams and you normally drink coffee, at least switch to tea."
posted by scody at 4:35 PM on December 17, 2010

Oh, sorry to chime in one more time, but another virtue to seeing your doctor on Monday is that even if they can't give you immediate relief or a specific diagnosis, they could get the ball rolling for a referral to a gastroenterologist (assuming your health plan requires you to get a referral to see a specialist). A GI doc is who I suspect you're ultimately going to want to see on this score, and better to get that process started now than having to wait till January.
posted by scody at 4:40 PM on December 17, 2010

Response by poster: Thanks a lot for your advice so far. I will try to remember to pick up some yogurt on my way home, and I do have PeptoBismol, which I will take before bed. Sleeping through the night would be huge.

I do not drink coffee (or drink or smoke). I do drink a lot of tea, but I will switch to herbal tea so that there is no caffeine.

scody, I appreciate your concern. I did experience similar issues in March, and I went to see a doctor who told me it was probably stress and to try Pepcid. I have taken Pepcid on a number of occasions since March and I have never definitely noticed it helping.
posted by prefpara at 4:43 PM on December 17, 2010

PPIs generally take from several days up to two weeks until you start to feel any relief, so don't count on Prilosec or Prevacid to give you instant relief if it is an acid problem.
posted by PorcineWithMe at 4:57 PM on December 17, 2010

I just wanted to chime in that I had very similar issues for 6 years. I was told for most of those years that it was gastritis- only to find out it had been gallbladder attacks when my doctor finally did an ultrasound.
posted by Zophi at 5:38 PM on December 17, 2010

I am certainly not a doctor, but your symptoms, especially the bloated feeling, and mentioning you had pasta and you're stressed etc leads me to wonder if it may be irritable bowel syndrome. Are you getting stabby pains as well?

For what it's worth, stress (for me anyway) exacerbates my IBS symptoms, as well as high carby-type foods, like some white breads and pasta.

It's really well-worth seeing a doctor anyway to get assessed - better safe than sorry when it comes to your health.

Best of luck for your papers.
posted by thelizardqueen at 6:13 PM on December 17, 2010

Wanted to chime in that I went through a period of about a month with abdominal pain that was diagnosed and felt like heartburn. Antacids sometimes seemed to help, but not much. After one night where I was pacing and moaning from the pain, I went to the ER. Turns out it was a gall bladder attack and five days later I had my gall bladder out. Symptom free ever since.

My advice is try and get to the dr, it's entirely possible that it will get worse and you will have to spend hours at the ER.
posted by lvanshima at 6:21 PM on December 17, 2010

Oh man, I totally had this problem my senior year of college (and actually it seems to be resurging lately...awesome.) I went to the GI specialist and had the whole nine yards--endoscopy, ultrasound, the works! Never found anything. You should still get checked out.

Two things helped me manage--one was just accepting that when I was awake at night, I was awake-- I put on the TV and relaxed as much as I could. Worrying about getting back to sleep wasn't going to help anything. The second was stress management (especially breathing exercises) and physical exercise. In the end I self-diagnosed it as partly acid reflux and mostly stress and other psychosomatic symptoms, so CBT type tactics were my solution.

The absolute worst thing I can do is stay up really late doing something stressful (i.e., studying). Can you give yourself more quiet downtime before bedtime? Finally, as others mentioned, I found PPIs helped somewhat, possibly through placebo effect. (But it's still an effect!) Good luck.
posted by parkerjackson at 7:08 PM on December 17, 2010

I had the same thing as thelizardqueen - stabbing, crampy pains, but no diarrhea or anything. I dealt with it for years before getting bentyl prescribed, and i just took it whenever the cramps started - i was actually clear of them for several years until this week during finals. It was markedly worse at night but got better during the day.
posted by kpht at 7:11 PM on December 17, 2010

I've had similar symptoms for the past 10+ years, and the only diagnosis I've ever had was a hiatal hernia and resulting GERD; the valve in between my esophagus and stomach is herniated so that it doesn't close, so I have acid reflux and a fairly consistent bloaty feeling plus a weird noise that happens in my chest after I eat most of the time (similar to a burp noise, but I actually have trouble burping, and physically can't make myself do it to help release some of the pressured feeling). The pains I get often feel like they're in my back too. (FWIW, I've been in the process of getting evaluated for gallbladder problems, too.) It is pretty greatly exacerbated with stress, to the point that I've had a couple episodes where I lost around 30 pounds over a few months because I was so nauseated I didn't want to eat.

I'd say definitely get to the doc sooner rather than later. Whatever you might be able to do to get a little relief will be worth it, plus as others have said, there will be a process of tests and junk to go through, and the sooner you get started, the better.

For me, Prilosec helps with the acid part, but doesn't get rid of the actual reflux part--that is anatomical (and I know Prilosec helps because on a day when I forget to take one, I can tell by 11am when I can feel burning pains in my chest). And Pepto is the only thing that helps even a little when I'm up in the middle of the night with a pukey-acidy feeling. I started propping myself up more with pillows to sleep, and that helps a lot too. Good luck!
posted by so_gracefully at 7:35 PM on December 17, 2010 [1 favorite]

PPIs take a while to work and once you are on them it can be very hard to get off them.

What helped me and is worth trying is
a. A commercial probiotic. You can find them in the refrigerated section of Whole Foods or some health food stores. I like Jarrodophilus
b. Kombucha or diluted apple cider vinegar after every meal
c. Avoiding bread, bagels, cereal, crackers, pasta and other wheat products. Just try this. I had amazing results and so did the rest of my family. We'd all been diagnosed with GERD/IBS and this really made a huge difference. Try eating rice or potatoes instead if you need carbs.

I also highly recommend trying to get some Librax from the campus clinic. When I couldn't follow my diet, this saved me so many times. It treats both upper and lower GI problems/
posted by melissam at 7:44 PM on December 17, 2010

I have had problems similar to this recently. (stomachaches, bloating, gas,nausea, constipation). I cut out white sugar and bread products from my diet and that helped a whole lot. After I started feeling better, I started eating bread and sugar more, but I still need to watch it. Also, avoiding processed food and eating too much at one sitting helps, as well as does exercise. For me, I don't think coffee was the issue but it may be different for you.
posted by bearette at 9:23 PM on December 17, 2010

I went through this in college. Actual stomach bug (some short-lived viral infection) followed by 2-3 weeks of pain with food / ideopathic gastroparesis during a stressful period. I went to the campus health clinic and got tested for H. pylori at my insistence, plus a bunch of other stuff, but honestly, the thing that helped most was eating lots of soup instead of solid foods, and just generally taking it easy / eating smaller meals.
posted by deludingmyself at 10:08 PM on December 17, 2010

Like melissam, I had similar symptoms that were alleviated by the elimination of wheat and wheat gluten from my diet. That said, I think you should see a doctor if you can. It is entirely possible that a doctor could prescribe you something that could help now, even if you have to have further tests later.
posted by bedhead at 11:51 PM on December 17, 2010

I used to suffer from ulcers every few months. Turned out it was Ibuprofen: take it one day, suffer horrendous rolling pressure waves of cold burning pain the next. I went for a long time without making the connection because of the time delay. Most NSAIDs cause microperforations in your GI tract, and apparently, they can be quite a bit more than micro- if you're particularly unlucky.
posted by Monsieur Caution at 12:51 AM on December 18, 2010

Agree with thelizardqueen that it's worth you investigating IBS - sounds like pain I get, especially when stressed, which is helped by IBS medication (Colofac). IANAD obviously.
posted by paduasoy at 3:00 AM on December 18, 2010

Response by poster: Thank you so much for your helpful advice. I took some Pepto Bismol just before bed and slept better than I have in ages. Hopefully I've found the solution to my exam disaster. You're all my knights in shining html.
posted by prefpara at 5:55 AM on December 18, 2010

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