Upper abdominal ache upon waking up.

[Chad01]

Hi, does anyone else get upper stomach/ epigastric pain when they first wake up in the morning which then fades after a while?

Should add generally fades before bm.

Had a bunch of unsound diagnoses over last few years.

Thanks.

[FRreedman]

Have you been tested for esophagitis? (Basically heartburn or indigestion, which is worse when laying down)

[Chad01 in reply to FRreedman]

Thanks for replying Freedman. I did have a couple of manometries a few years back. The 24 hr was very marginally high - but partly because I’d forgotten I wasn’t supposed to take my PPI pills and took 1 during the test.

One possibility that’s been mentioned is that it could be a hyper sensitivity to that kind of thing.

My gall bladder has a lot of sludge but it’s not felt that the pain is in the right place for that. I was given a dx of mild chronic pancreatitis for a while but that seems to have been discounted now.

During the several years that it’s been happening I’ve never come across someone who has the same aching upper abdominal pain in the morning. It’s an odd one.

Many thanks for your response.

[Hidden in reply to Chad01]

I get this too. Better just now because I’m being very vigilant about my new PPI and have dropped Ranitidine. I have Sjögren’s with overlap CTD (a point of debate about the overlap but probably limited systemic Scleroderma which the Sjögren’s rheumatologist says would explain my dysmotility both ends and gastritis). I get many other GI symptoms but what you’re describing sounds like my mix of chronic pancreatitis and gastritis. My gallbladder is gone.

[Chad01 in reply to Hidden]

Thanks Twitchytoes.

That’s interesting to know.

I’m on Ranitidine but only started it after I’d already been suffering with symptoms. Although i should probably review my meds at some point.

The CP diagnosis I had been given has since been discounted by one of senior CP people at the UCLH after my last EUS. That was what I’d initially assumed the pain was.

I guess it’s just a question of getting on with things.

Thanks for your reply.

Best wishes

C

[Hidden in reply to Chad01]

Hi C. Personally I’d review things re Ranitidine ASAP because it’s been recalled or stopped in many countries now due to concern about a potentially carcinogenic ingredient. I’ll let you look this up yourself and I’m sure it won’t explain your upper abdo issue any more than it explains mine. I took prescribed 150mg Ranitidine twice daily for 4 years so it is a bit concerning for me as I’ve got precancerous skin condition on my lips and have been immunesuppressed off and on for the past 8 years.

Also the reason I think I do have CP is that, despite investigations not supporting CP - I had acute pancreatitis 4 years ago while taking Azathioprine for my rheumatic disease. And CP, as you probably know, is almost impossible to confirm or exclude despite imaging etc. But upper abdo pain is just that and I would definitely push for it to be investigated again.

[Chad01 in reply to Hidden]

Thanks Twitchytoes. Very interesting, will take a look at all of that.

Hope you’re managing ok.

Best wishes

C

[DIANECUMMI]

Oh thank goodness. I have this and its been going on for years. Prescribed Omaprazole but didn't fix it and to be honest try not to take it along with Ranatadine as its not supposed to be long term use Been prescribed them so many times. Have been told it could be connected to menopause or hiatus hernia. I have had issues now for 9 years. Cameras down and up and only thing uncovered is a hiatus hernia. My diet is Gluten and dairy free by choice as it seems to be the only thing to have made a difference. Have been prescribed Fluroxatine to help with the pain (which wakes me up every single night). Also amytriptaline for the hot sweats that accompany my pain. Can I ask do you get any back pain as I also wake with a stitch about where gall bladder is. I have had a scan on my gall bladder, pancreas liver and kidneys but nothing shows.

I now have hyperparathyroidism and I am wondering if the two could be connected.

My problems are mainly under control in daytime but at night its awful.

[Viklou in reply to DIANECUMMI]

IBS symptoms are experienced with Hyperparathyroidism usually constipation, gerd and nausea. I also have hyperparathyroidism but not constipated xxx

[DIANECUMMI in reply to Viklou]

Thank you.

[Chad01 in reply to DIANECUMMI]

Hi Diane,

It sounds very similar.

I was having a really terrible time a couple of years back with night sweats and pain in my upper ab/ epigastrum - going through to my back (mainly left upper near shoulder blade). I was waking up throughout the night with soaking sweats and bad aching.

Was obviously v concerned by it. Had LOTS of tests - as I had private health cover at the time . But, despite seeing a lots of specialists from different disciplines, and several theories, I still don’t have a dx.

Since then (the last 1-1.5 years) it’s been a lot more manageable, thankfully. I’m currently on pregabylin, amitrypyline and ranitidine. I now, generally speaking, sleep through and have the upper stomach / epigastric pain only upon waking up but it tends to slowly fade before I get up.

I don’t know why it got ‘less bad’. It was around the time I started pregabylin and a little while after I’d finished a round of steroids. But I don’t know if this had any bearing on it.

I’m still seeing a specialist on the NHS who’s keeping tabs on things. The last idea was that it could be a type of hypersensitivity but the jury is very much still out....

[Chad01 in reply to DIANECUMMI]

I should add that I was also prescribed Omaprazole, in increasingly large doses which had little to no effect so I stopped it.

I drastically changed my diet to v low fat but that didn’t help either.

I know that alcohol seems to exacerbate things and had stopped completely for two years. Had started drinking a couple of glasses of red wine earlier this year but drank far too much wine at a 50th birthday celebration a month or so back and the pain was much worse for a couple of days.

[DIANECUMMI in reply to Chad01]

Oh thanks for reply. Sometimes I think its all in my mind as the Dr's just don't have a clue. I ate a burger for the first time in ages this weekend and felt so ill afterwards so that would tie in with the fat thing.. Gave up Alcohol ages ago. It was making me so ill. Even one drink. I hope you get some answers eventually.

[Chad01 in reply to DIANECUMMI]

That’s interesting. Yes it’s really frustrating not having a diagnosis. A couple of years ago I asked my gastro to get a pancreas scan/EUS because I was in such a bad way and that was the only thing I could think it might be that would tie everything together.

After that scan/ EUS showed some mild pancreatic atrophy and a few anomalies I was given a dx of ‘mild chronic pancreatitis’ which was a concern.

Thankfully, for whatever reason, the pain/ sweats decreased substantially and I wanted to firm up whether that dx was sound. After seeing a couple of senior pancreas specialists I was told that it wasn’t chronic pancreatitis and maybe it’s some form of hyper sensitivity.

That was a big relief but cp is still in the back of my mind tbh. I’m now under the care of my local nhs gastro department and have been told that they’ll do an EUS each year or two to keep an eye on things.

I wish I could be of some more help.

I’m ok eating most things, although I know not to have an ice cream in the evening because there is a direct link between that and increased pain and I try to eat fairly healthily now. As I said alcohol makes issues worse- but oddly enough notanywhere nearly as bad as it was. However the 3 days of pain after the birthday do a couple of months back has made me abstain from that again.

The fat/ dairy/alcohol thing is odd, because that could tie in with pancreas issues but then again it could also aggravate more general GI issues. I guess if it is a hypersensitivity issue then the discomfort caused by these GI issues would be amplified and that would tie in with the increased pain at night/ morning.

But, again I’m clutching at straws slightly. Which is what I’ve been doing for a while now. Anyway, thanks for sharing your experience. If I ever get any clarity on the whole issue I’ll make sure to share it with you in case it’s of any help.

Take care and best wishes.

C