Acute Sporadic Episodes of Severe Abdominal Pain

[MeBZ100]

Following is my case, please see if anyone can help or relate:

I randomly get "periodic episodes" of severe stomach pains that occur roughly about 2-3 months apart, almost always a few hours (anywhere from 1-4) hours of having a dinner (that is, almost all episodes occur at night time right before or at about bed time); each generally lasting 7-9 hours on the average. There have been a few shorter episodes and a few much longer, with differing intensities but generally a typical episode on the pain scale level of 1-10, 10 being worst, starts at about level 1-4 with peaking at about pain level 7-9 for the most part of an episode and then suddenly diminshing after about 6-7 hours of severe duration.

Note, the pattern of each episode is almost always about the same from start to finish - a sensation (kinda "feel like") of some heaviness in the stomach, then gradual increase in pain in abdominal area (about half an hour to an hour after that "heavy feeling"), which then quickly shots up to a severe pain scale level 7-9 that would last most through the night and then eventually resolving on its own after about 5-8 hours of peaking.

During a typical episode what I experience, almost always in the same order of occurrence: (1) A feeling that an episode is about to happen, a few minutes to about half an hour right before it actually starts - (this is important to mention because this is an onset of an episode where my body alerts me to stop intaking any food/drinks of any sort; howeveer, this initial stage is also full of anxiety and mental pressure with an unpleasant "sixth sensation" of a sort, if you will, that I am about to start facing yet another night of restlessness; (2) A mild to severe pressure in stomach and general abdominal area, lasting for a few minutes to about half an hour, that would signal positive that the episode has now begun; (3) a wave of cyclical/sinusoidal pain wave that suddenly increases in intensity from severe to extreme; typical time duration for each sinusoidal pain-wave lasts about a 1-2 minutes duration each, a low-peak-low acute cycle of sharp stabbing/burning sensation and intense pressure in the general mid-abdominal area, lasting about 5-7 hours; (4) during the peak pain hours my stomach muscles/wall may harden several times for 5-10 minutes for each time; I may lay down, get up, kneel, crouch, fold in fetal position, walk, pace, rub/massage my tummy, and try to use toilet to allow me pass gas/stool or throw up to help lower the pain and to get some relief from constant churning going on in my belly; (5) a feeling of chill/cold occurs during the early hours of an episode, followed by mild to severe dryness in mouth, that eventually is followed by a bit of nausea and/or mild-to-severe burbs upon which I "make" myself to vomit that often yields positive in throwing up of whatever may had been leftover inside the stomach by then; (6) the pain generally peaks out after 5-6 hours of acute/sharpness in severity, eventually subdueing itself almost suddenly; (7) I finally able to go to sleep after about 6-8 hours of intense pain.

I am generally so tired and full of fatigue towards the end of each episode that I fall asleep in no time and wake up in the morning all fine as if nothing ever happened - with no pain or any signs of it!  Apart from being tired the morning after and having to cope with general fatigue throughout the next day due to the restlessness night, I am able to resume all functions just as normal like no problem - that is, normal eating and normal bowel movements!  

I must state, during these episode, I do not have any fever (despite feeling chills/cold), headache, backache, diarrhea, blood in stool/vomit or anything else of that sort. I make myself to go to the bathroom several times during an episode to see if that would help and I am able to go with normal bowel movement (while the pain in the belly is still going on) and pass normal stool - with no extraordinary smell, blood or any abnormal discoloration - suggesting that the issue is not with my large intestine (colon).  I strongly suspect that this whole thing occurs and is confined to my small intestine. However, no doctor, gastrointestinal specialist, and even expert surgeons have been able to diagnose or detect any problem with any of my organs or digestive tract.  

I have had all sorts of blood and stool tests, ultrasounds, x-rays, colonoscopies, endoscopies, barium swallows, tests at the best-of-the-best hospitals and by the best-of-the-best specialists in my area but, alas, yet all to none avail. I do have insurance despite of which it has still cost me several thousand dollars in deductables.

I have had tried maintaining a food diary to isolate if there may be an issue with my diet, an unknown food borne allergy or malabsorptions, but, that too had not been helpful except to suggestively (but not conclusively) suspecting some ingredients such as certain fruits and veggies, etc, that perhaps may be the culprits. However, none of those suspected food items can be positively identified to be the actual culprits because some episodes had occurred even in absence of the suspected ingredients!

As a subject for a case-study: I am (otherwise) a healthy adult male with healthy lifestyle and normal dietary habits. I don't smoke, don't drink, nor eat/abuse junk/fast food nor go on eating binges. My preferred choice of drink is simply plain cold water. I avoid all sorts of sodas, sugary/salty drinks/snacks, and coffees etc. as much as possible. I do take a cup of hot black tea every morning and occasionally a glass of plain low-fat milk at bed time. I, in fact, have what known to be a balanced/healthy dietary lifestyle. It has been ruled out that I do not have intolerance to dairy, eggs, cheese, wheat/breads, cereals, etc.  I prefer chicken and fish over red meat, however, I have not shown any signs of indigestion after eating a meal containg beef or lamb meat.  I do get some stress on times but generally it's no more than any guy next to me and probably just what an average healthy normal adult would get during a working week. I do get to relax and excersize time to time (but not as regularly as I used to some years ago) since I pack quite a busy daily routine that does not allow me to even think or feel about having any extraordinary level of stress.

My stomach problom started about two and a half years ago (October 2009) and has been so typical in its recurring patterns that, by now, I have become accustomed to handling each occurrence as to just endure the pain through the whole night rather than rushing to an ER or going to see a doctor about it.  That said, it is still quite troubling (and annoying!) when it occurs and I have not (yet) lost all hope in finding a cure for it.  If anyone else out there suffering with similar issue(s), please kindly share. Thank you so very much.

[Jcbb]

I am the same.

[Avinashers]

I had severe stabbing pain in three to four different areas in my abdomen. After going through a thoroughly useless "specialist"-ordered colonoscopy, it has transpired that the pain was because of my lactose intolerance. With less milk in my diet, i am totally free of the pain, only for it to return because I'm such a coffee, ice-cream, yoghurt etc etc addict. so, please go for a food allergy test before any invasive procedure....

[LizzyUVA]

Thank you all so much for sharing, it's a sad relief in a way to know others are suffering from these sporadic bouts of extreme unpleasantness.  Same issues for me with the exception that I feel like I have to use the bathroom (num. 2) or vomit at the same time but usually cannot do either unfortunately though my suspicion is that it would help relieve some of the pain to expel whatever is in my tummy or intestines that is causing the issue.  My husband suffers has suffered from kidney stones since he was a teenager so we always have Rex painkillers around even if they are old they do work if I take them quickly enough.

Otherwise baths only help slightly when I can drag mysel doubled over to the bathroom, and I can't seem to keep down any fluids I try to drink.  I've also gone to the ER and have had scans but the Drs there don't have any information and act like I'm making the symtpoms up.

my attacks started when I was in college at around age 24.  The pain was so intense when I made my wa back to my room from an unsuccessful trip to the bathroom, my vision started to go black like I was blacking out.  

Usually I just lie in the fetal position and toss and turn trying to get comfortable to no avail.  This happens to me at night at bedtime or sometimes it wakes me up and happens to me about every six months - I'm 35 now.

I used to eat a lot of sugary foods but am trying to cut unhealthy foods from my diet.  I've given up caffein too so we'll see how these dietary changes go.

Please let me know if anyone has gotten a diagnosis and treatment that works as right now I have zero faith in established medicine for this problem.

[lu324]

Also I forgot to add, the next morning stomach feels really tender, I feel really hungry but even thinking of food puts me off and I feel nauseous.

[lu324]

I've never been able to find someone else with the exact same problem and here you all are. My first attack was when I was about 14-15 (i'm now 27) In my teenage years I had them much more frequently then it slowed down to once in a year maybe. I haven't had an attack for quite a while until last night. Mine also starts late in the evening I feel a slow burning that I almost mistake for being really anxious. By 12am I give up the idea of going to bed and basically sit on the couch all night crying from the pain. Standing, sitting and laying down does nothing to ease the pain. The pain comes in waves, it creeps up and builds to a excruciating point then slowly subsides over about a minute. I haven't been able to pin point any foods that set me off although I am quite sensitive to dairy but I can still eat it in moderation. I am a very anxious person and was particularly stressed yesterday before my attack so I don't know if it could be stress related. I've never been to a doctor for it and by reading everyone's comment I don't think I will be either. I have extremely sensitive skin and am prone to rashes and skin irritations I don't know if anyone else shares that. I really feel for everyone going through this it's an absolute nightmare.

[xxxoooo]

OMG hats me finally after bouts over the last 5 months ended up in emergency yesterday to no avail just put me on a drip for dehydration did tests etc,, and gave me panadol and nurofen today feeling better but lower abs very heavy and sore from cramping please please lets hope they can sort this out for all of us ..