Have abdominal pain after meals. History of hypertension. Need immediate care?
Patient: BP of 151/101 with upper left abdominal pain . 47yo male 220lbs 5 8 . Abdominal CT from 1 year ago is clear of any issues with Kidneys, Galbladder and Pacreus. GI doc says he has no idea. Ordered a EGD for 1 month out with follow up in 3 months. Pain in daily starting Dull/achy to sharp and stabbing especially after meals. Should I take him to the ER? Doctor: Hello and welcome.  Thanks for your query.  The one symptom of pain after meals, is most commonly associated with peptic ulcer disease (PUD). Which is an ulcer found either in the duodenum (which is the first part of the intestine, that is connected to the stomach) or the stomach itself.  The main differential factor is the duration or initiation of pain after a meal.  In the presence of an ulcer in the stomach the pain usually starts 15-20 minutes after a meal, which is how much time the food takes to reach the stomach and irritate the ulcer.   In the case of a duodenal ulcer, the pain starts around 2 hours after a meal, which is how much time the food takes to reach the duodenum after consumption.  Other findings of a gastric ulcer are:  -Vomiting helps in reducing the symptoms -Appetite is usually normal -Patient usually experiences loss of weight -In a complicated or bleeding stomach ulcer, we find traces of blood in the vomitus, and rarely black or dark brownish colored stools   -More common in patients belonging to lower socio-economic status (lower middle class most common)  Other findings of a duodenal ulcer are: - Higher socio-economic status patients -Normal or increased appetite -Normal or increased weight -Darkish brown stool is more common that bloody vomitus  I hope these details at least help you in ruling out an ulcer. An endoscopy would also help in visualizing the ulcer, size and location, and can also take a biopsy (tissue sample) at the same time.  Please discuss the details with your doctor.  For any further clarifications, you can always write back to us.  Wishing you good health.