Stomach pain(1)

JoseyWales

I need some advice, especially from you medical people out there. And the "been there, did that" group. 

DH has complained for years that his stomach hurts. Years. Even before dementia, it was a common complaint. It's ramped up. In the past 3 years we've been to the doctor for stomach pain MANY times. He's had a colonoscopy, blood work (more than once), stool sample analyzed, x-ray, ultra sound, CT scans, CT scan with contrast. Changed his anti-depressant meds several times (that's the only med he's on). Nothing. The diagnosis remains irritable bowel. 

We've tracked his diet. Changed foods, cut out foods. It doesn't stop. The doctor won't prescribe meds because it makes dementia worse. 

His stomach growls and he says it hurts. One day we were standing close together and MY stomach growled. He said his hurt. 

His anxiety is now sky-high. I've talked to the doctors, he's on a nightly med to help with anxiety and help him get to sleep. That works, he doesn't complain about his stomach at night. But by morning it starts again. He's miserable, he cries, he tells me to take him to the emergency room. 

And I think the doctor's are sick of hearing from me about this. What do I do????

King Boo

Another gastroenterologist for a second opinion?   Has he ever had an endoscopy, where they put the camera down into his stomach and biopsy a tiny amount?  Celiac disease, irritational gastritis can be diagnosed this way.

Slow gastric emptying can also cause stomach pain - a fairly easy test to do.   Have parasites been ruled out?

I went through this with a child - we didn't find a through MD the first time.

If anxiety is daylong, see a Geriatric Psychiatrist familiar with dementia.  They can prescribe and titer an appropriate dose to help with the correct medication.   Our GP's never used the correct amount or type.   Gamechanger for us, anxiety medication under the guidance of a Geriatric Psychiatrist.

Rescue mom

In changing his foods, did you try eliminating dairy? Lactose intolerance is more common than many think, and it can cause pain in the gut, gas and “growling”. Finding lactose-free, or nondairy, food is much easier now than a few years ago, there’s a substitute for almost everything. You could try without it for a week and see if it helps. There’s also Lactaid tablets that help, (not an Rx)  but they can be pricey.

On another tack, have you tried giving him a tums or a mint tac—something harmless—and tell him it’s “medicine to help your stomach” and see if the suggestion helps.

And as king boo said, gastritis could be an issue, that can be extremely painful, often right under the breastbone.

ElaineD

I have SIBO, Small Intestinal Bacterial Overgrowth, which happens when bacteria that the small intestine should move into the large intestine stays in the small intestine and then grows, producing gas, rumbling, pain, sometimes diarrhea, or constipation, etc.

At one point I actually became first glucose intolerant and then lactose intolerant as they exacerabated the activity of the bacteria.

Before I had my diagnosis I found that the FODMAP food elimination plan helped me.  I tried that because I thought I had IBS.

I finally realized it might be SIBO (I had heard about it on other forums) and was tested. 

The test is taking samples of your breath over about an hour.....SIBO shows up in your breath, believe it or not.  

The cure is a 10 days of antibiotic.  That usually gives me about two years of relief before the bacteria build up again.  Then I take the antibiotic again: problem solved.

Here is a link to a description of SIBO.  It's just a thought.  A good gastroenterologist will know all about SIBO, and order the test.

 

https://www.healthline.com/health/sibo

Here's a link to the FODMAP food plan.

 

https://www.healthline.com/nutrition/fodmaps-101#high-fodmap-foods

Good luck, 

Elaine

M1

Josey, everything is a tradeoff.  What your doc is referring to is that the proton pump inhibitors (Prilosec, Prevacid, Nexium) have been shown to worsen dementia if taken for long periods.  BUT:  stomach pain is also miserable, and your loved one already has dementia.  I have the same dilemma; my partner has terrible scoliosis and chronic reflux as a result of it (everything internal is out of alignment) and has to have chronic stomach therapy even though it may contribute to her dementia.  We try to keep the dose as low as possible, but she literally chokes if she doesn't take her daily omeprazole.

These meds are available over the counter.  I would go buy some 20 mg omeprazole tabs or capsules and give him one each evening.  See what happens.  If it's going to work, you'll know in 3-4 days.  If no better, increase it to two (40 mg, that's a prescription dose).  Continue it for two weeks; then you can try backing off, giving just one a day or even every other day, or at that point you could try switching to a less intense medicine like Pepcid or Zantac (they are a different class called H2 blockers).  This way you can do your own trial before you put him through anything more invasive.

Nothing in medicine is pure or absolute (that's why they call it an art, right?).  The perfect can be the enemy of the good....

Nowhere

Somatic delusion. It happened to my husband.  A 25 mg Seroquel stopped it over night.  I’ll search the archives for my post and paste it below. The stress of dementia and not knowing what was wrong created a story his brain held onto. The pain affect was really experienced in his brain. It could even drive his blood pressure up. 

Good luck. I hope you find relief...

Maybe key in and search this thread? 

How do you determine when a pain or discomfort is real

JoseyWales

Thanks all for your ideas. You gave me some more to think on. When we last met with the gastroenterologist, she mentioned doing a scope if things didn't improve. I really don't want to do something that invasive. I honestly think he just thinks there's pain when his stomach gurgles. I think that because he says he's in pain even when it's MY stomach making the noise. He's also not at all specific about where it hurts, which is so hard when we go to the doctor. He can't explain the pain or show where it is. At all. 

King boo - parasites were ruled out (stool sample). Anxiety is daylong - I think I need to get a geriatric psychologist visit set up.

Rescue mom - we did eliminate dairy for a while. And apple juice, apples, peanuts, and several other foods, each at different times. None of that seemed to do the trick. Dr. suggested keeping a food log - that is impossible to do with 5 different people and me with DH at different times. I do try to keep mental notes of what he's eaten, but I see no pattern.

ElaineD - That does sound a lot like what DH has trouble with. It's the rumbling that I think drives him nuts. I think I might look more into that.

M1- I'm going to get that medicine this weekend! It's worth a try, and simple. I honestly think I might push for IBS meds at his next visit too- I was thinking that his quality of life at this point is better than worrying about a small problem with cognition. 

Army Vet - that's a lot of what I'm thinking, too. I've never tried Maalox. It's now on my shopping list.

Nowhere - Somatic delusions - I really do think it's that combined with the sound of the gas in his gut. I'll look up your thread. The "pain" goes away with anxiety medicine. Every time. I KNOW there's gas, I hear it. I just hate to say there's no pain when there MIGHT be. 

Again, thanks all. You've given me some new options to try. I'm hopeful again!

JoseyWales

I thought I'd take time to update this post from months ago.

DH has not complained of stomach pain in just over 3 months. The official diagnosis had been irritable bowel syndrome. 3 months ago we again went to the doctor, this time for increased anxiety and depression.

The doctor increased his antidepressants, and added an anti-anxiety medication. Almost overnight the complaints of stomach pain disappeared, never to reappear. I almost never hear his stomach making noise now. So my theory is that his anxiety was causing IBS. 

I'm so relieved that we're not dealing with the daily pain anymore.