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I Have Had Constant Almost Sudden Dull Throbbing / Pulsating / Burning Upper Stomach Pain
Posted on
Sun, 3 Jan 2021
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sun, 3 Jan 2021
Answered on
Wed, 26 Mar 2025
Last reviewed on
Question : PLEASE READ BACKGROUND, SYMPTOMS, AND QUESTIONS. THANK YOU. GOD BLESS.
Background: I have suffered from GERD and gastritis for the last 5 years. Recently I was diagnosed with LPR due to chronic acidic burping with a burning throat. It is usually 15-30 minutes after eating a meal and continues for hours.
These symptoms seem to chronic and seem to be on and off. I have tried position changes, environment and diet changes (Specifically low acid diet, smaller meals, eating slower), several different types of PPI and H2 along with supplements.
Main symptoms: I have had constant almost sudden dull throbbing / pulsating / burning upper stomach pain all the time since November 1. It seems worse when I am on an empty stomach or sleeping. I have had loss of appetite, nausea, weight loss and severe pain. When I lay down, I feel a strong pulse in the upper middle of the stomach above the belly button. This pain keeps me up at night and makes it hard to sleep. It seems to subside a little when I eat.
Ultrasound for gallbladder came back fine. I am going to get a H pylori test but had previous
Previous Diagnosis
2015 – Saw Gastroenterologist Yevgeniy Ostrinsky and XXXXXXX XXXXXXX who assessed my situation and do an endoscopy.
Encounter Date Diagnosis
24 Sep, 2015 Dysphagia, unspecified (ICD9-CM - 787.20)
24 Sep, 2015 Unspecified gastritis and gastroduodenitis without mention of hemorrhage (ICD9-CM - 535.50)
24 Sep, 2015 Esophageal reflux (ICD9-CM - 530.81)
24 Sep, 2015 Duodenitis without mention of hemorrhage (ICD9-CM - 535.60)
2018 -Diagnosed by another ENT who said recurrent pharyngitis 2018
2019- Dr. XXXXXXX N. XXXXXXX – PLEASE SEE ATTACHED DOCUMENT.
Colonoscopy 9/22/2020
EGD 10/25/2019 Erythema in the antrum compatible with mild non-erosive gastritis
2020 -Was diagnosed by previous ENT, Dr. J. XXXXXXX McIntyre with performed autoimmune test... results below.
Sjogren's Anti-SS-A <0.2 AI Reference range - 0.0-0.9
Sjogren's Anti-SS-B 0.4 AI Reference range - 0.0-0.9
Angiotensin-Converting Enzyme
ACE - 73 U/L Reference range 14-82
Antimyeloperoxidase (MPO) Abs
<9.0 U/mL Reference range 0.0-9.0
Antiproteinase 3(PR-3)
<3.5 U/mL Reference range 0.0-3.5
Sedimentation Rate-Westergren
2 mm/hr Reference range 0-15
Questions:
1. What could the mid epigastric pain be from?
2. What is the treatment plan for this?
3. Are my test results normal for auto immune? Please explain what is means and what I may need to do with do.
4. I have the burning pulsating stomach pain constantly with burping and loss of appetite. Could it be Abdominal aortic aneurysm? I ask this because the pain is worse when laying down.
4. What tests do I need for the gastritis pain
Background: I have suffered from GERD and gastritis for the last 5 years. Recently I was diagnosed with LPR due to chronic acidic burping with a burning throat. It is usually 15-30 minutes after eating a meal and continues for hours.
These symptoms seem to chronic and seem to be on and off. I have tried position changes, environment and diet changes (Specifically low acid diet, smaller meals, eating slower), several different types of PPI and H2 along with supplements.
Main symptoms: I have had constant almost sudden dull throbbing / pulsating / burning upper stomach pain all the time since November 1. It seems worse when I am on an empty stomach or sleeping. I have had loss of appetite, nausea, weight loss and severe pain. When I lay down, I feel a strong pulse in the upper middle of the stomach above the belly button. This pain keeps me up at night and makes it hard to sleep. It seems to subside a little when I eat.
Ultrasound for gallbladder came back fine. I am going to get a H pylori test but had previous
Previous Diagnosis
2015 – Saw Gastroenterologist Yevgeniy Ostrinsky and XXXXXXX XXXXXXX who assessed my situation and do an endoscopy.
Encounter Date Diagnosis
24 Sep, 2015 Dysphagia, unspecified (ICD9-CM - 787.20)
24 Sep, 2015 Unspecified gastritis and gastroduodenitis without mention of hemorrhage (ICD9-CM - 535.50)
24 Sep, 2015 Esophageal reflux (ICD9-CM - 530.81)
24 Sep, 2015 Duodenitis without mention of hemorrhage (ICD9-CM - 535.60)
2018 -Diagnosed by another ENT who said recurrent pharyngitis 2018
2019- Dr. XXXXXXX N. XXXXXXX – PLEASE SEE ATTACHED DOCUMENT.
Colonoscopy 9/22/2020
EGD 10/25/2019 Erythema in the antrum compatible with mild non-erosive gastritis
2020 -Was diagnosed by previous ENT, Dr. J. XXXXXXX McIntyre with performed autoimmune test... results below.
Sjogren's Anti-SS-A <0.2 AI Reference range - 0.0-0.9
Sjogren's Anti-SS-B 0.4 AI Reference range - 0.0-0.9
Angiotensin-Converting Enzyme
ACE - 73 U/L Reference range 14-82
Antimyeloperoxidase (MPO) Abs
<9.0 U/mL Reference range 0.0-9.0
Antiproteinase 3(PR-3)
<3.5 U/mL Reference range 0.0-3.5
Sedimentation Rate-Westergren
2 mm/hr Reference range 0-15
Questions:
1. What could the mid epigastric pain be from?
2. What is the treatment plan for this?
3. Are my test results normal for auto immune? Please explain what is means and what I may need to do with do.
4. I have the burning pulsating stomach pain constantly with burping and loss of appetite. Could it be Abdominal aortic aneurysm? I ask this because the pain is worse when laying down.
4. What tests do I need for the gastritis pain
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
I passed carefully through your medical history and uploaded tests and would like to explain as follows:
1. Your epigastric pain (throbbing, burning and even pulsating) seems to be related to local gastric mucosa inflammation.
Neural endings could lead nociception impulses through vagus nerve to the brain. Antiacids, PPIs could help to relieve pain. Not frequently ulcers without an evident crater may be present and difficult to define.
2. It would be necessary to check for H. pylori as a positive test would help to properly guide therapy to its eradication and symptoms relief.
3. Your performed tests do not show evidence of any autoimmune disorders.
4. A pulsating epigastric pain alone is insufficient at raising reasonable suspicions on a possible abdominal aortic aneurysm. An abdominal ultrasound would have ruled out it.
On my opinion, if H. pylori test results negative and gastric antisecretory therapy doesn't seem to help enough, then a thoracic abdominal CT would be justified to further help on the differential diagnosis.
Hope to have been helpful to you!
Let me know in case of any further questions.
Kind regards,
Dr. Ilir Sharka
cardiologist
I would explain as follows:
Detailed Answer:
Hello!
I passed carefully through your medical history and uploaded tests and would like to explain as follows:
1. Your epigastric pain (throbbing, burning and even pulsating) seems to be related to local gastric mucosa inflammation.
Neural endings could lead nociception impulses through vagus nerve to the brain. Antiacids, PPIs could help to relieve pain. Not frequently ulcers without an evident crater may be present and difficult to define.
2. It would be necessary to check for H. pylori as a positive test would help to properly guide therapy to its eradication and symptoms relief.
3. Your performed tests do not show evidence of any autoimmune disorders.
4. A pulsating epigastric pain alone is insufficient at raising reasonable suspicions on a possible abdominal aortic aneurysm. An abdominal ultrasound would have ruled out it.
On my opinion, if H. pylori test results negative and gastric antisecretory therapy doesn't seem to help enough, then a thoracic abdominal CT would be justified to further help on the differential diagnosis.
Hope to have been helpful to you!
Let me know in case of any further questions.
Kind regards,
Dr. Ilir Sharka
cardiologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Should I follow through with an EDG, Manometry, ph study from Gastro surgeon?
Brief Answer:
I agree on the recommendation for these tests.
Detailed Answer:
Hello again!
Yes, I agree with your doctor recommendation on performing these tests. They will help investivate further on a possible gastric issue (gastro-esophageal reflux, an ulcer, the presence or not of Helicobacter pylory or a hiatal hernia).
Hope to have been helpful!
Wishing all the best,
Dr. Iliri
I agree on the recommendation for these tests.
Detailed Answer:
Hello again!
Yes, I agree with your doctor recommendation on performing these tests. They will help investivate further on a possible gastric issue (gastro-esophageal reflux, an ulcer, the presence or not of Helicobacter pylory or a hiatal hernia).
Hope to have been helpful!
Wishing all the best,
Dr. Iliri
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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