What Causes Recurring Upper Abdominal Pain, Nausea And Fatigue With Elevated CRP Levels?

Posted on Thu, 4 Feb 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 4 Feb 2016 Answered on

Tue, 5 Apr 2016 Last reviewed on

Question : Hi There. I have had upper abdominal pains on and off for the last b6 weeks. Initially I was admitted to hospital with a crp 0f 26 and Amylase count of 250. I was discharged as I had no temperature and some of the pain subsided with analgesia and little food, but I still get pain and nausea after food and I am still unable to eat normally, so I went to my GP and had another blood test on the 11th of January where my CRP had actually risen to 138 and my GP rang me and told me he would refer me for an urgent surgical review and I have been waiting since with symptoms of nausea, discomfort and extreme fatigue and wait loss.

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
Urgent Investigations and Surgical opinion and management

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Female/6 - pain upper abdomen 6 weeks - nausea, discomfort, extreme fatigue, weight loss - pain and nausea after food and unable to eat normally - initial CRP was 6 and Amylase of 5 - now CRP of 138 on XXXXXXX 11 - GP rang and told for reference to Surgeon -

This is almost days since the last report and makes me wonder that you have not had the further investigations and/or Surgical Opinion.

I would advise you the following:
CT scan of the abdomen.
Upper GI endoscopy.
Review regularly with ultrasonography.
Tests of blood, urine, stool.
Surgical opinion and
further management as per the findings.

I hope this answer guides you for an early diagnosis and further treatment as per the cause/s found.
CRP is indicative of inflammation somewhere.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (18 hours later)

You had my figures wrong, I clearly stated inmy original question that I was admitted when my CRP was 26 (not 6)and my Amylase was 250. The Amylase has gone down but my CRP has gone up to 138 and I have been waiting for an urgent surgical review since the 11/01 but have not had any blood tests or anything since. I would be relieved if my CRP was going down but I have not had it checked. My GP also dismissed when I complained that I have symptoms of Cystitis as well as he felt this was not connected. Whether it is connected or not, it is painful and unpleasant and adds to my fatigue and abdominal pain that radiates to my back, especially just under my ribs! I have not had blood, urine, stool test and feel I am not getting better, which is frustrating and depressing.

Answered by Dr. T Chandrakant (23 minutes later)

Brief Answer:
Try to get the investigations and the Specialist's opinion at the earliest.

Detailed Answer:
Sorry for the typo as my numeric key pad was making this happen.
I had read it clearly. initial CRP was 6 (26) and Amylase of 5 (250)- now CRP of 138 on XXXXXXX 11 - GP rang and told for reference to Surgeon - Corrected.

I can understand the situation you are going through.
Try your best to get the Surgical opinion and the investigations I suggested.

Which are the complaints you had suggestive of cystitis other than pain and unpleasantness?
Please insist for the tests and surgical opinion as soon as possible.
Get a proper diagnosis at the earliest.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (57 minutes later)

CRP was 26, no 138, Amylase now normal but was 250.

My symptoms of Cystitis are: frequent urge to pass urine and pain and burning. Still got discomfort and pressure in upper abdomen and back after eating.

Answered by Dr. T Chandrakant (11 minutes later)

Brief Answer:
Get a proper urine tests and a course of an antibiotic.

Detailed Answer:
Since you have problems of frequent urge to pass urine and pain and burning, are not the tests for urine done? - routine, microscopy, culture and sensitivity.
Have you been prescribed any antibiotic?

Still got discomfort and pressure in upper abdomen after eating. Get a PPI like Omeprazole and antacid gel to start with awaiting a Specialist opinion and further management.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar