instruction: hello doctor my father is 71 years old he having abdominal pain in the middle for the past four to five days pain is constant and mild to moderate in intensity he is not having any issue in passing stools or urine but sometimes complains of burning sensation while passing stools his appetite is good no vomiting or diarrhea no fever his current medial history includes diabetes and hypertension he is an alzheimer patient can you please prescribe some medication for his abdominal pain
output: hello I can understand you must be very upset about your father health well you see the abdominal pain in such age is often an alarming finding and I urge you to get him some investigations before giving any blanket cover of medicines common possibilities in his age are mesenteric ischemia which is the narrowing of the blood vessel supplying the blood to abdominal organs this can frequently occur in old age with diabetes and hypertension the pain arises because of lack of blood supply to organs like small bowel large bowel and others the second possibility is pain due to any organ within the abdomen which is inflamed commonly the pancreas a gland over the back of the tummy and large bowel and lastly since he has a problem with constipation the gas accumulation can also be the reason of his abdominal pain but remember we cannot say that it is because of gas distension unless we exclude all other possibilities which are more concerning I suggest you to get investigations which I write below only after the investigation we can be able to diagnose the problem and treat it appropriately I really hope this set of investigations will help us to approach the problem correctly mesenteric ischemia pancreatitis gall bladder or common bile duct stones colitis colonic neoplasia gas constipation related compete blood count serum amylase and lipase liver function tests serum lactate level and serum cop reactive protein hba1c glycated hemoglobin lipid profile stool for detailed report stool for occult blood on consecutive three days stool for fecal calprotectin capsule esomeprazole 40 my half an hour before meals ispagol husk two tablespoons full with water daily follow up after investigation