instruction: hi doctor I have had severe tummy cramps just under the ribs for about a month some days I cannot keep any food or drink sown but other days it is tolerable I have not been doing much bowel movement and feel constipated but when I do go it is still soft at first it was thought to be herd but the medication did not help and has lasted over a month now my doctor has booked me for an endoscopy to check for gall stones or ulcers I have not had any pain in the last few days and doing more of be does this mean the gallstones have passed do I still need the gastroscopy done I do not want to do any unnecessary tests the pain has been pretty severe but at the moment it is not too bad I am confused I am currently taking nortriptyline seroquel lamotrigine and metformin
output: hi it seems you are suffering from acid peptic disease or acid reflux disease this usually presents with pain in the upper part of abdomen however I would like to rule out any evidence of gall bladder stones that can cause pain if you have any hunger pains any fullness of stomach or gaseous distension of the abdomen after taking meals you should go for upper gi endoscopy to rule out peptic ulcers ultrasound abdomen to rule out gall bladder stones I would advise you to take a combination of pantoprazole and domperidone and to take antiflatulent and antacid syearup like digene or gelusil for symptomatic relief do not consume any alcohol as even a small amount of alcohol can precipitate that there is an infection called pyloric infection which causes recurrent gastric and duodenal ulcers and such episodes of acidity so if during an endoscopy your doctor finds ulcers he would take a biopsy and rapid grease test done for pyloric infection and to get it treated share my opinion with your doctor before acting upon it I hope this helps