The symptoms suggest acute epigastric pain, and the differential diagnosis includes acute gastritis/peptic ulcer disease, pancreatitis, biliary disease, and less commonly musculoskeletal pain.
Avoid alcohol, smoking, NSAIDs, spicy/fatty foods, and large meals.
• A proton pump inhibitor (e.g., pantoprazole) may help if gastritis or peptic ulcer disease is suspected.
Next Steps
Initial evaluation should include:
• CBC
• Serum amylase and lipase (lipase is more specific for pancreatitis)
•
Liver function tests
• Abdominal ultrasound if biliary pathology is suspected
Health Tips
Seek urgent medical care if the pain becomes severe or continuous, is associated with repeated vomiting, fever, black stools, blood in vomit, jaundice, dizziness, or abdominal rigidity, as these may indicate a surgical or pancreatic emergency.