Dr. Gott: Chronic abdominal pain revisited

DEAR DR. GOTT: In your article about abdominal pain, I think you might have missed a likely possibility: gallbladder disease.

I suffered from this for years, and no doctor took me seriously because I didn't have gallstones. When I finally had my gallbladder removed, I didn't have any more pain. Estrogen is known to irritate the gallbladder, and a 15-year-old has considerable estrogen in her body.

DEAR READER: Gallbladder disease is another cause of abdominal pain. The pain is typically on the upper right side of the abdomen and may worsen after eating, especially fatty foods. Nausea, vomiting and loss of appetite may also be present.

There are several types of gallbladder disease that include gallstones, inflammation, infection and blockage/obstruction. Two or more of these can be present at the same time. For example, inflammation can lead to blockage, which can lead to infection, or gallstones can lead to blockage, which can then lead to infection.

Symptoms may be reduced by making dietary changes. These can include eliminating suspected food allergens; increasing intake of fiber, fruits and vegetables; and reducing the intake of refined and fatty foods, trans fats, red meat, alcohol and tobacco.

Further treatment depends on which type of gallbladder disease is present. Gallstones can be treated with medication to dissolve the stone, but this can take up to two years and the stones often recur. Chronic issues with stones and inflammation more often necessitate surgery to remove the stones or the entire gallbladder.

DEAR DR. GOTT: Your article about the undiagnosed stomach problems sounded exactly like my niece. She suffered for several years until she saw an allergist, who found that she had many food allergies. As long as she avoids those foods, she is pain-free.

DEAR READER: I received three other letters similar to yours. Two of those also mentioned H. Pylori, along with the food allergies and sensitivities.

H. Pylori is a common type of bacteria thought to be present in about half of the world's population. Most people do not exhibit symptoms, nor do they experience any complications; however, for others, it can lead to potentially serious problems.

Symptoms include weight loss, bloating, nausea, vomiting, frequent burping and an ache or burning pain in the abdomen. Complications include ulcers of the stomach and small intestine, stomach cancer and inflammation of the stomach lining.

Treatment consists of antibiotics and medications to reduce stomach acid. Further testing to determine whether the infection has been eradicated may be recommended.

Food sensitivities are food allergies. The different names come into play because allergies conjure up thoughts of hives, rashes, swollen throats and tongues, and classic allergic reactions. Sensitivities, on the other hand, are often associated with other symptoms, such as gas, bloating, pain, constipation, diarrhea and more. Again, these are just different symptoms caused by the same problem: the body overreacting to a certain substance.

Avoidance of the offending food is the best treatment. Those who experience potentially life-threatening reactions when the offending food is accidentally ingested should use medication such as diphenhydramine or a prescription EpiPen.

To provide related information, I am sending you copies of my Health Reports "Irritable Bowel Syndrome," "Allergies" and "Managing Chronic Pain." Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 (per report) check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s) or print an order form off my website at www.AskDrGottMD.com.

• Dr. Peter H. Gott is a retired physician and the author of several books, including "Live Longer, Live Better," "Dr. Gott's No Flour, No Sugar Diet" and "Dr. Gott's No Flour, No Sugar Cookbook," which are available at most bookstores or online. His website is www.AskDrGottMD.com.