Episode Transcript
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Scot: You end up with some stomach pains and it's always hard to know if it's something you ate, or if you're paranoid like I am you assume it's food poisoning, or E. Coli, or something worse like the latest stomach bug that you read about in the news. What I'm looking for is a breakdown, an easy to remember symptoms that can help the average person decide if it's something to worry about or if it will pass. I'm here with Dr. Troy Madsen Emergency Medicine at the University of Utah Hospital. Dude what's wrong with my stomach? How common do you see stomach issues in the ER?
Dr. Troy Madsen: Extremely common. It's a very large number and I expect when I work a shift in the ER I'm going to see at least a handful of people that are there because they're having some abdominal pain.
Scot: How about a breakdown of easy to remember symptoms that can help like the average person like me decide if it's something to worry about, or if it's something that will pass, or if it's something that I can take some Tums for.
Dr. Troy Madsen: You know when people come in the ER that's the question in their mind. Do I really need to be there for this? And we see a lot of people in the ER who probably just have some kind of a stomach virus. You know the number one thing I would say is if you're really concerned come to the ER. I don't want to tell you not to come because your judgment is certainly better that just, than hey this, this, this and this.
Scot: Better safe than sorry.
Dr. Troy Madsen: Yeah, but there are some rules of thumb that can help you to try and decide is this really serious or not. One thing that is a real red flag is if you're in your car, let's say someone's driving you somewhere because you're just kind of feeling nauseated, you're going to the pharmacy to get something, and every bump you hit in your car makes your stomach just hurt like crazy that's a bad sign.
Scot: Okay.
Dr. Troy Madsen: Because then I worry whatever's going on in your abdomen if it's your appendix, or your gall bladder has gotten so inflamed and infected that it's actually infected the lining of your abdomen and that's what causes that really severe pain.
Scot: Okay.
Dr. Troy Madsen: So that's a big reason to come in right there.
Scot: So if bumps are hurting you when you're in the car...
Dr. Troy Madsen: Yeah.
Scot: ...that's a warning sign?
Dr. Troy Madsen: You're hitting the bump your abdomen just hurts like crazy with every bump come in.
Scot: All right, what are some other stomach issues and symptoms?
Dr. Troy Madsen: So some other things are think about the right side of your abdomen. If you're having a lot of pain on the right side, so if you feel it on your right upper side that's your gall bladder, your right lower side that's your appendix, and then people who are otherwise healthy those are the two big things I look for. The left side of the abdomen not a whole lot going on over there. The right side those are the two big things that cause problems. So if you push in that right side of your abdomen and the right upper side hurts, the right lower side and that hurts, that's something you need to come in for. You may have an infection in your gall bladder or your appendix.
Scot: So if the rights not right go to the ER.
Dr. Troy Madsen: That's a good way to remember it.
Scot: Well good. So but the left side it's interesting if you have severe pains on the left side what could that be then?
Dr. Troy Madsen: It can be a number of things, and if it's an older person I worry about an infection in the colon, usually that's more people who are 55 and older. Something called Diverticulitis. If it's down really low and you're a female I worry about the ovaries, maybe an ovarian cyst, or something twisting there, but usually with the ovary it's going to be really severe pain, but if it's just some kind of vague pain over on that left side of your abdomen usually not something to be too concerned about. Again use your judgment to see how you're feeling overall but the right side's the side that really gets me concerned as a doctor.
Scot: How do I know if I've got food poisoning? That's always a big question for me. Is it just upset stomach or food poisoning?
Dr. Troy Madsen: The only real way we can say, "Hey it was food poisoning." Is if there were several people who ate the same thing who were having the same symptoms. There's no real test we do for it. Most cases of food poisoning are going to pass within 12 to 24 hours. You're probably going to feel miserable. If you feel just so miserable that you're not keeping any fluids down, if you're dehydrated that's a reason to come in to the ER because we'll give you IV fluids, get you some nausea medication to try and help you feel better.
Scot: What about cramps, gas bubbles, like your stomach feels rock hard?
Dr. Troy Madsen: Yeah.
Scot: Are those major concerns or is it just gas?
Dr. Troy Madsen: You know most of the time it's just gas. A lot of times it's just some kind of viral infection that's making things feel kind of crumby. You can try some over-the-counter medications see if that helps you out, see if you can wait it out. Again if you're getting those real bad symptoms a lot of pain, just getting dehydrated because vomiting is associated with it, or diarrhea, other reasons to come to the ER, but you know that's a lot of what we see is exactly what you're describing, and you know most cases are probably okay to wait it out a day or two.
Scot: All right one more, so if it's food poisoning usually it will pass 12 to 48 hours you said?
Dr. Troy Madsen: Yeah usually yeah.
Scot: All right, what about if it's something more dangerous, E. coli, is there any sort of difference in the symptoms between the or maybe the latest bug that you hear about in the news that's going around?
Dr. Troy Madsen: Yeah you know those are things that sometimes something will come out in the news people will get really concerned, but E. coli is a very serious thing. It's not a lot that we see it but the big thing that we see with it is that often times bloody diarrhea that's kind of the classic thing we see with the most severe cases of coli.
Scot: With stomach issues what should one do to kind of take care of an issue themselves if they believe it's not a major issue, if it's on the left side, maybe it's gas, what would you recommend?
Dr. Troy Madsen: Yeah again try some over-the-counter stuff, maybe some Pepto Bismol, something like that to help with some of the symptoms, some of the cramping, drink fluids, don't force feed yourself, you know don't make it so you're just drinking so much fluid that you're vomiting it up, which I've seen some people do, try and stay hydrated. And again if things are just getting to a point where it is very dehydrated, you just feel absolutely miserable feel free to come to the ER. We can make sure nothing more serious is going on and get you the treatment you need.
Scot: What's the difference between using an antacid and like a Pepto Bismol?
Dr. Troy Madsen: An antacid is going to be more specific just for acid production in your stomach. So let's say you've got a little bit of a stomach virus that's just causing some irritation in the stomach where Pepto Bismol is going to be a little bit better at controlling things like diarrhea, you know controlling maybe some more nausea, more issues with cramping, where if it's just acid where you feel like kind of a burning feeling kind of going up in your chest you're probably fine just taking an antacid like Maalox, or Tums, or something like that.
Scot: What about a gas bubble?
Dr. Troy Madsen: Gas bubble, you know for that kind of thing where you're having a lot of gas and cramping Pepto Bismol is going to be better. An antacid usually is not going to do a whole lot for that.
Scot: All right dude thank you for telling me what's wrong with my stomach.
Dr. Troy Madsen: My pleasure
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