Compression Regression: A Rare but Curable Cause of Postprandial Abdominal Pain

Excerpt

A 30-year-old woman was evaluated in the gastroenterology (GI) clinic for complaints of chronic nausea, vomiting, and abdominal pain. Her past medical history was significant for migraine and endometriosis. Her surgical history included an appendectomy 5 years previously. The patient reported having nausea daily along with intermittent bilious, non-bloody vomiting 2–3 times a week, and early satiety for the past year. This was accompanied by sharp non-radiating epigastric pain that lasted for 20–30 min. Her symptoms were always postprandial occurring 5–10 min after eating a meal. She had started smoking marijuana daily 2 months after symptom onset with partial relief. She denied any benefit from using ondansetron or promethazine. She denied any dysphagia, bloating or excessive flatulence, alteration in bowel habits or overt GI bleeding. Nevertheless, she had lost 10 lb over the last 1 year. She denied smoking tobacco or using any illicit drug apart from marijuana. Her family history was insignificant. She was taking occasional ibuprofen for migraine and oral contraceptive pills for endometriosis. Her vital signs were normal and physical examination was unremarkable. Laboratory evaluation including complete blood count, comprehensive serum chemistry panel, TSH, HbA1c, ESR, CRP, and celiac panel were all normal. …