Mysterious and severe gastric pain causing patient to passing out after eating breads
Adult Asian/Russian native mix female, athlete, no history of any medical problems or allergies. Non-smoker and non-drinker. Postmenarcale, last was 2012 Jan 15. No history of passing out or seizures.
Day 1, suddenly develops severe pain in abdomen after eating a meal on Christmas, passes out from pain and sent to ER.
Doctors first suspect bacterial gastritis, (h.pyloric antibody test positive) treated with antibiotics (Amoxil and Cyclomyacin) for 14 days.
Day 14, during antibiotics treatment course patient passes out from severe pain 4 more times. Healthy stool (no diarrhea), no pain/burning from urinating. Patient only eating fruits, liquids, rice, and eggs and boiled avian meats (chicken, turkey). Not able to eat normal 2,000 calories per day, lost 30 lbs.
Each time patient is admitted to ER, tests show CBC normal (neurophiles slightly low), liver panel, kidney function, urine, EKG, BP, all normal.
Ultrasound is normal, sparse concentrations of calcium in kidneys but still within normal range.
Day 22, patient's own observations noted that she only passes out from pain after eating any amount of breads or pasta. Patient passes 2 hours from pain after eating a piece of wheat bread (plain).
Patient subsequently on morphine for pain as needed, 4 times normal dose, not helping.
Avoiding breads or pasta seems to avoid recurrence of pain. No prior allergies or reaction to breads or pasta.
Patient noted slight increase of burping after each meal.
ROs: Allergies ruled out (prior tolerance to glutine and breads). Parasites/tapeworm ruled out (normal ultrasound and no signs of seizures), bacteria infection ruled out (antibiotics finished course), stomach virus ruled out (only breads seem to trigger pain). Physical injuries ruled out by exams from 3 different ER doctors.
Need suggestions on other possible diseases/causes for severe pain reaction to breads/pasta with no prior history?