question: Hi doctor, I am a 35 year old male. My height is 5'9", and weight is 220 lbs. I am a smoker and not on any medication. Over the past seven months or so, I have been experiencing on and off severe upper abdominal pain (center), and that radiates through to my back. At times, the pain may just be some discomfort, and at other time it is completely unbearable whereas I cannot sit still, lie down or do anything even to get brief relief of pain. It feels almost like a gas bubble one receives before they belch. I would try to belch and rarely will get success. When I can belch, it seems like a struggle to come out, and other times I am caught off guard and regurgitate stomach acids or bile. This issue would come on progressively from discomfort to unbearable burning or knot feeling in my upper abdomen within an hour and last 6 to 8 hours and suddenly go away. As of currently, I have had these issues from the moment I awake till I fall asleep. I can feel something wrong with a range of pain levels. I have been avoiding food for almost three days now and only consuming water. Antacids do not seem to work, and change of food does not appear to make a difference on the pain level. I am extremely concerned. My research has lead me to three possibilities such as ulcer, pancreatitis and H. pylori infection.