Hi.

The substernal pain that lasts more than 5 hours and getting better on moving the bowels is indicative of gut problems. The second thing that comes to my mind is exacerbation of asthma episode. A simple question here, did you try using the Ventolin and did you get relief from it? If yes, most likely to be airway problem. At this age, I do not mind to rule out heart problem with simple EKG.

About gut problems, these come to my mind.
1) GERD or Reflux Oesophagitis -- It should be relieved by intake of antacids. Continue with the medicines (Lansaprazole) as prescribed by your doctor. Make sure you move your bowels regularly. Pain free stools can help relief of your symptoms.

Thinner poo is indicative of incomplete stool or constipation. I hope there is no pain or blood during stools. You should try to improve on your food habits, pick more greens, fibre and vegetables.

2) The symptoms you are complaining can be due to inflammation called Cholelithiasis/ Cholecystitis. They are commonly associated with belching, indigestion. It may be with Flax seed but can also be because of Gall bladder problems.

3) Stomach or Duodenal Ulcer- The pain is related with food intake. Does the pain increase on intake of food or reduce with intake of food?

4) Enlarged liver - It can be ruled out with Ultrasound of abdomen.

So the best next step is Ultrasound of the liver as ordered by your doctor. I agree with him and I feel he is going in right direction. If you still have few doubts, I suggest you to visit a Gastroenterologist for complete evaluation and treatment.

Wishing you good health.

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Hello,
Thanks for the query,

Gnawing and dragging pain under the sternum is typically due to peptic ulcers. Bloating from gas, esophagitis, reflux of acid or heartburn can also exacerbate the symptoms. The other possibilities are gall bladder inflammation and hepatomegaly (less likely). Mucus in throat is usually due to post nasal drip but in your case it is due to acid reflux.

So it can be due to bile or acid reflux. Peptic ulcers are ulcers of the gastrointestinal tract. Most of them are caused by the bacterium H. Pylori and some are worsened by drugs such as aspirin, Plavix (clopidogrel), ibuprofen, and other NSAIDs. Upper GI endoscopy is the commonest investigation and detection of H.Pylori is made by urea breath test, measurement of antibody levels in blood and detection of urease activity in a biopsy specimen by rapid urease test. To rule out any biliary cause, get an ultrasound abdomen done.

For peptic ulcers, try raising the head of your bed about four inches with blocks. It also might help to avoid eating or drinking for two hours before you lie down. To help control the stomach acid, one should not drink alcohol or drinks with caffeine in them, or eat chocolate or spicy or greasy foods. Treatment of choice is by antacids, H2 blockers and PPI inhibitors like Omeprazole and Lanseprazole which you are already being prescribed. Perforated peptic ulcers need surgical intervention.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards.

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