
I Have Gassy Feeling In My Chest(not Sure If Thats

I am 28 year old South Asian male. Weight has been consistent for the last 3 months. No issues with diet and motion.
I have also developed sensitivity to certain foods now, again not sure if its GERD or what. I am trying to find what is causing the issues.
I have tried changing my diet but the symptoms are the same, burping and gassy feeling/burning in the chest. I also have have mild pain in the right side of the abdomen which is vague and not in one single position. It comes for a min or so and goes away and on a scale of 10 I would 1-2 XXXXXXX It kind of feels like gas passing through the bile ducts but I know it should not happen.
I have had Upper GI Endoscopy with biopsy, CT scan with contrast, US of abdomen, MRI of Spine, numerous blood works: CBC,LFT,lipase, amylase, all of them have come back as normal.
I have been on Omeprazole and Sucralfate for some time and its not helping.

I am 28 year old South Asian male. Weight has been consistent for the last 3 months. No issues with diet and motion.
I have also developed sensitivity to certain foods now, again not sure if its GERD or what. I am trying to find what is causing the issues.
I have tried changing my diet but the symptoms are the same, burping and gassy feeling/burning in the chest. I also have have mild pain in the right side of the abdomen which is vague and not in one single position. It comes for a min or so and goes away and on a scale of 10 I would 1-2 XXXXXXX It kind of feels like gas passing through the bile ducts but I know it should not happen.
I have had Upper GI Endoscopy with biopsy, CT scan with contrast, US of abdomen, MRI of Spine, numerous blood works: CBC,LFT,lipase, amylase, all of them have come back as normal.
I have been on Omeprazole and Sucralfate for some time and its not helping.




GERD
Detailed Answer:
Hi...
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX
As per the symptomatology and reports which you have attached,I agree with your clinician that it is due to GERD and gastritis.
Organic diseases of bile ducts,gallbladder or pancreas have already been excluded by relevant investigations.
Diseases of gall bladder,pancreas and bile ducts usually present with severe upper abdominal pain,nausea,intractable vomitings,abdominal distention,dehydration due to decreased oral intake,jaundice,yellowish urine and not passing flatus and faeces.
Gastritis and heart burn may cause discomfort in chest,retching,acid reflux,burping,indigestion,pain in back,cough,trouble swallowing and gas.
Do certain life style and dietary changes.
1.Eat small and frequent meals instead of large 3 major.
2.Avoid overeating.
3.Take an early dinner.
4.Avoid fatty,greasy,spicy and junk food meals
5.Avoid alcohol and tobacco.
6.Abstain from tea and coffee.
7.Be physically active.
8.Take a good 8 hour sleep in night.
9.Sleep at a slight angle with the head elevated(35 degrees)
10Avoid Carbonated beverages
11Avoid Chocolate.
12Avoid citrus fruits and garlic.
13Increase the intake of curd and probiotics.
Identify the food substrates which you are not able to digest and which triggers the heartburn and avoid those stuffs.
Stress can trigger and accentuate heartburn and other symptoms of acid reflux hence de stress yourself.Do yoga and meditation.
You were already on a PPI (Omeprazole) which helps to decrease acid production.You can start Pentoprazole 40 mg once a day,before meals instead of omeprazole.
Sucralfate is an antacid which is alkaline in pH and forms a coating on the gastric mucosa thus saving it from the acid attack.
To my patients I some times also start Pro kinetics which helps the stomach to empty empty faster.
Hope that I have answered your query.
If you have any doubts,kindly let me know.
Stay healthy.
Regards.

GERD
Detailed Answer:
Hi...
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX
As per the symptomatology and reports which you have attached,I agree with your clinician that it is due to GERD and gastritis.
Organic diseases of bile ducts,gallbladder or pancreas have already been excluded by relevant investigations.
Diseases of gall bladder,pancreas and bile ducts usually present with severe upper abdominal pain,nausea,intractable vomitings,abdominal distention,dehydration due to decreased oral intake,jaundice,yellowish urine and not passing flatus and faeces.
Gastritis and heart burn may cause discomfort in chest,retching,acid reflux,burping,indigestion,pain in back,cough,trouble swallowing and gas.
Do certain life style and dietary changes.
1.Eat small and frequent meals instead of large 3 major.
2.Avoid overeating.
3.Take an early dinner.
4.Avoid fatty,greasy,spicy and junk food meals
5.Avoid alcohol and tobacco.
6.Abstain from tea and coffee.
7.Be physically active.
8.Take a good 8 hour sleep in night.
9.Sleep at a slight angle with the head elevated(35 degrees)
10Avoid Carbonated beverages
11Avoid Chocolate.
12Avoid citrus fruits and garlic.
13Increase the intake of curd and probiotics.
Identify the food substrates which you are not able to digest and which triggers the heartburn and avoid those stuffs.
Stress can trigger and accentuate heartburn and other symptoms of acid reflux hence de stress yourself.Do yoga and meditation.
You were already on a PPI (Omeprazole) which helps to decrease acid production.You can start Pentoprazole 40 mg once a day,before meals instead of omeprazole.
Sucralfate is an antacid which is alkaline in pH and forms a coating on the gastric mucosa thus saving it from the acid attack.
To my patients I some times also start Pro kinetics which helps the stomach to empty empty faster.
Hope that I have answered your query.
If you have any doubts,kindly let me know.
Stay healthy.
Regards.



GERD
Detailed Answer:
Yes ....... It can be in right part of abdomen too.
GERD pain is vague and it is usually in upper half of abdomen.
At times,it is diffuse and there is generalized pain in the whole of abdomen.
The endoscopy may be normal in chronic persistent gastritis ,low grade gastritis and when gastritis is not extensively erosive.
For decades,the term and concept of "gastritis" has been used in the absence of strict definitions,resulting in confusion in the clinical settings.
Basically "Gastritis" is a term used by gastroenterologist s for an abnormal-appearing gastric mucosa rather than representing a particular endoscopic entity.
It is usually diagnosed by a review of personal and family medical history and physical evaluation.Then it is clinically co related with reports of endoscopy,endoscopic biopsy,stool for occult blood and serum pepsinogen levels.
There is a very clear and important role of gastric endoscopy and endoscopic biopsy in documenting GERD and gastritis yet it's diagnostic and prognostic value depends on the biopsy site and identification of the biopsies as to the site from which they were taken.
Hope that I have answered your query.
Happy living.
Regards.

GERD
Detailed Answer:
Yes ....... It can be in right part of abdomen too.
GERD pain is vague and it is usually in upper half of abdomen.
At times,it is diffuse and there is generalized pain in the whole of abdomen.
The endoscopy may be normal in chronic persistent gastritis ,low grade gastritis and when gastritis is not extensively erosive.
For decades,the term and concept of "gastritis" has been used in the absence of strict definitions,resulting in confusion in the clinical settings.
Basically "Gastritis" is a term used by gastroenterologist s for an abnormal-appearing gastric mucosa rather than representing a particular endoscopic entity.
It is usually diagnosed by a review of personal and family medical history and physical evaluation.Then it is clinically co related with reports of endoscopy,endoscopic biopsy,stool for occult blood and serum pepsinogen levels.
There is a very clear and important role of gastric endoscopy and endoscopic biopsy in documenting GERD and gastritis yet it's diagnostic and prognostic value depends on the biopsy site and identification of the biopsies as to the site from which they were taken.
Hope that I have answered your query.
Happy living.
Regards.


Thanks

Thanks
GERD/GASTRITIS
Detailed Answer:
Hi Sir.....A gas pain due to indigestion and gas trapped in right sided intestine mimics a pain associated with liver,biliary tree,gall bladder.
Follow the dietary restrictions and avoid gassy foods,you would improve very soon.
Regards.

GERD/GASTRITIS
Detailed Answer:
Hi Sir.....A gas pain due to indigestion and gas trapped in right sided intestine mimics a pain associated with liver,biliary tree,gall bladder.
Follow the dietary restrictions and avoid gassy foods,you would improve very soon.
Regards.



GERD/GASTRITIS
Detailed Answer:
There is a step wise approach to abdominal pain which have been followed in your case.
History,physical examination and pain location guides the clinician about differential diagnosis.
Your abdomen has been searched for any evidence of any pathology.
Ultimate tests for right upper quadrant abdominal pain include liver function tests,serum amylase,lipase,X ray of abdomen-standing posture,abdominal ultrasound,endoscopy and a CT scan of abdomen with I.V contrast XXXXXXX
A hepato biliary cause gets ruled out for sure.
Now only evaluation modality left is a diagnostic laparoscopy.
You can go for it if you are that anxious but it is an invasive procedure.
Regards.

GERD/GASTRITIS
Detailed Answer:
There is a step wise approach to abdominal pain which have been followed in your case.
History,physical examination and pain location guides the clinician about differential diagnosis.
Your abdomen has been searched for any evidence of any pathology.
Ultimate tests for right upper quadrant abdominal pain include liver function tests,serum amylase,lipase,X ray of abdomen-standing posture,abdominal ultrasound,endoscopy and a CT scan of abdomen with I.V contrast XXXXXXX
A hepato biliary cause gets ruled out for sure.
Now only evaluation modality left is a diagnostic laparoscopy.
You can go for it if you are that anxious but it is an invasive procedure.
Regards.



GERD/GASTRITIS
Detailed Answer:
No Sir.....It is ERCP.
It is a procedure where an endoscope is passed down the food pipe into stomach and duodenum.
Duodenal papilla (ampulla of Vater) is viewed which is the point where the pancreatic duct (from pancreas) and the common bile duct (from gallbladder and liver) empty their secretions into the duodenum.
After identifying duodenal papilla,clinician passes a catheter down through the scope and injects contrast XXXXXXX through it into the pancreatic and bile ducts.
This is seen by sequential x rays.
Gallstones, stricture or obstruction in bile duct/pancreatic duct,tumors,cancers and evidence of inflammation.
MRCP is a safer alternative to a more invasive test called Endoscopic retrograde cholangio-pancreatography (ERCP) but less informative.
Here, magnetic resonance imaging (MRI) is used to procure detailed pictures of hepato biliary ducts and organs
ERCP is recommended due to procedural ease during an ERCP.
Diagnostic and therapeutic procedures like taking tissue biopsies,inserting a stent,taking out gall stone or bile sediment etc can't be performed during MRCP.
REGARDS

GERD/GASTRITIS
Detailed Answer:
No Sir.....It is ERCP.
It is a procedure where an endoscope is passed down the food pipe into stomach and duodenum.
Duodenal papilla (ampulla of Vater) is viewed which is the point where the pancreatic duct (from pancreas) and the common bile duct (from gallbladder and liver) empty their secretions into the duodenum.
After identifying duodenal papilla,clinician passes a catheter down through the scope and injects contrast XXXXXXX through it into the pancreatic and bile ducts.
This is seen by sequential x rays.
Gallstones, stricture or obstruction in bile duct/pancreatic duct,tumors,cancers and evidence of inflammation.
MRCP is a safer alternative to a more invasive test called Endoscopic retrograde cholangio-pancreatography (ERCP) but less informative.
Here, magnetic resonance imaging (MRI) is used to procure detailed pictures of hepato biliary ducts and organs
ERCP is recommended due to procedural ease during an ERCP.
Diagnostic and therapeutic procedures like taking tissue biopsies,inserting a stent,taking out gall stone or bile sediment etc can't be performed during MRCP.
REGARDS


I do know if there is anything wrong they can biopsy it but as a mode of looking at the bile ducts is MRCP a good option?

I do know if there is anything wrong they can biopsy it but as a mode of looking at the bile ducts is MRCP a good option?
GERD/GASTRITIS
Detailed Answer:
Yes Sir......MRCP is less invasive,safer,less informative option but can very well be used to visualize hepatobiliary tree and it's basic abnormalities.
Regards.

GERD/GASTRITIS
Detailed Answer:
Yes Sir......MRCP is less invasive,safer,less informative option but can very well be used to visualize hepatobiliary tree and it's basic abnormalities.
Regards.



GERD/GASTRITIS
Detailed Answer:
Sir .......
You have been under medical supervision in the past,have been extensively investigated (Upper GI Endoscopy with biopsy,CT scan with contrast, US of abdomen, MRI of Spine, numerous blood works: CBC,LFT,lipase,amylase and all of them were normal) and a contrast enhanced CT has been procured.No abnormality was detected.
Looking to your history and symptoms (which do not relate to any hepatobiliary pathology),I would like to reassure you that your symptoms are not suggestive of anything serious.
As per clinical protocols and policies,you hardly need any further work up.
If the things are seen from your perspective,you can go for further evaluation to relieve your stress and anxiety.
That would likely restore your mental peace.
Wishing you the best.
Kind regards.

GERD/GASTRITIS
Detailed Answer:
Sir .......
You have been under medical supervision in the past,have been extensively investigated (Upper GI Endoscopy with biopsy,CT scan with contrast, US of abdomen, MRI of Spine, numerous blood works: CBC,LFT,lipase,amylase and all of them were normal) and a contrast enhanced CT has been procured.No abnormality was detected.
Looking to your history and symptoms (which do not relate to any hepatobiliary pathology),I would like to reassure you that your symptoms are not suggestive of anything serious.
As per clinical protocols and policies,you hardly need any further work up.
If the things are seen from your perspective,you can go for further evaluation to relieve your stress and anxiety.
That would likely restore your mental peace.
Wishing you the best.
Kind regards.

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