I Was Initially Having Intermittent Shoulder Ache And Chest Ache

Posted on Fri, 3 May 2019

Question: I was initially having intermittent shoulder ache and chest ache on right side. I first thought it was my neck which has degenerative disease or possibly a shoulder issue but my shoulder is much better but I note intermittent pains under my right ribs and occasionally my right chest ache. I also belch and have some gas. I have a 30 year + history of IBS...is it most likely the IBS causing these symptoms? Thanks

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Some baseline cardiac tests to be done initially.

Detailed Answer:
Hello Duke and thanks for asking query on this forum,
Have seen your details,
There is a protocol of exclusion which is followed when a male patient above 60 complains of chest pain with shoulder involvement whether right side or left side.. intermittent or continuous.
The first thing to rule out is cardiac involvement.A cardiac case can be an emergency and can even be lethal so first thing to rule out is involvement of heart.
I would suggest you to go for two tests easily available at any diagnostic centre.
A 2 d echo- Motion of all areas of heart would be seen on computer screen.If blood supply to a particular area is compromised motion of wall of the particular area decreases.Test is almost 60% sensitive.

Stress test-You would run on a treadmill mill which is designed as per XXXXXXX PROTOCOL.Continuous ecg's would be taken to see any loss of blood supply to a particular area.
Together both these tests are highly sensitive and would rule out cardiac involvement.

Now we would move to gut.You have a history of irritable bowel syndrome.Though chest pain is caused by acid peptic disorder and gas(gas compresses the nerves and increases abdominal pressure) but usually Gastritis and acid peptic disorder is involved.So does not seems to be your case i.e chances are a bit less that pain and that too involving shoulder is because of gas.However if with IBS you have Gastritis(acid disorder) it could be a possibility.

So my dear patient my suggestion is based on the golden rule of medical science.Rule out life threatening disease first.

So initially go for baseline cardiac tests if they are normal would suggest you an endoscopy.Lets see how things turn up after that.
I hope I was clear and easy to understand.
Follow ups are welcome.
Thank you and wish all tests are normal.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ramesh Kumar (13 minutes later)

I did not mention I play tennis singles 2 x per week for 2 hours hard. I understand your approach but unlikely my heart.

But IBS can not cause intermittent pain under right ribs and occasionally in chest? Shoulder pain largely gone.

Thanks

Answered by Dr. Ramesh Kumar (7 minutes later)

Brief Answer:
Follow up.

Detailed Answer:
Hi again yes IBS can cause inflammation along intestines can produce lots of gases which compresses the intestines and nerves passing through them which may cause pain in chest.Shoulder pain can be related to tennis.
It is either costochonditic pain/muscular pain as a result of some sports injury or sprain or can be due to IBS.
Would suggest you to take anti inflammatory ibugesic for 3 days if pain does not responds to it then very likely IBS is the culprit.
Thank you.

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Above answer was peer-reviewed by : Dr. Raju A.T