Pain Just Below The Right Chest And Upper Abdomen And

Posted on Tue, 27 Aug 2019

Question: Pain just below the right chest and upper abdomen and excessive belching.

In the image, the light blue is where the pain is in general, the black part is where the pain originates.

Its not present like always but comes and goes.

I am worried that it could be something more than gastritis. I fear it could be something to do with pancreas or gallbladder.

My doctor has said that we have done all the tests and since everything including the blood works came back as normal theres nothing really to worry about and that it could be GERD/GASTRITIS/IBS.

I have done US of abdomen, CT scan, MRCP and Upper GI Endoscopy. Stool test for H-Pylori and Elastase. Blood Test= LFT,GGT,Lipase,Amylase,CBC.

All of them normal.

This has been going on since May this year.

Follow up: Dr. Hari Charan Perigela (1 hour later)

The pain also sometimes spreads to the side of my right rib.

Answered by Dr. Hari Charan Perigela (1 hour later)

Brief Answer:
It looks like Gastritis.

Detailed Answer:
Hi,
I reviewed the picture.

The location that you have marked corresponds to the Stomach. It starts from the lower end of the Esophagus and extends upto the Duodenum.

Any lesion inside the stomach like Erosions, Ulcer, etc will cause pain in that area.

In GERD, the pain starts in the upper Abdomen and moves upwards into the throat (sometimes).

In IBS, there will be either Constipation or Diarrhea along with pain Abdomen.
For Gastritis/GERD, I suggest a Capsule containing Rabeprazole along with Domperidone to my patients.
You should take small frequent feeds. Avoid spicy foods, carbonated drinks, caffeine products.

Gallbladder, Pancreas diseases can be diagnosed with CT scan/MRCP. As these investigations are normal, nothing to worry.

Hope I answered your query. If you have any questions, I will clarify further.

Wish you good health.
Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Hari Charan Perigela (1 hour later)

Will gastritis last for 3-4 months and can it be cured completely?

Can gastritis cause the pain to spread on the side of the rib?

My doctor is asking me to do an EUS, can you let me know in your opinion why is he asking to do the test, I am confused.
He says it’s gastritis but wants to do EUS.

Answered by Dr. Hari Charan Perigela (1 hour later)

Brief Answer:
EUS is not necessary

Detailed Answer:
Hi
Pain due to Gastritis can spread to surrounding areas,even.below the rib.
Gastritis can be cured completely.But,in addition to medicines, there should be dietary modifications and life style changes.
You should be stress free.
As Endoscopy, Ultrasound, CT scan,MRCP are normal,there is no need for EUS in my view.These investigations will give a clue.As they are normal,there is no need for another investigation.
Your doctor should tell the reason for this.
Hope I answered your question
Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Hari Charan Perigela (1 hour later)

Okay, thanks for the explanation. My doctor has also given me XIFAXAN for 2 weeks, he says this will help me. I am not sure if I should take this antibiotic, should I?

Answered by Dr. Hari Charan Perigela (7 minutes later)

Brief Answer:
It a Rifaximin

Detailed Answer:
Hi
It is Rifaximin.It is a Gastrointestinal Antibiotic.It is not useful in Gastritis.It is useful in cases of Diarrhoea due to gut Infection.
I am sorry to say that I cannot comment on the doctor's prescription.
Regards

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Hari Charan Perigela (1 hour later)

Brief Answer:
It can be Musculoskeletal pain also

Detailed Answer:
Hi
Pain related to exercise could be due to Musculoskeletal cause.Skeletal muscle relaxant tablet containing Thiocolchicoside will help.
Another possibility is that the Pain due to Gastritis may come because of exercise induced stress.
If the pain is in Abdominal wall layers,then it is Musculoskeletal.If it is deep seated,it could be due to Gastritis.
Hope I answered your question
Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Hari Charan Perigela (4 minutes later)

Okay, one last question, sometimes while exercising it hurts in that region like (1 or 2 out 10), is it due to gastritis like irritation in the region?