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Suggest Treatment For Severe Stomach Pain Along With Stomach Ulcer
Question: I am still not feeling that great. I am now on medication for a possible stomach ulcer that might have caused the internal bleeding and been caused by or made worse by the warfarin, medication for pericarditis or pleursy (they don't know which) which was likely caused by the PE or the warfarin, and the warfarin. I have a lot of constant pain in my chest, which is worse at night so it is hard to sleep, and pain in my stomach, so I am tired all the time.
Please suggest PROGNOSIS
Please suggest PROGNOSIS
Brief Answer:
Inadequate symptomatic treatment
Detailed Answer:
Hello
Thanks for the query
I understand that you are having constant chest pain and you were diagnosed with gastric ulcer. Doctors do not know if the pain is of pleura, pericardial or gastric origin.
In order to help you better I need the following details
1. Please mention the medications you are on right now
2. When was the last Hemoglobin done and what was the level?
3. Is the pain more after meals or anyway associated with meals?
4. The pain constant or comes and goes? Is it pricking type
5. Which part of the chest is the pain? ( upper, lower, back, etc). Right and left?
I believe one must get adequate symptomatic relief for a better quality of life, in order to give you a good symptom free living I need to know your medications so that I can recommend alterations.
I hope to hear from you soon
Regards
Inadequate symptomatic treatment
Detailed Answer:
Hello
Thanks for the query
I understand that you are having constant chest pain and you were diagnosed with gastric ulcer. Doctors do not know if the pain is of pleura, pericardial or gastric origin.
In order to help you better I need the following details
1. Please mention the medications you are on right now
2. When was the last Hemoglobin done and what was the level?
3. Is the pain more after meals or anyway associated with meals?
4. The pain constant or comes and goes? Is it pricking type
5. Which part of the chest is the pain? ( upper, lower, back, etc). Right and left?
I believe one must get adequate symptomatic relief for a better quality of life, in order to give you a good symptom free living I need to know your medications so that I can recommend alterations.
I hope to hear from you soon
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1. Please mention the medications you are on right now
Warfarin for DVT (confirmed by ultrasound) and multiple PEs (suspected after VQ scans but not conclusive) - 7.5 mg/day
Colchicine for suspected pericarditis or plerusy, but not confirmed
Pantaloc for suspected ulcer and to treat confirmed GI bleed
2. When was the last Hemoglobin done and what was the level?
Don't have that information
3. Is the pain more after meals or anyway associated with meals?
Pain not associated with meals
Pain is worst at night when lying down and especially on opposite side
4. The pain constant or comes and goes? Is it pricking type
Pain is constant
Sharp, stabbing pain comes and goes (worst at night)
Dull, aching pain is constant and spreads across lungs and leads to feeling of heaviness in the chest and breathlessness
5. Which part of the chest is the pain? ( upper, lower, back, etc). Right and left?
Sharp, stabbing pain is below left breast
Dull aching pain mostly on left side, but can radiate across sternum and to upper part of chest
Doctors considered 1) Possible damage from 2 PEs, however, PEs were both on right side of chest and pain is on the left; 2) Pericarditis, 3) Pleursy; and 4) Pulmonary Hypertension.
Doctors did echocardiogram, ECG, and chest xray but saw no evidence of any of the above. Pre-existing scarring on right lung from H1N1 infection.
Warfarin for DVT (confirmed by ultrasound) and multiple PEs (suspected after VQ scans but not conclusive) - 7.5 mg/day
Colchicine for suspected pericarditis or plerusy, but not confirmed
Pantaloc for suspected ulcer and to treat confirmed GI bleed
2. When was the last Hemoglobin done and what was the level?
Don't have that information
3. Is the pain more after meals or anyway associated with meals?
Pain not associated with meals
Pain is worst at night when lying down and especially on opposite side
4. The pain constant or comes and goes? Is it pricking type
Pain is constant
Sharp, stabbing pain comes and goes (worst at night)
Dull, aching pain is constant and spreads across lungs and leads to feeling of heaviness in the chest and breathlessness
5. Which part of the chest is the pain? ( upper, lower, back, etc). Right and left?
Sharp, stabbing pain is below left breast
Dull aching pain mostly on left side, but can radiate across sternum and to upper part of chest
Doctors considered 1) Possible damage from 2 PEs, however, PEs were both on right side of chest and pain is on the left; 2) Pericarditis, 3) Pleursy; and 4) Pulmonary Hypertension.
Doctors did echocardiogram, ECG, and chest xray but saw no evidence of any of the above. Pre-existing scarring on right lung from H1N1 infection.
Brief Answer:
Pelural origin pain
Detailed Answer:
Hello
Thanks for getting back, I am sorry for the short delay in my response to you. I was on call at my hospital.
Here are my inferences
1. The pain that you are describing is of pleural origin.
2. It could be due to the damage caused during the episode. If the ECHO is normal and it does not show dilatation of the cardia then it is unlikely to be cardiac origin
3. Pulmonary hypertension is painless. It is associated with chest discomfort and cough
4. Scars are painless as well
These are my suggestion
1. I have learned from my professor during my early days of residency and I believe it as well that it is criminal to keep a patient in pain in this day and age when there are so many pain killers to choose from and very potent ones as well.
2. I recommend that you are started on Tab Paracetamol thrice daily, if the pain does not subside then I would shift you to a non steroidal anti inflammatory like Ketorolac or an opiod based analgesic like Tramadol.
3. I also recommend chest physio therapy exercises. There is no harm going ahead and getting a pleural biopsy at this point to know if it is inflammed.
4. Continue to taking Warf
I hope I was of help, if you have any further queries please get back to me. I am once again sorry for the delay
Regards
Pelural origin pain
Detailed Answer:
Hello
Thanks for getting back, I am sorry for the short delay in my response to you. I was on call at my hospital.
Here are my inferences
1. The pain that you are describing is of pleural origin.
2. It could be due to the damage caused during the episode. If the ECHO is normal and it does not show dilatation of the cardia then it is unlikely to be cardiac origin
3. Pulmonary hypertension is painless. It is associated with chest discomfort and cough
4. Scars are painless as well
These are my suggestion
1. I have learned from my professor during my early days of residency and I believe it as well that it is criminal to keep a patient in pain in this day and age when there are so many pain killers to choose from and very potent ones as well.
2. I recommend that you are started on Tab Paracetamol thrice daily, if the pain does not subside then I would shift you to a non steroidal anti inflammatory like Ketorolac or an opiod based analgesic like Tramadol.
3. I also recommend chest physio therapy exercises. There is no harm going ahead and getting a pleural biopsy at this point to know if it is inflammed.
4. Continue to taking Warf
I hope I was of help, if you have any further queries please get back to me. I am once again sorry for the delay
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. RM.
We are going to take your prescription to our Family Physician and hope for the best. Much obliged.
Kindest Regards.
XXXXXXX
We are going to take your prescription to our Family Physician and hope for the best. Much obliged.
Kindest Regards.
XXXXXXX
Brief Answer:
Welcome
Detailed Answer:
Hello
I am glad I was of help. Please get back to me and let me know what they had to say
Regards
Welcome
Detailed Answer:
Hello
I am glad I was of help. Please get back to me and let me know what they had to say
Regards
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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