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What Causes Abdominal Bloating, Pain Under The Sternum And Nausea?

Posted on Thu, 16 Feb 2017

Question: I would like to ask a gastroentrologist a few questions.

Answered by Dr. Ramesh Kumar (5 hours later)

Brief Answer:
Plwase ask your questions.

Detailed Answer:
Hi Dear,
Thanks for choosing HCM.

Please ask you questions so that i can reply.

Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Ramesh Kumar (1 hour later)

I have had stomach issues for several years. First was determined to be an ulcer but it couldn't be found via cat scan or ultra sound. Everything was normal. This was about a year and a half ago, it started about 3 years ago. Initially I was given antibiotics even though I was negative for h pylori and acid reducers. I changed my diet and it got better. I went back to my old ways drinking alcohol and high calorie diet and it came back. That's when I had imaging done. I've been on acid reducers since. It would get worse and better, largely based on what if I was drinking alcohol and my diet. Full feeling stomach, pain right under sternum, occasional nauseau. About two months ago I decided to stop drinking cold turkey and totally alter my diet to low fat. I've kept it up, but the healing has been very slow. Today I started to have back pain, then my sternum pain got very intense, I became a little shaky. The pain mostly subsided. Could that be gallstones? Would stopping alcohol and losing weight (20 pounds in two months) be partly responsible for the stones? My temp today has been about normal, 98.1 to 97.7.

Answered by Dr. Ramesh Kumar (24 minutes later)

Brief Answer:
No its very unlikely that its because of gall stones.

Detailed Answer:
Hi dear,
Have gone through your history in detail.
Answers to your questions are-
1)No most likely they are not gall stones,Infact you already had a CT abdomen and Ultra sound done,If there were gall stones they would be reflected in the films.
2)I don't think they are gall stones rather you are having severe gastritis,Heart burn due to reflux of acid into esophagus is causing chest pain.Retrosternal chest pain which increases on alcohol intake is suggestive of Gastritis with Gastroesophageal reflux disorder.However if you want to be sure about gall stones get a Ultrasound whole abdomen and X ray abdomen lateral view done.
Though not asked yet
Signs and symptoms of gastroesophageal reflux disease, or GERD, include both acid reflux and heartburn and may also include chest pain and difficulty swallowing. Gastritis involves a group of conditions that cause inflammation of the stomach lining.
Ask your gastroentrologist to prescribe you proton pump inhibitors like Pantoprazole with Domperidone combination.Acotinamide is also a motility inhibitor and would be very helpful for your symptoms
Some general measure that would help you are-
Give up alcohol or smoking.
Don't eat over spicy,fried food.
Try to take 250 gram yoghurt daily as a part of your diet.
Drink Cold milk to relieve you from symptoms.
Drink plenty of water.
Eat lots of fibres and vegetables

Thank you!.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Ramesh Kumar (25 minutes later)

I was prescribed dexilant a month ago, along with carafat, healing is slow. I've been on Prilosec for over two years, seeems to not work well anymore. Can I switch ppis and a different one might work? I've started Prevacid until I get to see doctor. How much can I take per day? I have stopped all alcohol and fatty food, I'm on extremely low fat diet. I drink a lot of water. I've been having sore throats lately which must mean my ppi isn't working? Btw, the pain goes away while I sleep, and return after I wake up if I don't sit up.

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Details below.

Detailed Answer:
Hi
Prevacid can be taken from 15mg per day to 60mg per day.If you are not relieved by PPI's ask your gastroentrologist to use a combination of levosulpride or domperidone along woth PPI's .Acotiamide 30 mg could be added thrice daily by your treating doctor and will definitely help you a lot.A combination of antacid plus local anaethetic(Mucaine gel) can also be added to your regimen.
Discuss these options with your gastro and you will feel much relieved.

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Above answer was peer-reviewed by : Dr. Nagamani Ng