Brief Answer: Possibilities:Acid peptic disease, ischaemia,renal Detailed Answer: Hi, I went through the query and understood your concern. If I were your treating Doctor for this case of severe pain under the left rib cage radiating to back, I would come up with three possibilities, these include: The first possibility is of Peptic ulcer disease. Diagnosis can be confirmed by upper GI endoscopy. Try raising the head end of your bed about four inches with blocks. It also might help to avoid eating or drinking for two hours before you lie down. To help control the stomach acid, one should not drink alcohol or drinks with caffeine in them, or eat chocolate or spicy or greasy foods. Also take some antacid but if the symptoms are severe, then you may need drugs like proton pump inhibitors like pantoprazole. The second possibility is ischaemic heart disease (IHD). Though the pain may be very severe in left chest region in IHD,the associated symptoms of tiredness, dizziness, tightness in left jaw region suggest to evaluate your cardiovascular system once. ECG, 2 D Echo and stress test should be done to rule out any cardiac cause. The last possibility is of any kidney stones which may present as such sharp pain radiating to the back. For this purpose you need to get an ultrasound abdomen and kidneys done. Also check for your BP, blood sugar level and lipid profile once and these needs to be monitored at normal level. I suggest you to consult a physician and get an ultrasound upper left abdomen, ECG or upper GI endoscopy to rule out any above mentioned based on your symptoms. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Regards

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