hi this is dr.subhadeep thanks for the opportunity to help you.
from your description and taking your words that numerous necessary tests have been done without any abnormalities gastritis,gastric ulcer or
hiatus hernia can be the most probable diagnosis
you should get an upper gi endoscopy which will show you any ulcer and a cect abdomen to rule out any hiatus hernia.now management of the condition will be as follows:
1)if it is a simple gastritis either H2 blocker or
proton pump inhibitor with syrp.sucrafil-o 2tsp tds can be given.
2)if there is a gastric ulcer UGI scopy guided biopsy can be obtained.if biopsy proves evidence of h.pylori ulcer then h.pylori regimen that is combination of
clarithromycin,
amoxycillin and
metronidazole with proton pump inhibitorsx2weeks followed by proton pump inhibitor for another 2 weeks.
3)if cect abdomen or usg shows evidenence of hiatus hernia then open or laparoscopic nissens fundoplication with diaphragmatic crural tightening can be done.
4)sometimes inferior wall MI can simulate
abdominal pain so kindly get an ECG or 2D ECHO done. if ecg shows evidence of MI and trop t is positive kindly visit your physician and take treatement for MI.
5) kindly get LFT or S.amylase,S.lipase done.if there is any liver disease or
pancreatitis should be ruled out and if any evidence of liver disease or pancreatitis is present,visit the physician/surgeon for further management.
6)lastly if you r doing heavy workout spasm of rectus muscle can lead to pain abdomen so local analgesic spray or painkillers can be used.