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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Xiphoid Process Pain And Hurts To Drink Hot Beverages, Kindly Advice

I have pain - tender to touch - on my xiphoid process. It also hurts to swallow any hot beverages or food. I have been scoped by GI, x-rayed, MRI Abdoman, CT chest, Stress Test, ultrasound of left side (where pain radiates the most) EKG , Blood count, cardiac enzymes, metabolic panel, Sed rate, Rhematologist, Cardiologist - all normal normal normal. Docs dont think it is pancrease or gall bladder . Still I have this pain and it is makes it hard to do much of anything - much better when laying down, not using any of my abdominal or chest muscles. Scheduled for an injection on Friday but nervous it won t work. Not sure how it got here - was made worse by underwire bra. Hurts to take the bra I do have on off (one of the worst things I can do). Hurts to bend, sit at the computer in any kind of tense position (like when you are thinking and typing). Worse with exertion or deep breaths unless laying down. Any thoughts on what this is and if injection is likely to work. Seems pretty localized but weird that hot hurts so much. My bottom rib close to it seems like it might be a little involved too - hard to tell. Chiro thinks it is facia as opposed to cartilage but he isn t sure.
Fri, 5 Aug 2011
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Endocrinologist 's  Response
Well sometimes pain can be difficult to treat .... A gastro esophageal reflux (gerd) often typically presents in a similar manner and not easy to diagnose even after an endoscopy ... I think u should go for a trial of proton pump inhibitors (omeprazole 20mg a day ) for about 4 wks before u undergo anything more invasive.

An local injection would only work if it is a musculoskeletal pain .... But since it hurts when u swalow something i think it is something gi.... My advice avoid the injection.... Ps : even if it is musculoskeletal go for non nsaid painkilllers like tramadol...
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Xiphoid Process Pain And Hurts To Drink Hot Beverages, Kindly Advice

Well sometimes pain can be difficult to treat .... A gastro esophageal reflux (gerd) often typically presents in a similar manner and not easy to diagnose even after an endoscopy ... I think u should go for a trial of proton pump inhibitors (omeprazole 20mg a day ) for about 4 wks before u undergo anything more invasive. An local injection would only work if it is a musculoskeletal pain .... But since it hurts when u swalow something i think it is something gi.... My advice avoid the injection.... Ps : even if it is musculoskeletal go for non nsaid painkilllers like tramadol...