I am a 53 year old healthy fit female I

Patient

Q: I am a 53 year old healthy fit female.

I have a pain /heavy feeling in the centre of my chest . It feels it's sort of under my rib cage. A few weeks ago I felt a twisting spasm like sharp pain when I bent forward which lasted about 15 seconds. I have had this in the past few years a few times
but I have not been left with this feeling in my chest. It is fine when I'm walking or lying down and seems to get a bit better when I take painkillers. It's worst when sitting so worse at work when at my desk but it gets better when I move position. The pain
is in the middle but can radiate to the right and left at times. I am able to sleep fine because it's ok when I'm lying flat. I have had it for about 3 weeks. About 15 years ago I had inflammation in my duodenum which caused similar pain but that caused me
to have pain up through my throat and my appetite was effected.

Doctor

A:   Hello,
Thanks for the query to ATD for opinion,
The typical pain in the lower chest which aggravates only while in sitting position and relieved on lying down and standing and located in on particular region especially in the epigastric region indicates a possibility of dyspepsia and gastritis. Another differential diagnosis can be costochondritis which can cause similar pain but it aggravates on pressing the lower rib cage.

It is suggested that you may opt for antacids or proton pump inhibitors like TAB PANTOPRAZOLE 40mg once a day for a week and if its dyspepsia you are likely to be relieved. However, costochondritis shall require hot fomentation and pain killers for relief in about 2 weeks.

It is also suggested that an ultrasound abdomen may be done to look any mass or gall bladder swelling (cholecystitis). Please meet your physician if the pain is not relieved in next 48 hrs.
I hope I have answered your query in detail,
Wishing you good health,
Regards

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