Patient: I have been having pain on my left side, from beneath ribs to just above the hip, for about 5 months. I also have lower back pain. The abdominal pain moves around a little, but is always on the left, and it goes from burning to crampy to dull to sharp. Appetite and BMs do not seem to be affected. I have had urine and blood tests, chest X-Ray, abdo/pelvic CT scan, and endoscopy. I was diagnosed with hiatal hernia, GERD, and erosive gastritis. My concern is that the pain doesn’t seem to be in the right place for these problems, and I have had no relief despite being on PPI and diet for over a month. I am so worried that something else is going on, and since I have anxiety, it’s making things worse. Having a colonoscopy in a few weeks. Is there anything that may have been overlooked, in your opinion? I can’t stand feeling so lousy…
Doctor: Hello, Welcome to Ask The Doctor. We are here to help you.It seems you have two co-existing issues, which are over rided with each other and causing confusion with the diagnosis.In my opinion, you have:1. Acid Reflux Disease.2. Inter vertebral disc compressionMoreover, if you take any pain killers for the back pain, you might get your acidity aggravated.Your hiatus hernia and acid reflux are causing the pain in the ribs, while your hip pain and low back pain are due to disc compression.You should get a MRI lumbo-sacral spine done to rule out the disc compression.For muscular pain, I advise to take a combination of pain killer and muscle relaxant containing Diclofenac and Thiocolchicoside.You should do hot fomentation of the affected area and apply Diclofenac ointment locally.You should also physiotherapy done particularly Ultrasonic heat massage.I would advise you to take a combination of Pantoprazole and Domperidone and to take anti-flatulent and anti-acidity syrup like Digene/Gelusil for symptomatic relief. Don’t consume any alcohol and if you have Acid Reflux, even small amount of alcohol can precipitate that.There is an infection called as h.pylori infection which causes recurrent gastric and duodenal ulcers and such episodes of acidity. So, if during Endoscopy your doctor finds ulcers, he would take a biopsy and Rapid Urease Test done for h.pylori infection and to get it treated.I hope it helps.If you have any further query, please ask me
Comments / Follow Ups
Patient: Thank you so much for your thorough response! This is very helpful. No one has mentioned the possibility of disc compression to me, but I too felt as though there was more than one issue going on, so this gives me some hope. I will ask my GP for the MRI, and try the remedies you have suggested. Thanks again!
Doctor: Good luck friend. Write to us whenever you need any medical advice.