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Abdominal pain, heart burn, fullness of stomach - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Good Posted in: Digestion and Bowels
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3385 Questions
User :   56 yr old male. 6 weeks ago developed burning and pain in both nipples after a few days pain moved to left side upper abdomen and arm was seen in E.R. and cardiac issues ruled out. Pain has continued across abdomen and back last week or so heart burn and full feeling in stomach after eating. Pain has also developed back side of each arm pit. The pain is moderate (7-8) The pain has and still is worst on the left side abdomen and under ribs. The following test have been performed.
1. Stress echo -9/17/10
2. CT Scan chest with contrast-9/26/10
3. CT scan abdomen noncontrast (given antibiotics for abdomen pain) 10/2/10
4. CT scan abdomen/pelvis with contrast 10/4/10
5. Blood work 10/4/10 Showed a low thyroid stimulating hormone also Strep titer (ASO) was elevated (Placed on antibiotic)
6. Colonoscopy 10/13/10 was negative
7. Ultrasound 10/5/10 found large solid nodule on thyroid 4.3 cm
8. Fine needle aspiration showed Benign nodule
Is it possibe for all of this pain and discomfort in my body to come from my Thyroid. The first 3 week of this pain I lost about 15 Lbs. Weight over the last week has been stable. Poor appetite but still eating even though I get a full gas feeling in stomach area. Any thoughts would be great.
Doctor :   Hi,
Doctor :   DrXXX here
User :   Hello
Doctor :   Please give a couple of minutes to read your post
User :   Ok
Doctor :   Hve you got your T3 and T4 levels to confirm the thyroid issue
User :   Yes they were fine
Doctor :   Tsh will be low due to feedback inhibition by raised T3 and T4 levels,
Doctor :   hence i would suggest you to repeat the test
Doctor :   as the symptoms you mention are typical for increased BMR or acid peptic disease
User :   New blood work was done 10/15/10
Doctor :   the increased BMR is seen in Hperthyroidism
Doctor :   ok, i suggest you to wait for one more week and repeat the t3 and t4 levels along with tsh
Doctor :   if they turn to be normal then you may need Upper G I endoscopy to rule out Acid peptic disease, which can present the same way
User :   ok Initial bloodwork done 10-04 and again 10-15. what is the major health issues with acid peptic disease? what is BMR?
Doctor :   Stressed out life style will induce gastrin hormone, leading to high acid output which can cause erosions in the stomach leading to the symptoms you have
Doctor :   BMR , is Basal metabolic rate, fast metabolism
Doctor :   to fasten the metabolism again there will be high gastrin levels
User :   upper gi done about 4 wks ago but not a scope but by drinking barium and xray. results negative sorry i don't know technical name.
Doctor :   yes , its called Barium swallow, it is to rule out any growing mass or a big ulcer , but the detailed study would be possible with an endoscopy only
User :   what is treatment for high gastric level?
Doctor :   Antacids
User :   i will contact family dr. mon. and ask for an endoscopy. is it possible to have this much pain in entire body cavity from this type of condition. i have used mylanta in past with minimal results
Doctor :   its called referred pain, due to the overlapping of the nerves one with supplying stomach with the other supplying the other structures
Doctor :   there are many other antacid other than mylanta
User :   if antacids aren't working what is next step?
Doctor :   there are medicines to inhibit gastrin secretion
User :   for example... so i can take them to my family physician
Doctor :   I am sorry i cannot do that on a chat , its against my ethics to prescribe the H drugs, i am sure your doctor will know them
User :   i understand. thank you. what are the inherent problems with a nodule that large on my thyroid? should any further tests be done for it?
Doctor :   yes, as i said you to repeat the thyroid tests, if the values are abnormal then you may have to go for a thyroid scan to rule out hot nodules( cancerous )
Doctor :   Since the biopsy says its benign , i think the chances of it being hot nodule are remote
User :   Could it possibly be Graves?
Doctor :   yes, until ruled out
User :   ok thank you very much. you have given me some other ideas to take to family dr.
Doctor :   is there anything i can help you with ?
User :   not tonight. thanks
Doctor :   Thanks for consulting me, kindly provide your feedback
Doctor :   Bye take care
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