Hi XXXXXXX
Thanks for writing in.
It seems as if you have been suffering from Gastro esophageal reflux disease (GERD) or peptic ulcer disease for a long time.
GERD is a condition where the food from the stomach enters the food pipe to cause pain. However, before starting treatment for this, I would request you to answer the following questions so that we can exclude the remaining causes:
a.     Did you hurt your right chest recently?
b.     Does the pain increase on breathing in?
c.     Do you have fever, cough or cold?
d.     Does the pain increase on touching the chest?
e.     Do you have any other medical condition like high blood pressure or diabetes?
f.     Has any investigation been done for you?
The most logical step here would be to do an ECG here ( to rule out a heart condition). In addition, the following lifestyle modifications should help:
1.     Avoid oily, spicy, fatty food, alcohol and smoking.
2.     Take small amount of food frequently.
3.     Avoid lying down within 1.5 hours after meal.
4.     You can take a proton pump inhibitor (like omeprazole) and prokinetic (domperidone) combination. This is a prescription drug and you would need to consult your physician in person
Consult your physician, test to de done and follow his advice for further management.
Awaiting your reply
Wish you a speedy recovery.
Regards,
Dr Sourav Ganguly

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Hi,

Thanks for posting query.

Thank you very much for providing me 'to the point answer' of all my questions.

After going through your answers my initial diagnosis of Gastro esophageal reflux disease (GERD) strengthen.

But some facts to be considered:

You have mild cough that may be due to GERD itself but it can be due to aspiration pneumonitis. So do a Chest X XXXXXXX to rule out any lung involvement.

You have previous ECG and ECHO showing mild abnormality so better to do a repeat ECG. Please remember, though heart problem causes pain in the left side of chest, it can produce right sided chest pain also due to radiation. We sometimes get patients of heart problem who presented to us with right chest pain.

As mentioned previously the following advises can be helpful-

1.     Avoid oily, spicy, fatty food.
2.     Take small amount of food frequently.
3.     Avoid lying down within 1.5 hours after meal.
4.     Can take a proton pump inhibitor (like- omeprazole, pantoprazole, rabeprazole etc)) and prokinetic (like-domperidone, cisapride etc)) combination for at least 6 weeks. I hope you are getting these drugs nowadays but please consult your doctor for dose and duration.

First consult your physician, test to be done by his advice and depends on the reports. If no cardiologic and lung cause found, then please consult a Gastroenterologist for proper management of GERD.

Hope I have answered your query. If you have any further questions I will be happy to help. If you do not have any clarifications, you can close the discussion and rate the answer and write a review for me.

Wish you a speedy recovery.

Regards,
Dr Sourav Ganguly

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Hi,

Thanks for writing back.

I think your physician by normal means that though there is mild abnormality in ECG & ECHO, it is not severe enough to cause chest pain which is a sign of angina.

Now that the cardiac problem is ruled out, please do a chest X XXXXXXX to rule out any lung involvement. If no lung cause is found, then please consult a Gastroenterologist for proper management of GERD.

Hope I have answered your query. If you have any further questions I will be happy to help. If you do not have any clarifications, you please close the discussion and rate the answer and write a review for me.

Wish you a speedy recovery.

Regards,
Dr Sourav Ganguly

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