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Pain above liver and below rib on empty stomach. What am I suffering from?

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
pain on empty stomach and goes away after some time with antiacids. I have been having this pain for some time now. At first it use to travel to my backbone. This is just above my liver and below in between my last rib. What I have diagnosed is that is in the end of my osaphagus.Iit started after i was doing stomach exercise for few days and one day in the moring I drank tea empty stomach and then it started. It is basically on the outside because when I sleep at night straight it does not give me nausea in the morning.  this usually happens when I have empty stomach.  At first it used to have it after every 2 hours. Now I have it at 1 pm and in the morning and usually goes away after my breakfast and when I stand straight. I have been having nexium h2 blocker for the fast 3 months and things have gone much better now but still get it on and off.  it feels like that the it inflmaes and then it gives me pain. What should I use to repair it. Then I never had to vomit or had blood in my stool.
Posted Wed, 20 Mar 2013 in Liver and Gall Bladder
Answered by Dr. Mayank Bhargava 39 minutes later
Welcome to XXXXXXX forum.

With the available described symptoms, you are most likely suffering from Gastric ulcer disease; a form of peptic ulcer disease.
Location of pain and its relief after taking meals suggests the diagnosis.
Acidic belching, abdominal discomfort, abdominal heaviness, excessive flatulence, sour fluid in throat, nausea or vomiting are collectively called as Dyspepsia and you have most if these symptoms.
Vomiting and blood in stool may or may not be present but it doesn't rule out possibility of peptic ulcer disease.

Peptic ulcer disease may be in form of chronic gastritis, fundal gastritis, nodular gastritis, follicular gastritis and gastric & duodenal ulcer, adenocarcinoma of stomach and GERD (all these disease are diagnosed by endoscopy).
Helicobacter pylori bacteria is responsible for peptic ulcer treatment and eradication is essential for complete relief.

Possibility of esophagus pathology appears to be low as it is associated with pain during swallowing. There may be possibility of esophagus ulcer or erosions due to gastric ulcer disease.

Are you a smoker?
Smoking increases acid production in stomach with increased possibility of gastric problems.

You should consult with your treating doctor/ XXXXXXX medicine specialist/ gastroenterologist and should go for thorough check up.
You should go for complete hemogram, thyroid profile and blood sugar, urea breath test for H. Pylori bacteria.
If urea breath test is found to be positive then you must have to take treatment against Helicobacter pylori bacteria.
You should also go for endoscopy for better clarification.
Hypothyroidism and diabetes may be associated with abdominal bloating and constipation and frequent feeling of dyspeptic symptoms.

Meanwhile, you should take proton pump inhibitors along with prokinetics (which increase gastrointestinal motility).

Kindly follow these dietary restrictions:
1) Avoid tomatoes, citrus fruits, onion, garlic, oily and spicy food (particularly at night times), tea and coffee.
2) Keep difference of 3 hours between meals and sleep.
3) Take soft diet along with yogurt.
4) Take frequent small amount meals.

Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava

Above answer was peer-reviewed by
Follow-up: Pain above liver and below rib on empty stomach. What am I suffering from? 1 hour later
no I dont smoke.
i forgot to tell you I got tested for h. pylori virus it came negative.
and for how long can I take the proton pump inhibitors.
any suitable prokinetics.
what is the way ti heal the ulcer.should I take antibiotics.
Answered by Dr. Mayank Bhargava 9 hours later
H. Pylori is a bacteria and not a virus.
You can take PPI for 5 years safely. Whatever side effects has been described are confined to the animal, not human beings.
Prokinetics are Itopride/ cinitapride/ Levosulpride; all of these are suitable and you can take it on written prescription.
You should go for Endoscopy and if ulcer is present then you should take treatment for ulcer.
Meanwhile you can continue proton pump inhibitors.
Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
Follow-up: Pain above liver and below rib on empty stomach. What am I suffering from? 15 days later
I got tested and they have told me the same you told me gastric ulcer. please can u advice me any meds to cure this ulcer.
Answered by Dr. Mayank Bhargava 4 hours later
Treatment of gastric ulcer contains amoxycillin 1000 mg BD, Clarithromycin 500 mg BD, proton pump inhibitors BD.
These three medicines are also available in kit form.
You should consult with your treating doctor.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
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