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Suffering from epigastric pain between rib cage and naval. LFT , RTF, ultrasound, stool test normal. Taking Levoflox

Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
I am 38 year old suffering from epigastric pain for last 5 days between ribcage end and naval in upper abdomen. This is accompanied by huge gas formation. I had gas problem earlier also but this time the pain was acute the area has become tender. So I went to a doctor who suggested Blood test - routine, LFT , RTF and ultrasound and stool. All the reports came normal. He suggested that i have swelling in intenstine and so he suggested the following medicines.

1. Levoflox - 1 tablet daily
2. Sampoz (ezomoporazale) 1 table befor meal
3. Duton +

But after 5 days , the problem remains, the pain has subsided but the tenderness is still there in the upper abdomen area. Kindly suggest what is the problem . What could be the reason and why it is not healing even after 5 days of medication ??

Posted Fri, 5 Apr 2013 in Abdominal Pain
Answered by Dr. Mayank Bhargava 29 minutes later
Welcome to XXXXXXX forum.

Let me know the associated symptoms along with mentioned.
Do you have yellow discoloration of eyes and urine/ fatigue/ weakness/ acidic belching/ nausea or vomiting/ watery diarrhea/ constipation/ frequent urge to use washroom?
What is the type of abdominal pain? Whether spasmodic or pricking type.
Do you have any urinary symptoms?
Does this pain has any aggravating or relieving factor?

With the available described symptoms, there appears to be possibility of Acute pancreatitis/ gastroenteritis and peptic ulcer disease.
Presence of pain along with location suggests the diagnosis.
I have seen your all blood reports and ultrasound imaging studies of abdomen but it is within normal limits.

Presence of watery diarrhea generally suggests gastroenteritis but at times watery diarrhea is absent and patient has only spasmodic sweet pain at recurrent interval and it also indicates gastroenteritis.

You should consult with XXXXXXX medicine specialist/ general surgeon and should go for through check up.
You should go for serum amylase and lipase, endoscopy and CT/ MRI scan of abdomen for better clarification.

Treatment depends on exact diagnosis.
Meanwhile, you should take complete antibiotic course, antispasmodics and tramadol for relief of your symptoms.
You should also continue your other medications as advised by your treating doctor.
You should also avoid tomatoes, citrus fruits, and oily spicy foods.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
Follow-up: Suffering from epigastric pain between rib cage and naval. LFT , RTF, ultrasound, stool test normal. Taking Levoflox 49 minutes later
dear dr XXXXXXX

thank you for your reply. I dont have any kind of yellow discoloration of eye or urine . I also dont have any burning sensation in chest as such, nor nausea or vomiting.

But Yes i do have feeling of constipation and this feeling is from few months , when I feel that my bowels are getting relieved at 1 go. generally I used to release bowels atleast twice a day. It sometimes had loose bowel with lot of gas release.

What i feel now is kind of swelling / bloating / hardness in stomach and when press on upper abdomen area creates pain. Its a kind of gentle pain / uneasiness in stomach all the time with feeling of gas. Its kind of sweet pain all the time and tenderness in stomach.

Kindly suggest what kind of disease is this gastrointeris or peptic ulcer ?
What will the doctor find out after CT scan or endoscopy?
Wil the test confirm that I indeed have this uclers?
If the ulcers are indeed there .. then what is the medicine. How will it get healed ??
Most important is please explain the long term implication of my health ?
Can it be permanently cured ? How many days it will take to heal ?
What should be my diet this time till I heal ?

Sorry for so many questions ? I am having lot of anxiety as my work is getting suffer.

Answered by Dr. Mayank Bhargava 12 minutes later
Gastroenteritis is an infectious disease caused by bacteria or virus.
Peptic ulcer disease could be due to Helicobacter pylori bacteria, bile reflux induced. decreased gastrointestinal motility.
Endoscopy is suggested for diagnosis of peptic ulcer disease while CT scan to confirm pancreatitis (Pancreas is not very well visible by ultrasound imaging).

Endoscopy is done by endoscope on which a high power camera is present. This is just visualization of stomach and small intestine by use of camera and ulcers are diagnosed by endoscopy now a days.

Ulcers are due to H. Pylori bacteria and complete eradication is required for treatment.

Long term implications in case of gastroenteritis is less as it is caused by infectious agent and gastroenteritis is completely treatable disease with complete antibiotic therapy.
Long term implications with ulcer is also less and untreated ulcers may at times lead to cancer formation in ulcers.

You should avoid tomatoes, citrus fruits, and oily spicy foods.

Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
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