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Suggest Treatment For Severe Chest Pain

Posted on Tue, 3 Jan 2017

Question: I have had chest pain for over a period of three weeks now, and it moves to the abdominal very sharp.my doctors have done some tests like the CT for the chest, abdominal US SCAN, d-dimmer, crp, RFT, LFT , and found nothing apart from a small echogenic mass in the liver measuring 16mm in the widest diameter.
No flow is seen to the mass , urinary bladder is ok, spleen appears normal in size, the gall bladder and biliary tree appear normal. Both kidneys appear normal but the pain has not gone as am pain killers and muscle relaxers. What can I do?

Answered by Dr. Hari Charan Perigela (4 hours later)

Brief Answer:
You should get an Upper GI endoscopy.

Detailed Answer:
Hi
As per your description, the pain could be due to Acid peptic disease.
You should get an Upper GI endoscopy. It will give a clue regarding Ulcer in the stomach Duodenum/Esophageal reflux/ hiatus hernia .
Please consult a Gastroenterologist and get an Upper GI endoscopy.
Till investigations,I prescribe Rabeprazole 20mg twice daily ,Tablet Dicyclomine and Syrup containing Sucralfate along with Oxetacaine 10ml thrice daily to my patients with similar complaints.
It's better to stop pain killers till investigations.
Hope I answered your query.If you have any questions, I will clarify further.
Wish you good health.
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Hari Charan Perigela (14 hours later)

For how long is this medicine taken?And in Uganda we can only find Antepsin,Trigan-D and Rabeprazole sodium tablets.
Can these work as the ones you wrote. And my doctors says that your suggestion may be right.

Answered by Dr. Hari Charan Perigela (23 minutes later)

Brief Answer:
You can take Rabeprazole.

Detailed Answer:
Hi
You can take Rabeprazole 20mg tablet twice daily before food.
You should take this till symptoms subside.
There is no time limit.
Please avoid spicy foods,carbonated drinks.
Wish you speedy recovery.
Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Hari Charan Perigela (3 hours later)

If at all I can find all the medicine you sent in the first answer, do I use it all at one go.

Answered by Dr. Hari Charan Perigela (50 minutes later)

Brief Answer:
You can use them.

Detailed Answer:
Hi
You can use all the medicine at a time that I wrote in the first reply.
Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Hari Charan Perigela (2 days later)

Hi doctor,
Thanks my chestpain is improving on the treatment of Rabeprazole for three days now on that drug but the heartburn is still bad.
Here our medicial industry is not that good as for the Upper GI Endoscopy , I booked for Friday next week as not many hospitals do it.
Can I do an MRI and any thing for the heartburn .
Thanks.

Answered by Dr. Hari Charan Perigela (13 minutes later)

Brief Answer:
MRI cannot diagnose acid peptic disease.

Detailed Answer:
Hi
I am sorry to say that MRI cannot diagnose acid peptic disease.
Endoscopy visualises Esophagus, Stomach and Upper Duodenum.It will also diagnose Hiatus hernia and Gastroesophageal reflux.
Till then , continue Rabeprazole tablet 20mg twice daily and Syrup Sucralfate 10ml thrice daily.
Wish you speedy recovery.
Regards

Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Remy Koshy