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What Causes Pain Under The Left Shoulder Blade While Having Acid Reflux Disease?
Question: Hello........I have been on meds off and on for 5 years for cid reflux but over the past 10 days when I burp I am experiencing pan on left side under shoulder blade ? I now panicking and convinced its cancer
Brief Answer:
Information
Detailed Answer:
Hello XXXXXXX
If the pain occurs only when you burp, then it is pain referred because of gas.
If the pain is continuing and is more of a pressure type pain, then it can be related to your heart, for which you would need to go in to be seen now. But given your history of acid reflux, and that it seems to only happen from burping, this is attributable to referred pain from gas.
If the omeprazole doesn't work well enough for you at 40 mg, you may need a different proton pump inhibitor or H2 blocker.
Also, have you been tested for H.pylori which is a bacteria which can cause stomach ulcers and reflux?
Information
Detailed Answer:
Hello XXXXXXX
If the pain occurs only when you burp, then it is pain referred because of gas.
If the pain is continuing and is more of a pressure type pain, then it can be related to your heart, for which you would need to go in to be seen now. But given your history of acid reflux, and that it seems to only happen from burping, this is attributable to referred pain from gas.
If the omeprazole doesn't work well enough for you at 40 mg, you may need a different proton pump inhibitor or H2 blocker.
Also, have you been tested for H.pylori which is a bacteria which can cause stomach ulcers and reflux?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
ok I understand ........so do I need to ask GP to change meds ? also I have changed my lifestyle re no eating fatty foods late at night thengoing to bed straight away and no alcohol basically Ive have stopped gauging and as a result have weight lose ..........or is this weight lose due to cancer ? you see how my mind is working overtime
Brief Answer:
Information
Detailed Answer:
Hi XXXXXXX
If you are eating less overall and especially if you are eating less "junk" food and refined carbohydrates, that would definitely explain your weight loss. And weight loss can often help with reflux.
Weight loss due to cancer usually occurs near the end of the disease, and often by then there are other more specific symptoms that make the diagnosis more apparent. So it does not sound like what you are dealing with.
I don't know how long it's been that you have been on the increased dose of omeprazole (40 mg) but if it's been more than 6 weeks, and you are not noticing improvement, then it is time to consider making a modification.
The thing about PPIs like omeprazole, is that while they markedly decrease acid production, they also increase the stomach hormone gastrin (which can cause more acid production). So in some people, going off of them causes "rebound" hyperacidity until things even out again. Also, in some people, PPIs can increase reflux. Increasing reflux isn't that common a side effect of PPIs, and I don't know what the mechanism is for that to happen. But it is something to consider may be going on if the 40 mg of omeprazole does not help more than the 20 mg.
H2 blockers such as ranitdine (in the US sold as brand name Zantac) do not have that rebound effect or increase of the hormone gastrin that PPIs do. H2 blockers decrease acid production and are safe medications but they are not generally quite as powerful as the PPIs (proton pump inhibitors).
So what to do - here are some ideas to consider when talking with your doctor (if the 40 mg isn't helping and you've given it a trial such as a month):
1. Change from omeprazole to another PPI such as pantoprozole.
or
2. Add an H2 blocker such as ranitidine 150 mg twice a day (or 300 mg at bedtime) while gradually decreasing the omeprazole.
You probably already know what foods set you off and make the GERD worse. Some find tomatoes, certain spices, acidic foods such as citrus, caffeine, and chocolate to be problems. Avoid aspirin and NSAIDs such a ibuprofen too.
Mint (peppermint) can be a problem because it relaxes the lower esophagus which allows for more reflux!
And do you know the idea of raising the head of your bed with blocks under the posts so that gravity decreases the risk of acid coming up at night in bed?
I hope this helps. It sounds like you have been making very good lifestyle changes.
Information
Detailed Answer:
Hi XXXXXXX
If you are eating less overall and especially if you are eating less "junk" food and refined carbohydrates, that would definitely explain your weight loss. And weight loss can often help with reflux.
Weight loss due to cancer usually occurs near the end of the disease, and often by then there are other more specific symptoms that make the diagnosis more apparent. So it does not sound like what you are dealing with.
I don't know how long it's been that you have been on the increased dose of omeprazole (40 mg) but if it's been more than 6 weeks, and you are not noticing improvement, then it is time to consider making a modification.
The thing about PPIs like omeprazole, is that while they markedly decrease acid production, they also increase the stomach hormone gastrin (which can cause more acid production). So in some people, going off of them causes "rebound" hyperacidity until things even out again. Also, in some people, PPIs can increase reflux. Increasing reflux isn't that common a side effect of PPIs, and I don't know what the mechanism is for that to happen. But it is something to consider may be going on if the 40 mg of omeprazole does not help more than the 20 mg.
H2 blockers such as ranitdine (in the US sold as brand name Zantac) do not have that rebound effect or increase of the hormone gastrin that PPIs do. H2 blockers decrease acid production and are safe medications but they are not generally quite as powerful as the PPIs (proton pump inhibitors).
So what to do - here are some ideas to consider when talking with your doctor (if the 40 mg isn't helping and you've given it a trial such as a month):
1. Change from omeprazole to another PPI such as pantoprozole.
or
2. Add an H2 blocker such as ranitidine 150 mg twice a day (or 300 mg at bedtime) while gradually decreasing the omeprazole.
You probably already know what foods set you off and make the GERD worse. Some find tomatoes, certain spices, acidic foods such as citrus, caffeine, and chocolate to be problems. Avoid aspirin and NSAIDs such a ibuprofen too.
Mint (peppermint) can be a problem because it relaxes the lower esophagus which allows for more reflux!
And do you know the idea of raising the head of your bed with blocks under the posts so that gravity decreases the risk of acid coming up at night in bed?
I hope this helps. It sounds like you have been making very good lifestyle changes.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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