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What Causes Sensation Of Pressure Under The Sternum?

Posted on Tue, 22 Apr 2014

Question: Hi Doc' I am 64 yrs old, not overweight and am quiet fit and healthy. But in the last 2 months have increasingly become aware of a sensation of pressure under my Sternum, there is no pain. It seems to be more prevalent after breakfast and throughout the day as wind (from both ends) becomes more frequent. On passing wind (or Bowel movement) it seems to lessen for a short time. When I get up in the morning it does not seem to be there. I would be grateful for a bit of guidance. Many thanks. XXXXXXX

Answered by Dr. Ashish Verma (30 minutes later)

Brief Answer: it can be a hiatus hernia or gerd or gastritis Detailed Answer: Hi XXXXXXX Thanks for writing to HCM. That pressure sensation after food which relieves on burping or bowel movements are very much suggestive of either a hiatus hernia or gastro esophageal reflux disease (GERD). But as you are not having any pain abdomen or heart burn so chances of gerd are relatively less. With advancing age the body's musculature gets weekend including the diaphragm, so a part of stomach may herniate into the thoracic cavity causing the above symptoms. Another possiblity is of simple gastric distension due to gastritis. What i would suggest that you take a ppi (antacid) like omeprazole or pantaprazole for 2-3 days and see if your symptoms improve or not. (But for the prescription you need to see a local doctor.) If they subside, then its gastritis and you need to continue them. If they don't then you need to undergo an upper gi endoscopy to rule out hiatus hernia. Hope i have been helpful. Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ashish Verma (1 hour later)

Hi Dr XXXXXXX Thanks for the swift reply. I forgot to mention that occasionally during the night I get woken up by a burning sensation in the throat which I believe is caused by an acid reflux due to a fatty or spicy meal and only happens when I'm lying on my side. As soon as I sit upright or lie on my back the symptom subsides and does not re-occur. I usually have a quick drink of water as that seems to help also. I will take your above advice in due course. Again, Thank you. XXXXXXX

Answered by Dr. Ashish Verma (44 minutes later)

Brief Answer: its GERD then Detailed Answer: Hi XXXXXXX If reflux is there then its gerd, but still it may be associated with a hiatus hernia. Now along will a ppi you also need to take a prokinetic drug like levosulpride (again for the prescription you need to see your local doctor) to hasten gastric emptying and prevent reflux. This reflux is due to lax lower esophageal sphincter. This leads to reflux of gastric acid into esophagus and throat. Along with the medicines, you also need to follow a few dietary modifications like avoid tea, coffee, soda drinks, spicy food - as these increase gastric acid production. Also avoid eating heavy meals and fatty meals - these make the sphincter more incompetent. And dont lie down for an hour or so after a meal. Reduce the quantity per meal, but you can increase the meal frequency. You can eat every 4th hourly. Regards Dr. Ashish Verma

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj