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What Causes Upper Abdominal Pain Along With Heart Burn And Acid Reflux?

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Posted on Tue, 27 Dec 2016
Question: I have been having the following symptoms;
-upper abdominal pain
-upper back pain
-passing gas (sometimes)
-heart burn, acid reflux

Based on my doctor's suggestion, I have been on omaprexole and pantoprexole for around a month in order to reduce acid reflux. I believe my symptoms are due to h pylori infection and/or gastric ulcer. As I took pantroprezole, doctors suggested that I can not do urea breadth test. I am worried about the risks involved with upper endoscopial biopsy, can u please suggest me any mon-invasive methods to test for h pylori and gastric ulcer?
doctor
Answered by Dr. Tayyab Malik (1 hour later)
Brief Answer:
urea breath test(UBT) is the most recommended test to detect H.pylori

Detailed Answer:
hi.
thanks for posting query @HCM.

urea breath test(UBT) is the most recommended test to detect H.pylori. however, if a patient has been taking PPI ( like omeprazole or any other) , the patient is advised to wait 4 weeks after withholding the PPI medication.
after 4 weeks, the UBT maybe done.

secondly, endoscopy is the investigation of choice for diagnosing gastric ulcer. its not necessary that ulcer is the cause of present symptoms.
secondly, IF ulcer is found in any patient, its NOT always necessary to biopsy it.

hope to answer your concern.
further questions are welcomed

regards
dr Tayyab Malik






Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Tayyab Malik (9 hours later)
Hello doctor,

Thanks a lot for your reply. I am not sure if I can stop taking the ppi medications for 4 weeks before taking the Urea Breath Test as it may increase the acid secretion and hence the abdominal pain. Will I be able to take the UBT by switching from pantoprazole which is a ppi to a H2blocker like rantidine? Is that even a recommended approach?
If ulcer is not a cause then what do you think could be the reason for the upper abdominal pain?
What do you think would be the next right step to relieve me from the symptoms?

I hope to hear back from you soon.

Thank you!

doctor
Answered by Dr. Tayyab Malik (2 hours later)
Brief Answer:
Continue PPI for another 4 weeks and follow-up

Detailed Answer:
hi.
thanks for getting back to me.

H.pylori / gastric ulcer may cause abdominal pain.
gastritis , GERD may also cause upper abdominal pain.

as you have been taking PPI since one month, so you may take it for another
"4 weeks" and then follow up with your treating physician. If your symptoms have subsided , you may have the urea breath test - 4 weeks after you stopped the medication.

Endoscopy/ biopsy maybe an indication if your symptoms do NOT subside or increase in severity after taking the PPI for atleast "8 weeks".

further advise:
- decrease salt intake
- eat small meal at regular interval
- include plain yogurt in your meals
- whilst taking PPI, AVOID chocolates, coffee, and beverages ( soft drinks/alcohol)
- avoid eating anything 2 to 3 hours before going to bed

hope to answer your concern.
further questions are welcomed

regards
dr Tayyab Malik


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Tayyab Malik (3 hours later)
Thanks doctor. Should I take only 20 mg of pantoprezole or shall I increase the dosage to 40 mg as I am having increased acid reflux during night. Also, I am having increased upper back pain. Is my upper back pain also due to acid reflux?
doctor
Answered by Dr. Tayyab Malik (1 hour later)
Brief Answer:
Pantoprazole twice daily

Detailed Answer:
hi.

yes, you may take 20mg before breakfast n 20mg before dinner.
it would make 40mg per day.


upper back pain is usually muscular in origin.
usually , its NOT related to increased acid reflux.
you may do stretching exercise (back) and/or take OTC pain killer.....

hope to answer your concerns.
wish you good n sound health.

regards
dr Tayyab Malik
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
Answered by
Dr.
Dr. Tayyab Malik

Gastroenterologist

Practicing since :2009

Answered : 819 Questions

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What Causes Upper Abdominal Pain Along With Heart Burn And Acid Reflux?

Brief Answer: urea breath test(UBT) is the most recommended test to detect H.pylori Detailed Answer: hi. thanks for posting query @HCM. urea breath test(UBT) is the most recommended test to detect H.pylori. however, if a patient has been taking PPI ( like omeprazole or any other) , the patient is advised to wait 4 weeks after withholding the PPI medication. after 4 weeks, the UBT maybe done. secondly, endoscopy is the investigation of choice for diagnosing gastric ulcer. its not necessary that ulcer is the cause of present symptoms. secondly, IF ulcer is found in any patient, its NOT always necessary to biopsy it. hope to answer your concern. further questions are welcomed regards dr Tayyab Malik