Brief Answer: Take GERD Meds& Do Workup for gallbladder/Pancreas Detailed Answer: Dear XXXX! Welcome to Healthcare Magic :) let me summarise everything after reading your query. Your digestive discomfort increased in intensity and nature and now you think you are having something more than GERD. Following are the steps you should take to properly manage and treat your disease. STEP 1: Treat your GERD treatment Properly GERD is a disease which is progressive in nature and always surprise patients with new symptoms if not treated properly. your all symptoms can be explained with a complicated and untreated GERD. so before going for any invasive procedures and tests you should treat it properly. The two important steps to treat GERD are => Lifestyle Modification: 1) Losing weight (if overweight) 2) Avoiding alcohol, chocolate, citrus juice, and tomato-based products 3) Avoiding peppermint, coffee, and possibly the onion family as well. 4) Avoiding large meals 5) Waiting 3 hours after a meal before lying down 6) Elevating the head of the bed 8 inches => Medications There are many over the counter medications available which you can take to relieve these symptoms 1) Antacids (by the name Gaviscon, Digex) 2) Omeprazole and Essomperazole 40 mg (By the Name ESSO) apply both above steps and 95% patient promptly respond. just medications are not enough. STEP 2: Need Workup If Still Problem does not Resolve Your female gender and almost 50 year age along with you shoulder pain and back pain points towards Cholecystitis (Gall bladder problem) and Pancreatitis (Pancreas problem) . Because -> Pain of Gall bladder refer to shoulder. -> Pain of pancreas refer to back For gall bladder: Visit a Ultrasound Specialist to get you an Abdominal Ultrasound to look for any disease inside your gall bladder. For pancreas: Check following blood tests 1) Serum Amylase 2) Serum Lipase If these two levels are raise then the culprit is Pancreas. SUMMARY: Take GERD Medication if you have already stopped or you are non-compliant. Also visit a ultrasound specialist to check your gall bladder for stones/infection. and do blood panel for pancreas check up. Do let me know if you have any further question. Ill be very happy to respond.

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Brief Answer: Yes There is possibilty of other disease Detailed Answer: Dear XXXX! Thanks for writing back to me. and These reports are very helpful to diagnose your disease. 1. Given the above, does anything stand out that would indicate a diagnosis other than GERD? Well one good thing which is XXXXXXX is pancreatitis and your normal amylase level ruled it out :) Pancreatitis need emergency management and as your blood work ruled it out so now there is no hurry. None of the above test exclude the possibility of advance GERD and Cholecystitis (gall bladder). So give one or two days to antacid to work and see does your symptoms resolve or not. Because Cholecystitis does not need prompt management. so before going to any invasive procedure for your gall bladder we should rule out GERD progression. 2. Is the back and shoulder pain, in your experience, ever a symptom of GERD? I have had check pain before with the GERD, but this is new. I find it alarming and uncomfortable. I have seen many patients with upper back pain but never seen lower back pain with GERD. but back pain can be additional symptoms of your female hormonal level change which pretty much take place at your age. But im not prescribing you any pain medication for that because pain medication increases stomach problem. so give antacid a little time. The only big concern to me is your shoulder pain which is specific for cholesytitis. that is why I told you to visit ultra-sonologist and take Ultrasound of gall bladder. Ultrasound is the first best test for Gall bladder problem followed by CT Scan. So in summary take Gerd medications which will solve most of your problems and visit ultrasound specialist/gastroenterologist for exclusion of gallbladder problem. and as pancreatitis is ruled out you can get appointment any later time. If you have further query please feel free to ask

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