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Had quad bypass done. Getting nerve pain in shoulder, hiccups and pain under diaphragm. Worrisome

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General & Family Physician
Practicing since : 2009
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My husband had a quad bypass done three and a half years ago. He has had nerve pain in his shoulders and rib area ever since, but in the last few weeks he has had numerous cases of hiccups and stabbing pains in the upper diaphragm. He says it is difficult to get food down and feels like something is crowding it. There is a hot slight lump just below his rib in the left middle side. He is in increasingly more pain. What could it be and what should we do?
Posted Sun, 12 May 2013 in General Health
Answered by Dr. Luchuo Engelbert Bain 4 hours later
Hi and thanks for the query,

Hiccups are generally associated with an irritation of the diaphragm. It would be important to know whether he has actual difficulties in swallowing or any pain. Is there any past history of gastro-esophagal reflux disease? Is there any weight loss lately?

He shall deserve a clinical evaluation to know the actual nature of this mass. If it is fluctuant, red and painful, this could an indication of an infection or pus collection. A chest X XXXXXXX shall be of utmost importance, and abdominal ultrasound and probably an abdominal CT scan if need be. This could exclude a mass that might be irritating the diaphragm. An endoscopy might be important especially to visualize the esophagus and stomach. This could give an idea of the possible lesions impeding or implicated in causing difficulties in getting food down. Past history of smoking could be an important risk factor.

I suggest you book an appointment with the gastro-enterologist for proper evaluation and management.

Feel free asking further questions if need be. Thanks for using XXXXXXX and best regards,

Luchuo, MD.
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