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Dr. Andrew Rynne

Family Physician

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Suggest treatment for sharp pain at the centre of the chest just below the diaphragm along with abdominal bloating and diarrhea

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 2850 Questions

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Posted on Wed, 29 Aug 2018 in General Health
Question: I have a sharp pain just at the centre of the chest just below the diaphragm. I had fresh garlic for dinner. It is particularly painful when laying down and I have been suffering recently of bealching stomach and dhiareea
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Answered by Dr. Bonnie Berger-Durnbaugh 56 minutes later
Brief Answer:
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Detailed Answer:
Hi,

Duspatalin is an antispasmodic so it may help large intestinal cramping but may not help what sounds like GERD (gastroesophageal reflux). The garlic may have caused some irritation that is causing reflux. The location of the pain you described is likely the lower esophageal sphincter which helps keep food and acid from coming back up.

You can try a Bismuth Subsalicylate (in the US it's sold as Pepto Bismol). This can help settle the entire digestive tract and also counter any possible gut infection that may be causing diarrhea.

If the main problem is the substernal/mid-epigastric pain, I recommend an H2 blocker such as Zantac (ranitidine) for a few days until it resolves. Ranitidine decreases acid production by 70% so the tissues can heal. An alternative to ranitidine/Zantac is Pepcid (famotidine) or Axid (nizatidine). But I would avoid proton pump inhibitors (Prilosec, Omeprazole, Nexium) because they can have more side effects.

In addition, avoid lying flat (you can raise the head of the bed with blocks under the posts), no food for 2-3 hours before lying down, and avoid alcohol, caffeine, soda, acidic foods and drinks (citrus and tomato) and spicy or greasy food. This will also allow it to heal.

Thanks
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 21 minutes later
Thank you Dr Berger. It’s actually getting more painful and I had to vomit twice (not productive). It’s the middle of the night where I live (I am an expatriate in Ethiopia) and I was wondering if there is anything to reduce the pain which is fairly sharp. I have iboprufen, buscopan, tramadol (but I never used it before)

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Answered by Dr. Bonnie Berger-Durnbaugh 14 minutes later
Brief Answer:
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Detailed Answer:
Hi,
Definitely do NOT take Ibuprofen now, not until this has healed up, as that can cause further irritation and even bleeding of the stomach lining.

The Buscopan (hyoscine) can help if it is spasmodic - but it is unlikely to help the pain at the base of the sternum.

Tramadol is a strong pain medication but it can cause nausea, which I don't think you want to increase at this time.

Is there an A & E you can go to?

Take care
Regards
Dr. Bonnie Berger-Durnbaugh
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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