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What Causes Burning Sensation Under The Ribs When Suffering From Acid Reflux?

Posted on Mon, 23 Jun 2014

Question: I have a question, I have been dealing with acid reflux from a ulcer or something? not sure, I am on prevacid twice a day 15 mg. I feel better from the acid but I have this burning sore under my right rib at times and
I went to hospital yesterday they checked my heart and said it was fine, but I am having like fast beat if I over exert or just walk a ways its like a panic attack but I am not sure that is what I am having I did really good all day today until I had to go out back and pick up a package then it came on me - is it the meds doing that - I see on blood work I am low in potassium just a little bit and I have neutrophils just a little bit in range they are like one point off oflab from being bad which could mean bacterial infection ????

Answered by Dr. Chobufo Ditah (2 hours later)

Brief Answer:
Not caused by Prevacid

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about this pain and the rapid heartbeats that you have reported during exercise and all the inconveniences this has caused you.

Increased heartbeat during a physical exercise is totally normal and it is an adaptation of the body to be able to meet up with extra energy demands. To know whether it is a panic attack or a normal body adaptation, we need to look further into the symptoms. Panic attacks often result suddenly, last about 10mins and leave you with the feeling that you could die immediately, sweating and breathing rapidly. If these symptoms are present, then it may be more of a panic attack. If not, probably a normal reaction to exercise.

From the description of your neutrophils and potassium levels, there is nothing to be concerned about. I will like you to give me the absolute numbers so that I can independently comment on these. Infections and electrolytes abnormality cause XXXXXXX changes and not borderline suspicions.

I am a little concerned about the pain under the right ribcage. Was your liver and gall bladder checked as this could be possible causes of this pain?

I hope this helps. I wish you well. Thank you so much for using our services and do feel free to ask for more information and clarifications if need be.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chobufo Ditah (3 hours later)

Here is blood work… and just wondering about burining under right
rib cage when this first happened I had all symptoms of gallbladder
attack and my doctor called me in prevacid it did kill the pain …
but it is still inflamed there like something is mad and I feel hot
liquid at times .. I can eat again and prevacid helped that, just
wonderingwha t it is. thanks for any info

Laboratory and Radiology this Visit (tast charted value for your
05l20/2014 visit)

Hematology

Eos Auto: 0.2 % Normal range between ( 0.0 and 5.0)

Hgb: 14.4 gm/dL Normal range between ( 11.0 and 14.5 )

Lymph_ Auto: 21.1 % — Normal range between ( 15.0 and 45.0 )

MCH: 31.2 pg Normal range between ( 27.0 and 32.0 )

35.0 gm/dL Normal range between ( 32.0 and 36.0 )

MCV: 89.2 fL Normal range between ( 84.0 and 103.0 )

Mono Auto: 5.1 % Normal range between ( 3.0 and 10.0 )

MPV: 10.9 fL — Normal range between( 7.5 and 12.0 )

Neutro Auto: 73.4 % Normal range between ( 45.0 and 75.0 )

Hct: 41.2 % Normal range between ( 34.5 and 44.0 )

Platelet Count: 227 x10(3)/mcL Normal range between ( 150 and 450 )
RBS: 4.62-x10(6)fmcL — Normal range between ( 3.60 and 5.00 )

RDW: 13.2 % — Normal range between( 11.5 and 16.0 )

5.1 x10(3)lmcL Normal range between (4.0 and 11.0 )

Basophil Auto: 0.2 % Normal range between ( 0.0 and 2.0)

Mono Absolute: 0.3 x10(3)/mcL Normal range between ( 0.1 and 1.3 )
Eos Absolute: 0.0 x10(3)/mcL — Normal range between ( 0.0 and 0.7 )
Baso Absolute: 0.0 x10(3)/mcL Normal range between ( 0.0 and 0.7 )
Neutro Absolute: 3.8 x10(3)lmcL — Normal range between ( 1.7 and 8.1 )
Lymph Absolute: 1.1 x10(3)lmcL — Normal range between ( 0.6 and 4.9 )
IG Absolute: 0.0 x10(3)/mcL — Normal range between ( 0.0 and 0.1 )

IG Auto: 0.2 % Normal range between ( 0.1 and 0.3 )

NRBC Absolute: 0.0 x10(3)/mcL Normal range between ( 0.0 and 0.1 )
NRBC Auto: 0.0 % Normal range between (0.0 and 2.0 )

Coagulation

D-Dimer: 0.19 mg/L FEU — Normal range between ( 0.19 and 0.66 )

Urinalysis

UA Character: Clear

UA Bacteria: None /HPF

UA Bili: Negative

UA Blood: Small

UA Color: Straw

UA Glucose: Negative

UA Protein: Negative

UA RBC: Rare /HPF

UA Spec Grav: <1.005 _
UA Squam Epithelial: Rare /HPF
UA Urobilinogen: <2.0 mg/dL
UA WBC: None /HPF

UA Ketones: 5 mg/dL

UA Leuk Est: Negative

Name XXXX XXXXXXX XXXXXXX MRN 0000
DOB 09122;‘1962 4 of 12 Mayl20l2014 13:14:20

UA Nitrite: Negative
UA pH: 6.0
UA Ascorbic Acid: Negative mgldL

Chemistgl

Creatinine: 0.8 mg/dL — Normal range between (0.6 and 1.3 )

Osmolality calc: 278 mOsm/kg — Normal range between ( 275 and 295 )
CKMBICK Index: <0.8 % — Normal range between ( 0.0 and 2.5 )
AIG Ratio: 1.3 Normal range between (0.6 and 1.4)

Glucose Lvl: 103 mg/dL - Normal range between ( 74 and 106 )
Lipase Lvl: 117 - Normal range between ( 73 and 393 )
Magnesium Lvl: 1.9 mg/dL — Normal range between( 1.8 and 2.4 )
Sodium Lvl: 140 mmol/L Normal range between ( 136 and 145 )
BUN: 9 mgldL — Normal range between ( 7 and 18 )

Chloride: 104 mmol/L Normal range between ( 98 and ‘|07 )
Total Protein: 7.9 gm/dL — Normal range between (6.4 and 8.2 )
Potassium Lvl: 3.4 mmol/L — Normal range between ( 3.5 and 5.1 )
Troponin-l: <0015 ng/mL Normal range between ( 0.000 and 0.100 )
Albumin Lvl: 4.5 gm/dL Normal range between( 3.4 and 5.0 )
Alk Phos: 84 Normal range between ( 50 and 136 )

ALT: 24 UIL - Normal range between ( 12 and 78 )

AST: 16 - Normal range between ( 3 and 34)

Bili Total: 0.5 mg/dL Normal-range between ( 0.2 and 1.0 )

Total CK: 60 UIL Normal range between ( 26 and 192 )

(202: 26.0 mmol/L Normal range between ( 21.0 and 32.0 )
Globulin Lvl: 3.4 gm/dL — Normal range between ( 2.7 and 4.8 )
Calcium Inst: 9.2 mg/dL Normal range between ( 8.5 and 10.1 )
CKMB: <0.5 ng/mL — Normal range between ( 0.5 and 3.6 )
eGFR-AfrAm: >60.0 mL/min/1.73 m2

eGFR-NonAfrAm: >60.0 mL/minl1.73 m2

Point of Care Testing

Nitrite Urine Dipstick: Negative

Urobilinogen Urine Dipstick: 0.2 mg/dl
pH Urine Dipstick: 7

Blood Urine Dipstick: Trace

Specific Gravity Urine Dipstick: Less than 1.005
Ketones Urine Dipstick: 15 mg/dl
Glucose Urine Dipstick: Negative

Urine Appearance Urine Dipstick: Clear
Urine Color Urine Dipstick POC: Yellow
Bilirubin Urine Dipstick POC: Negative
Protein Urine Dipstick POC: Negative
Leukocytes Urine Dipstick POC: Trace
Quality Check Urine: Positive

Urine Pregnancy: Negative

Diagnostic Radiology

XR Chest 1 View Frontal: XR Chest ‘l View Frontal

Answered by Dr. Chobufo Ditah (7 hours later)

Brief Answer:
Thanks for this follow up!

Detailed Answer:
Hi and thank you so much for this follow up information.

I have taken a look at these results. They are normal and nothing suggests an ongoing abnormality right now. Please, do not freak out about these findings. Special attention to the neutrophil counts and potassium levels don't seem concerning to me. Do you take any medications beside prevacid? Please, let me know.

I understand prevacid helped with this pain. It is not uncommon for two pathologies with similar clinical presentation to be present at the same time. Seen the fact that this pain was not completely eradicated by prevacid, I will suggest that you get an ultrasound just to make sure the gall bladder is fine and we are not missing out on something here.

I hope this helps. I wish you well. Thank you so much for trusting us with your health query. Feel free to keep the discussion going.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chobufo Ditah (4 hours later)

I have thought all along gallbladder but no one seems to think so, 8 yrs ago, I had an attack and it was similar things.. and now 3 yrs later its back... its been all the symptoms of gallbladder issues to me... I am tired of suffering feel like I am dying at times because its like they are masking the issue...
I could send over the report of this passed sono and it only says distended gallbladder it makes no sense to me... I am so tired of wondering and hoping its not poisoning me. It feels like hot liquid at times moving.. I can say the prevacid has helped I wil lgive it some credit. Just only eat certain foods and hate being thin thin... I so appreciate your help - I will send over report in new email. I can't get it to go from here

Answered by Dr. Chobufo Ditah (5 hours later)

Brief Answer:
Am so sorry to hear about this persistent pain

Detailed Answer:
Hi and thank you so much for this follow up precision.

I understand how terrible it is to continue in severe pains. I wish we could identify the exact cause of this and manage it appropriately. What is the intensity of your pain on a scale of 0-10? And how often are you in pains?

It is great that the intensity of the pins have been reduced but would be better if you can go without. I understand prevacid has done a great job already but what keeps me more concerned is this residual pain. Have you ever had an endoscopic exam to look at the stomach? If not, I will like that you do it and have more evidence to think this pain is entirely from the stomach and not related to any other organ.

With a distended bladder, the doctors should look for the possible reasons of this. Gall bladder disease pain would be most intense about 2hours after meals and more severe with lipid/fatty foods. You may also have some diarrhea/poor digestion. I do not know if you have these symptoms.

Have you been evaluated by a Gastroenterologist? It may be about time to do something in this regard. Also, I will like to see the complete report to understand what the thinking and conclusions were concerning this enlarged gall bladder.

Once more, am so sorry for this pain and hope together we may be able to help relief you of it.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chobufo Ditah (8 days later)

I need little more help not sure of my next step I need up with reaction to prevacid now weeping off that I am doing bio hpf and gastrazyme one 15 previcd in am and pepsid ac before bed ...i am going to try to get off prevacid all together it's not good for me ..allot of ppi.s make me sic.k but what gets me is I have back pain terribly and chills in morning tired headache over eye sometimes bad breath and at times heartburn down low after eating also had a cramp in leg this morning what is going on with me still what test should I do anxirty wise I am better stomach area has healed more still a little left to heal scared to not do prevacid in morning cause I want my stomac to heal completely should I try aloe juice? Thanks for help

Answered by Dr. Chobufo Ditah (20 hours later)

Brief Answer:
Please, what stomach is healing?

Detailed Answer:
Hi and thanks for this follow up question.

I am so sorry to hear that you still go n with pains. Can you please provide me with a complete list of your medications and how you take them daily? I want to make a thorough review and see if any drug interaction could be a possible cause of these symptoms.

Also, I did not understand what you mean by the stomach area is healing. Can you please shed more light on this?

Aloe juice is completely natural. Give it a try and should it help., then continue with it. However, aloe juice cannot be used as a substitute to your medications.

Hope to hear from you. Wish you well.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chobufo Ditah (30 hours later)

I meant that stomach is feeling a little better on right side where the burning is but it is still there some, I still get some burining like hot liquide coming up to my middle chest, when i chew gum it helps, i also get soreness in back like a burning in my back still it does go away when the prevaicd is not as active around 4:00 in the day, weird. I also get anxiety when i am on it, when i am off it i don't so werid. the only other things i have taken is bio-hpf, 1 with my meals, 1 gastrazyme a day and a pepcid ac chewable at night at bedtime. What is my next step to do I so appreciate your help and thankful.. my doctor is thingin about doing a upper gi? and she may want me to try carafate do you think it will be better? thanks again

Answered by Dr. Chobufo Ditah (55 minutes later)

Brief Answer:
Thank you!

Detailed Answer:
Hi and thank you so much for this follow up precision.

I had taken a look at this ultrasound reported. Though it mentioned a distended bladder, there was no other information to suggest a gall bladder disease.

I think you have been well treated for this acid reflux. With persistence of symptoms, I will strongly support your doctor to push for an upper GI endoscopy. This will help establish the exact nature of this problem. If findings are still in support of this diagnosis with no new possible causes, there may be need for more aggressive measures to manage this reflux if medical treatment fails to get all symptoms controlled.

Carafate is another drug used in treating reflux. With the other medications not providing adequate relief, I will find no reasons not to try other options. They may prove to be more helpful and open the doors for a better management.

I hope this helps. Please,strongly consider doing the upper GI. It will provide more information that would prove helpful either in pursuing more aggressive measures or new findings that may open the door to other possible causes and treatment. Let me hear from you when the updates are available or if need be.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chobufo Ditah (1 hour later)

Thank you I will do so.. I so appreciate your hard work on this. I want to heal up and get off medications and eat right and be me again.. this has been a tiring ordeal and I do see that after I eat it stings in that area some -- that is weird makes me feel it is a sore there i guess still. I just want them to make sure I don't need antibiotics or have any underlying issues still, because the 2 attacks I had where pretty scary back first of may. I have not had to deal with this for over 4 or 5 yrs and it came back - i at that time had Hplori and they had to treat it with antibotics and prevaid this time i am not sure it that is the case but i hope one of the test will tell them.would upper gi tell them?

Answered by Dr. Chobufo Ditah (1 hour later)

Brief Answer:
Yes

Detailed Answer:
Hi and thank you so much for this information.

During an upper GI scope, biopsy samples are obtained which would be able to tell whether you have H. pylori or not. Also, it would look directly at the defect of the causing this reflux to tell if for real it can explain all the symptoms that you have reported. Also. it would look at other neighboring organs to make sure all is okay.

I understand how difficult it can be to deal with such a pain. I look forward to these further investigations with great optimism of a possible lead to what the problem is and propose durable and effective solutions to help relief you of this pain.

Let me hear from you on what the findings are.
I wish you well.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chobufo Ditah (23 hours later)

my doctor is talking about doing a upper gi with barium drink to look for reflux
and ulcers and all and i think this one uses radiation, is this a safe test for me to do or should i wait and do a endoscopy - i am torn with not knowing what to do
i was up last night with that burning in my side again and i could not sleep good and nerves are little bad now.. this is a terrible ordeal to manage to get your nerves back and health back. how do people do it...would you do the upper gi or get the
gi scope test done? or wait for it to heal more? thanks allot

Answered by Dr. Chobufo Ditah (14 hours later)

Brief Answer:
I would have preferred a scope but both are safe!

Detailed Answer:
Hi and thank you so much for this follow up information. I am so sorry to hear about this continued pain. I understand how frustrating this can be but then I call on you not to loose your nerves and make the already existing problem a bigger one.

Both tests are safe and provide reliable results. What is utilized depends on what options are available in the milieu. If both were present, I will most likely go for the scope as seeing directly is always a plus. Also, biopsy from the scope would be able to tell whether H. pylori is still of concern or not.

The radiations used with barium are very small and have been shown to be safe. there is no point in getting too worried about this. It would not cause cancer or any other concerning condition in future because of this one time exposure.

I hope this helps. I wish you well. Thanks and feel free to keep the discussion going. Let me know what you settle on with your doctors and the findings.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chobufo Ditah (3 hours later)

ok I will go with the program and get this done and see where it takes me
I am hoping it will heal up soon anyway - it seems like nerves come with this problem and you have to work your way thru it all. I will let you know how it goes
appreciate your help and guidance here. I asked for scope and I guess they do that next if they see things not right, must be insurance reasons attached to that cause she said - first upper gi, then hida scan if necessary? then endoscope so we shall see... hugs and thank you

Answered by Dr. Chobufo Ditah (5 minutes later)

Brief Answer:
Thank yo, too!

Detailed Answer:
Thank you so much for your kind words.

I wish you the best of all possible outcomes. I also await updates from you. Hope we get to identify the cause and propose longterm solutions to you.

Please, do keep me updated!

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar