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Dr. Andrew Rynne

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What causes midsternal pain radiating to shoulder blades with loss of appetite?

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Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2921 Questions

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Posted on Mon, 2 Nov 2015 in General Health
Question: I'm a 29 year old female. I've had esophageal pressure/fullness, loss of appetite, occasional nausea, squeezing/pressure and sharp pain midsternally that radiates in between my shoulder blades.
I have had these symptoms before, but not as severe as they are now.
The pain has been constant to some extent for the past 24 hours, is unrelated to eating, exertion, or being supine. Antacids are not effective.
What could this be?
Should I see a family practice physician or be seen more urgently?
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Answered by Dr. Muhammad Sareer Khalil 28 minutes later
Brief Answer:
assess for Upper GI endoscopy

Detailed Answer:
Hello and Welcome

I appreciate your concern

If these symptoms are occurring despite taking omeprazole at XXXXXXX dose then an upper GI endoscopy should be considered especially if there is associated weight loss. Two weeks of empiric GERD/Gastritis treatment can be done empirically. If there is no response then endoscopy should be done, in consult with a gastroenterologist. Barium swallow can be done as an alternative though its less accurate than an endoscopy. Esophageal manometry can be advised if there is suspicion of motility disorders like achalasia or DES. For the time being an EKG should be done to rule out any cardiac cause if the pain is persistent and esomeprazole can be taken along with metoclopramide to relieve the symptoms. If the painful symptoms subside then you may get an appointment with a gastroenterologist. If they persist or worsen then ER consultation should be done.


Wishing you best of health

Thanks

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

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Dr. M.S. Khalil

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