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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes pain below the breastbone?

Answered by
Dr. Ramesh Kumar


Practicing since :1986

Answered : 1992 Questions

Posted on Thu, 2 Mar 2017 in Digestion and Bowels
Question: I have a dull pain right under my breast bone and sometimes feel like i have heart burn. SOmetimes it can feel like a gall bladder attack but I dont have one anymore, what could this be?

Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Retrosternal dull pain classic feature of heart burn associated with GERD.

Detailed Answer:

Thanks for choosing HCM.

Most likely your symptoms are because of Gatro esophageal reflux disease (GERD),It is a chronic digestive disease. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe . The backwash irritates the lining of your esophagus and causes, heart burn,chest pain and intense burning sensation in throat are often the presenting complaints however every patient does not have all symptoms.Both acid reflux and heart burn are a part of GERD.
Ask your gastroenterologist to start you on pantroprazole or esomeprazole,Pantoprazole can be used in dosage as high as 40 mg twice daily ,Ash him to add Domepridome 30mg slow release once daily,This will slow down the reflux of acid back and would provide symptomatic relief.An antacid containing local anaesthetic could be added to drug regimen.Acotiamide is a new drug and is very effective in controlling symptoms of GERD and esophagitis.In trials- Acotiamide,a gastrointestinal motility modulator,at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults.
All these drugs can be considered by your gastroentrologist to provide you with symptomatic relief.Ask your gastroenterologist to take the suggestions and follow them for 21 days;If not relieved a upper G.I endoscopy should be done.

Apart from medicines few other life style changes are adviced-
- Increase XXXXXXX warm water intake
- Do not drink water during and after meals
- Eat small meals (rich in fiber),Avoid spicy,oily and heavy meals.
- Eat plentiful "fresh oranges" and "pear "
- Drink COLD milk and and AVOID junk food.
- avoid beverages / alcohol/ soft drinks
- do some exercise early in the morning
- avoid carbonated drinks
Above answer was peer-reviewed by : Dr. Nagamani Ng

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