What do chest soreness and heartburn indicate despite taking Naproxen?

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Posted on Thu, 2 Nov 2017 in Back Pain
Question: I pulled a muscle in my lower back, went to the ER and was put on 60mg prednisone 3 times a day. I took for one day and stopped because of severe heart burn. I was also prescribed 500mg of naproxen. I took one of those the next morning after taking a full day of prednisone. I still have heartburn and my next and chest is sore to touch. I also have dark urine
doctor
Answered by Dr. Ramesh Kumar 38 minutes later
Brief Answer:
You are having severe gastritis due to steroid toxicity.
180 mg prednisolone a day...i have never even heard of these doses in my 40 years of practice.

Detailed Answer:
Hello My Dear patient,
Have gone through your query and i appreciate your concerns.

60 mg prednisolone thrice a day for pulled muscle?
This is something pathetic on part of your othopedician.
180 mg prednisolone a day is not even used in patients suffering from severe auto immune diseases.
Infact i have never seen a single patient in my life who is on 60 mg prednisolone( for muscle sprain).

Firstly and foremost stop it asap(as soon as possible).This dose is not recommended even if you have multiple muscle tears in your body.
As per our medical manuals- 5 to 60 milligrams (mg) per day in divided doses is maximum of prednisolone we can use.

Prednisolone can cause severe gastritis even in doses as low as 10mg a day and should therefore always be given with antacids and proton pump inhibitors.
And on top of that he had prescribed you naproxen which is also a potent anti inflammatory and causes severe acidity and heartburn.

Suggestion stop all medications asap. XXXXXXX the doctor.
Take proton pump inhibitor Nexium 80 mg thrice a day(high dose as your gut is burning).
Take Peptobismol 10-20 ml thrice a day.
Drink plenty of chilled cold milk.
Take sucralfate 1 gram 4 times a day so that in case there is any mucosal ulceration,it could be healed before it becomes a ulcer.

Infact if you are not relieved by oral therapy in two doses go for Nexium infusion at a rate of 8ml/hour for 3 days.
If not relieved even after that an endoscopy should be done to access the level and grade of injury to your gastric mucosa.


I am very sorry that you encountered such a sham doctor.
Please take this seriously.
I wish you a great day and fast recovery.

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 10 hours later
Ok thank you for your time. I will find a PCP and follow up.
doctor
Answered by Dr. Ramesh Kumar 57 minutes later
Brief Answer:
follow up.

Detailed Answer:
Hello my dear patient,
Yes you can get prescription from PCP and follow medications.
Hope i was helful and get well soon.
When closing the thred please do rate the answer.

I wish you a great luck and quick recovery ahead.
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2406 Questions

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