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What Does My Lab Test Report Indicate?

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Posted on Wed, 25 Oct 2017
Question: Hey doctor,

For the last 2 month I have been having this pain on the left side just under my rib cage, I have attached an image of exactly where. The pain seems to come on a couple of hours after eating and it's kind of like a dull ache that sits there for a long period of time usually the pain is around a 4/10 to 5/10. Now I have had an Gastroscopy 2 months/half ago now as well 2 weeks before this pain started for a different issue my acid reflux that I have had for about 2 years which came up completely clear and I have had numerous blood tests too. I had an ultrasound of my entire abdomen near the end of August when the pain started to flare up and that also seemed to come up clear, I now have a Colonoscopy scheduled in a weeks time which I am unsure if it it is really necessary? What are your opinions on what this could be the first thing I search up on google seems to be pancreatic/spleen cancer but would that have shown up on my ultrasound or blood tests and is that relative to the position of my pain? I have also been passing a lot of gas too and just feeling generally unwell I do also have some form of health anxiety from what the doctors have said but why am I having these physical symptoms? I seem to also be sensitive to certain foods that I used to be able to eat just fine like for example at the start of this year I could eat a whole pizza or drink alcohol but now I struggle to do that?

To note I was an Minocycline for about 3 months at the start of the year for a bad acne flareup but I ended up coming off it because of developing a rash from it could that be what is causing all of these issues a distribution in my gut?

Thank you in advance any insight would be much appreciated.
doctor
Answered by Dr. Ramesh Kumar (2 hours later)
Brief Answer:
Dear you are having Gastritis with reflux problem.

Detailed Answer:

Hi,
Firstly thanks for choosing HealthcareMagic for your query.

As per your query most likely you are having symptoms due to 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.Both acid reflux and heart burn are a part of GERD.The presence of gastritis has proved additive to your symptoms.Frequent retrosternal heartburn is a cardinal symptom of reflux disorder; acid reflux causes a retrosternal or epigastric burning feeling that characteristically radiates up towards the throat, Sometimes this burning sensation can be pulsating also.Every time the acid from stomach refluxes back into esophagus it injures esophageal mucosa.This injured mucosa undergoes severe spasmodic contractions due to inflammation causing sensations of abdominal spasm.

Take a proton pump inhibitor like Esomeprazole 40 mg twice daily .Once daily 40 mg is a suboptimal dose and wont be effective for you,along with it take a prokinetic drug (eg.Domperidone) for 10 days. This will provide you symptomatic relief from symptoms.Prokinetic would prevent acid to reflux back into esophagus hence symtoms would subside.
Antacid like Pepto bismol can be taken for few days along with it.
Any over counter probiotic should be taken for few days to provide relief in symptoms.

Apart from this, some dietary restrictions are to be followed-

- Avoid alcohol or smoking.
- No aerated beverages.
- Take light non spicy easily digestible food for few days.
- No Fast food like pizza or burger should be taken.
- Drink a cup of cold milk daily.
- Avoid fatty foods.
Now lets move to your queries-
a)No colonoscopy is not at all required right now.What you require is proper treatment and life style changes.

b)Its not cancer its a clear cut case of acid problem and you are not relieved as doses used are suboptimal.

c)You have to completely stop fast food alcohol etc atleast for few months.After that you can have cheat days.

Please don't panic just follow the medications i suggested you above an tell me how you feel in 5 days.

Its neither cancer nor any drugs side effect its a clear cut case of acid reflux problem.

Hope i was helpful.
Follow up after 5 days.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar (37 minutes later)
Thanks for that doctor I will try all of what you have mentioned and see if I improve. All though I have tried PPI in the past which didn't work too well for me and I decided to come off them when the Gastroscopy came out clear. I already have the colonoscopy booked in though and my doctor wants me to do it to rule out everything and it's only a week away would it worth still going through with just to be sure? I am unsure if it is too late to cancel it or not since it is only a week away.My Gastroenterologist was pretty adamant that there was nothing really sinister wrong with me and she seems to think it's a combination of IBS and minor GERD, but she said I should do the colonoscopy to ease my mind and rule out anything bad I do sometimes have pains that are a little lower down from my rib cage as well like a heavy ache.
doctor
Answered by Dr. Ramesh Kumar (18 hours later)
Brief Answer:
Follow up answer.

Detailed Answer:

Hi.

1)All though I have tried PPI in the past which didn't work too well for me -Try in doses i have suggested you my dear patient. In suboptimal doses it won't help you much.

2)week away would it worth still going through with just to be sure? -No harm in going for the test.So yes if appointment is fixed then you can proceed for it dear.

3) it's a combination of IBS and minor GERD-May be dear but Major GERD and Gastritis with minor IBS.
All your signs and symptoms are suggestive of GERD with acid disorder.

As suggested earlier just give me 10 days and it would be clear-
Esomeprazole 40 mg twice daily .
Domperidone 30 mg slow release once daily) for 10 days.

GERD and IBS are both diagnosis of exclusion as no specific test is confirmatory for them so overall history investigation and response to medicine will help us reach a proper diagnosis.

Definitely yes go for endoscopy colonoscopy and MRI abdomen if all three are normal its GERD or IBS.

Revert back with reports of colonoscopy.
Hope i was helpful.
Good luck and get well soon.
It was a pleasure answering you.

Warm regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar (1 hour later)
Thanks for the follow up reply, just one other question in terms of the colonoscopy preparation what are some tips that you have for it? The prep i've been given is called ''Glycoprep-C kit', my only concern is that with this gastritis wouldn't the prep liquids make it flare up a lot more and is it ok to take Nexium and/or Zantac a certain amount of days before the colonoscopy?
doctor
Answered by Dr. Ramesh Kumar (3 minutes later)
Brief Answer:
Follow up.

Detailed Answer:
Hello Dear,
Yes its given for prepration of bowel and don't worry it won't make any of your symptoms worse.
However you can take a tablet of 40 mg nexium an hour before taking it(just top be on safe side).
Thanks
Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2805 Questions

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What Does My Lab Test Report Indicate?

Brief Answer: Dear you are having Gastritis with reflux problem. Detailed Answer: Hi, Firstly thanks for choosing HealthcareMagic for your query. As per your query most likely you are having symptoms due to 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.Both acid reflux and heart burn are a part of GERD.The presence of gastritis has proved additive to your symptoms.Frequent retrosternal heartburn is a cardinal symptom of reflux disorder; acid reflux causes a retrosternal or epigastric burning feeling that characteristically radiates up towards the throat, Sometimes this burning sensation can be pulsating also.Every time the acid from stomach refluxes back into esophagus it injures esophageal mucosa.This injured mucosa undergoes severe spasmodic contractions due to inflammation causing sensations of abdominal spasm. Take a proton pump inhibitor like Esomeprazole 40 mg twice daily .Once daily 40 mg is a suboptimal dose and wont be effective for you,along with it take a prokinetic drug (eg.Domperidone) for 10 days. This will provide you symptomatic relief from symptoms.Prokinetic would prevent acid to reflux back into esophagus hence symtoms would subside. Antacid like Pepto bismol can be taken for few days along with it. Any over counter probiotic should be taken for few days to provide relief in symptoms. Apart from this, some dietary restrictions are to be followed- - Avoid alcohol or smoking. - No aerated beverages. - Take light non spicy easily digestible food for few days. - No Fast food like pizza or burger should be taken. - Drink a cup of cold milk daily. - Avoid fatty foods. Now lets move to your queries- a)No colonoscopy is not at all required right now.What you require is proper treatment and life style changes. b)Its not cancer its a clear cut case of acid problem and you are not relieved as doses used are suboptimal. c)You have to completely stop fast food alcohol etc atleast for few months.After that you can have cheat days. Please don't panic just follow the medications i suggested you above an tell me how you feel in 5 days. Its neither cancer nor any drugs side effect its a clear cut case of acid reflux problem. Hope i was helpful. Follow up after 5 days.