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What is the treatment for radiating chest pain with regular upper abdomen cramps?

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Internal Medicine Specialist
Practicing since : 1980
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I am having regular upper abdomen cramps these days. I have high triglycerides for the last 2-3 years. Have been taking aspirin babydose for last 2 years. Severe bloating is also experienced. From last 5 days chest pain radiating into the armpits is being experienced. Also there is a under the skin type of headache on left side just behind and over the ear. There has been neck stiffness also around 5 days back but the same is subsiding fast. I am a smoker. Can I get some proper advise please.
Posted Thu, 30 Jan 2014 in General Health
Answered by Dr. Rakesh Karanwal 1 hour later
Brief Answer: You need to undergo relevant tests Detailed Answer: Hi Mr. XXXXXXX Thanks for your query. Your symptoms of abdominal cramps and severe bloating, are suggestive of aspirin + smoking- induced gastritis (inflammation of the stomach with increased acid formation) along with stomach + intestinal infection (due to either, H.pylori bacteria and/or ameba and worms). Neck stiffness associated with chest pain and mild headache are apparently due to a condition called Cervicalgia (including cervical spondylosis, spasm of neck, shoulder, chest and head muscles). At the same time, given the history of chronic smoking with elevated triglyceride levels, silent ischemia (silent hear disease) needs exclusion. You should therefore undergo breath test for H.pylori, stools test for ameba, ova/cyst and blood, if any; TMT and stress Echo to rule out/detect silent heart disease. Consult your doctor and apprise him of my opinion. I am certain that he will agree with my opinion; order required tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment for your problems. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Have a nice day, Col (Dr.) Rakesh Karanwal
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Follow-up: What is the treatment for radiating chest pain with regular upper abdomen cramps? 8 hours later
Thanks a lot doctor .Since this was this was my first interaction with healthcare magic I did not elaborate much. But now having got convinced, I thought I have missed out bringing a few more observations to your notice. 1) the abdominal pain referred by me is more pronounced in the right upper abdomen (under the ribs - right above the appendix area). The same gets worse with sudden movements like hiccups, belching etc. 2) I have been observing that my stools are generally sticky and loose and slightly blackish (not yellow) 3) I have been diagnosed with very mild PAH around 1 year back 4) I have also been advised rosevastatin 10 mg - one tablet per day but I have not started yet. Can u pl advise on the following : 1) can a liver or pancreatic problem be ruled out? 2) is there no need for further investigations on lungs as I have cut down heavily on smoking now. (infact stopped totally for 5 months in between) 3) would you advise that I should continue ecosprin and Rosulip and what should be the best method and timing for taking the above two medications. 4) is there something like a painkiller that I should try and see so as to positively ensure that the spasms in head,neck and chest are due to cervicalgia only?
Answered by Dr. Rakesh Karanwal 51 minutes later
Brief Answer: Answers to your queries are given below Detailed Answer: Hello Mr. XXXXXXX Nice hearing back from you. Additional details are quite informative. 1. Pain in right upper abdomen can be due to Gastritis (as already highlighted), associated with, Non-Alcoholic Fatty Liver Disease (NAFLD). 2. Sticky, loose and dark colored stools raise the possibility of Non-alcoholic Steato-Hepatitis (NASH), a condition in which Fatty liver is associated with deranged absorption of food leading to the nature of stools as mentioned by you. (I presume that you do not take alcohol). 3. Chronic, advance problem of Pancreas (which produces enzymes responsible for digestion of fats, proteins and carbohydrates present in ingested food) too manifests in the similar manner. An ultrasound and CT scan of upper abdomen (to include Liver, Gall Bladder and Pancreas), along with Liver Function Tests and Serum Amylase will provide valuable information on the involvement (if any) of Liver and Pancreas. 4. The damage to lungs, already caused by smoking, will NOT revert back by giving up smoking! Damage to the lungs due to chronic smoking are irreversible. Hence, you should get further evaluation of Lungs structural and functional status, done. Chest X-ray and Pulmonary Function Test (PFT) will give accurate information on the status. 5. In view of history of chronic smoking and elevated Triglyceride levels, evaluation of the heart condition is also essential. An ECG, 2-D Echo and TMT should be done to rule out/detect silent heart disease. 6. Ecosprin is NOT indicated at present. Several studies have shown that preventive Ecosprin has no role. However, Ecosprin would be invaluable in heart disease. 6. I would recommend that a combination of Rosuvastatin (Rosulip) + Fenofibrate be taken- instead of Rosulip alone-, as Fenofibrate specifically lowers Triglyceride levels. It should be taken daily at Bedtime, after dinner. 7. A 7-10 days' course of a combination of Ibuprofen + Paracetamol + Chlorzoxazone will give substantial relief from pain due to Cervicalgia. Lastly, it may be appreciated that your treating doctor- who has examined you and is fully conversant with your complete medical history- is the BEST JUDGE. Consult him and apprise him of my opinion. I am sure he will agree with me and guide you further. Take care, Col (Dr.) Rakesh Karanwal
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