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When did the dull ache start?
Did you have any test?
When did you consult doctor last?
Pain in that area can be due to reflux, hiatus hernia.
Nexium usually helps in reflux.
As it is not helping, further tests should be taken.
Gall bladder disease can cause such pain.
Try to avoid fatty food, tea, coffee alcohol.
Ultrasound can look for gall bladder and pancreas.
Pancreatic enzyme study can assess its disorder.
Pain in this area can also come from heart conditions like angina.
At your age it should be checked.
An EKG. blood tests should be taken if you have not had it yet.
If the doctor did not find any cause, then H. pylori test, CT scan, endoscopy can be taken.
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Usually pain from gall bladder is felt on right side below the rib margin.
But in a small percentage of cases, the site may not be typical.
As reflux medicines are not helping & you have got antibiotics for SIBO, so doctor is evaluating the other possibilities.
If you had EKG, echo after start of the pain then it is unlikely to be related to heart.
Sometimes, costochondritis of ribs can also cause pain there.
Repeat tests for H pylori can be taken, if you did not have it recently.
Simple non invasive tests from blood, breath or stool can be considered.
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