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Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Medical
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Experience:  MBBS, MD.Currently working in Critical Care Medicine with 6 year experience in internal medicine
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I have upper back discomfort, feels like trapped gas, and some

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I have upper back discomfort, feels like trapped gas, and some serious heartburn, mostly at night, which I've never had before, and twinging on my right side. I had a colonoscopy a wk and a half ago, and haven't felt right since. Could they be related? I am in remission from Chron's disease, and had a biopsy of my terminal ileum during the colonscopy.
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 4 years ago.
Hi,
Im sorry to hear about your symptoms,

Can i ask where in the upper back do you have these symptoms? near the right shoulder?
Any pain on pressing on the abdomen?
Have you had any other tests done? such as ultrasound? endoscopy?
Any nausea or vomiting?
Other medical conditions? medications?
Customer: replied 4 years ago.
between my two shoulder blades. no abdominal pain. no vomiting, but not hungry either. i am taking prozac(40mg) and desipramine(25mg) for depression, but have been for 7 years.
Expert:  Dr. Muneeb Ali replied 4 years ago.
Thanks for the additional information,

Ok so the first thing you should know here that a colonscopy does not cause the sort of pain that youre describing. There are several causes for this type of pain but colonscopy wouldnt worsen or even cause any of these diseases.

Now the presence of the symptoms mostly at night when you lie down and the presence of heartburn all can indicate that this disease is GERD which is also commonly known as reflux. This can cause worsening of the pain and heart burn when you lie down at night because of reflux of the acid back in the oesophagus which can cause back pain as well. This can be diagnosed clinically initially and treated with the help of drugs such as OTC prilosec 20 mg once at night. A trial of the drugs can be done for 2-3 weeks to see if that works, if it doesnt then we can do certain tests to confirm the diagnosis such as Endoscopy to look at the stomach itself, 24 hr ph monitoring, barium swallow. If needed h.pylori infection of the stomach can be ruled out by doing two tests, urea breath testing and stool antigen tests. If this is the case then we can use antibiotics alongwith prilosec or nexium or prevacid.

Another cause of this pain can be problems related to the pancreas or the gallbladder. Gallstones is a common cause of this sort of pain and teh pain can be referred to the back and to the shoulder blade as well. This common disorder c an be diagnosed with the help of abdominal ultrasound which would show the stones or also by doing a HIDA scan which would help in determining the gallbladder function as well. The treatment for this condition is with the help of drugs such as prilosec to reduce the acid reflux and the definitive treatment is with surgery to remove the gallbladder which can be done laproscopically that using a camera.

Pancreatic disease is another possiblity espeically if you use a lot of alcohol because it can give rise to chronic pancreatitis which can cause similar sort of pain and also cause altered bowel movements. In adidtion there are other pancreatic diseases which can cause this. A CT scan of the abdomen would help diagnose the problem.

Now while i mentioned GERD i should also mention other associated problems such as that of gastric or duodenal ulcers or even gastritis which is inflammation of the lining of the stomach. This is treated in the same way as GERD with similar drugs. Also i should mention that you should initiate the conservative measures for GERD which involve elevating the head of the bed at night by using 3-4 pillows and eating your last meal atleast 2-3 hrs before bedtime.

I suggest that you start the conservative measures and start using Prilosec or prevacid which are available OTC and schedule an appointment with your gastroenterologist in the meantime. I hope this helps

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Category: Medical
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Experience: MBBS, MD.Currently working in Critical Care Medicine with 6 year experience in internal medicine
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Dr. Muneeb Ali
Dr. Muneeb Ali
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MBBS, MD.Currently working in Critical Care Medicine with 6 year experience in internal medicine