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Dr.Israr, Doctor
Category: Medical
Satisfied Customers: 909
Experience:  MBBS, FCPS
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I get excessive pain in the diaphragm area (under both the

Resolved Question:

I get excessive pain in the diaphragm area (under both the rib cages, towards their ends). The pain sometimes comes after a meal and sometimes comes even without a meal. If I eat meals like noodles, chicken, cool milk, even pizza etc. the pain subsides. Meals like salads, cornflakes, beef / lamb, pulses, coffee/ tea etc increase the pain.

I normally do not have reflux, do not feel acid coming up the oesophagus. I do not feel bloated in the morning, after sleeping but do feel bloated all throughout the day.
Also, exercising (jogging, using the strider etc) have nowadays been increasing the bloating. My height is 180 cms, weight is 103 kgs.
This has been effecting my productivity for a long time. I get relief only after sleeping.
Pls. advise.
Submitted: 6 years ago.
Category: Medical
Expert:  Dr.Israr replied 6 years ago.

Thanks for using just answer.

Did you see a gastroenterologist for this?

What medicine for this problem you are currently using?

Any history of diarrhea or constipation associated with these problems?
Customer: replied 6 years ago.
The doctor I saw the first time was a gastroenterologist in India.
He conducted an endoscopy. I do not have the prescription he gave me that time. I just remember it did not stop the burps much.

After that, went to another doctor in Kuwait (where I am working now). This doctor prescribed Omeprazole and a magnesium based antacid.
Expert:  Dr.Israr replied 6 years ago.
What i understand you have three problems, one is pain in lower diaphragm area, others are bloating and burping? Am i right?

Are you using omeprazole and magnesium based antacid?
Customer: replied 6 years ago.
There is one more problem I should mention - though it does nto cause too much discomfort. Not know if it is connected to the above problems.
I pass stool almost 3 times a day. Morning, afternoon and then evening.
At-least 2 normally.

So basically - pain in lower diaphragm, excessive burping, bloating, passing stool 3 times a day.

I have stopped using the Omeprazole and antacid. They did not have much effect.
I am having pain right now, took cold milk and the pain has reduced.
Expert:  Dr.Israr replied 6 years ago.

Respected customer, there are two possibilities in your case. Gastritis with acid reflux, and other is Irritable bowel syndrome.
I advise you to start on cap lansoprazole (prevacid). Tab domperidone and probiotic sachet containing saccharomyces bouladii should be added to it. These three medicine will decrease acidity, burping ( by early emptying of stomach) and bloating in your case respectively.
You need this combination of medicine to relieve your all current symptoms. You can discuss these with your current gastroenterologist.
Thanks and feel free for your any follow up questions.
Dr.Israr and 2 other Medical Specialists are ready to help you
Customer: replied 6 years ago.
Are the medicines you advised prescription? Or can I obtain them over the counter? Also dosage (mg) ?
Frequency to be taken?

Also, I heard that pain under the diaphragm can be caused by hiatus hernia. Are you ruling out hiatus hernia?
Expert:  Dr.Israr replied 6 years ago.
Respected customer, its difficult to rule out hiatal hernia on web and even on physical examination in person. It needs endoscopic examination. As your endoscopy already done and it only found loose valve of lower esophagus and does not show hiatal hernia. So it seems less likely.

All these medicines are available over the counter in most countries. I cannot say with confirmation about Kuwait. They will be available OTC most likely. You can confirm it by near pharmacy.
You can use cap lansoprazole 15 mg once daily half an hour before meal at night daily
Tab domperidone 10 mg twice daily before meal
Probiotic sachet twice daily after meal.
Please do consult your gastroenterologist before using all these medicines.