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Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 4766
Experience:  Int. Med., Gastroenterology. Fellow American College of Physicians. Trained, located in the U.S.
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I have had pain in my upper stomach below the breast bone for

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I have had pain in my upper stomach below the breast bone for three days now. It is accompanied by reflux and very bad heartburn. Also running a low grade fever. I am scheduled for a colonoscopy and also the test with the tube down the throat on the 23rd of this month. I don't know whether I should go to emergency or try to hold out for the test. I cannot lie flat but need to prop up in bed. The reason I am having the test is occult blood was found in by stool and I have many stomach problems.

your symptoms are consistent with possible GERD or gastro-esophageal reflux disease. Occasionally this can be severe enough to cause irritation of the esophagus and cause occult bleeding. However it should not be assumed that this is the cause of occult bleeding and you should also have a colonoscopy in addition to the upper endoscopy to rule out any polyps or other bleeding problems. In the meantime although I am sure you have tried certain treatments I will make the following suggestions for the possible diagnosis of GERD in order to helped you will feel better until you see your doctor and the correct diagnosis is made. Eat bland foods. Although many doctors tell their patients to avoid spicey foods, fatty foods, citrus fruits, tomato juice or sauce, chocolates, alcohol and carbonated drinks, coffee (also decaf), there is no scientific evidence that is is helpful. You should avoid PROVOCATIVE foods which are any foods that specifically causes you discomfort. You should also stop smoking. You should not eat anything 2 hours before bedtime. The head of the bed should be raised 6-8 inches (can use large cans with sand) and try sleeping with left side down IF you have nighttime reflux. Don't lie down for 2-3 hours after a meal. Some medications may make the reflux worse, including anti-cholinergics, NSAIDS, antibiotics, anti-depressants, nitrates, progesterone, beta blockers and calcium channel blockers, iron, potassium, sedatives and bronchodilators. Several non-prescription agents may help; Gaviscon, Mylanta or Maalox as directed on bottle, acid suppressing agents such as OTC Tagamet, Zantac, Pepcid, or Axid or the stronger agents ( PPI's) such as Prilosec or Nexium, Prevacid, Aciphex and Protonix. Again follow instruction on the labels. Your Doctor may want to double your dose if you fail to improve.

It is important to LOSE WEIGHT if you or overweight. This has been clearly associated with worsening of reflux disease.

If you do not improve on the above regimen or if you have trouble swallowing or pain upon swallowing your doctor may want to proceed with other tests such as endoscopy or pH monitoring.

If your symptoms persist or worsen, surgery ( laparoscopic Nissen Fundoplication ) may be considered.

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Internist and 3 other Medical Specialists are ready to help you
Thank you. It is not common for gallbladder to cause severe reflux or occult blood.