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Dr. David, Board Certified Physician
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Symptoms: Dull, achy, tingly, burning pain under right ribcage

Customer Question

Symptoms: Dull, achy, tingly, burning pain under right ribcage daily, comes and goes but occurs daily (often several times), lasts from 1 hr to several hours. When I don't eat well (like over Christmas) my symptoms are more noticeable. My doctor has me on tecta twice per day for 3 months now (suspecting duodenal ulcer). I haven't really seen any improvement over this time. I had my gallbladder out 4 yrs ago and an ercp to remove stones in my bile duct left behind about 2 years ago. The pain is not at all like I had when my gallbladder was having issues but it is around the same area. I don't have gerd - no heartburn. The pain is way over on my right side. I'm scheduled for an ercp in 3 weeks but never had a consultation with the gastroenterologist that is doing it!?! I had extensive blood work done and everything was normal. I also had an ultrasound done and it was normal. Obviously, I'm concerned that it's something serious. The anxiety makes it worse. Any ideas what could be causing this? Could it be something serious?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 2 years ago.
Hello
You could easily have formed new stones in the ducts.
ERCP would show this and allow treatment as well.
This can be bowel pain, or liver pain.
But lab tests would show liver problems.

I believe your doctors are pursuing the most logical explanation at this point.
good luck

Let me know if you have further questions, details or need clarification, just use reply.......

Customer: replied 2 years ago.
So you don't think it's an ulcer... everyone I ask about it seems to think it's a duodenal ulcer. You can form new stones, even after an ercp?
Expert:  Dr. Thomas, MD replied 2 years ago.
Yes you can.
Yes an ulcer is possible, but that would be seen on scope.

An h pylori stool test would show if you have the ulcer bug,,,which needs antibiotics.
good luck again

Let me know if you have further questions, details or need clarification, just use reply.......

Customer: replied 2 years ago.
I had a blood test for H Pylori but it was negative. In August, I had a really sore foot. I took a lot of Advil for about 1 1/2 months. I probably took too much because I just took a few whenever it hurt and never really took notice of how many I was taking but the bottle sure emptied fast. The pain in my side started shortly after this. I was also under a lot of stress at the time. Could this be a cause of my pain? How long do these kind of medications usually take to work (tecta)? On the package it says I'd see symptom improvement in 8 weeks but it's been double that.
Expert:  Dr. Thomas, MD replied 2 years ago.
So it is unlikely ulcer than.

your docs are going in the correct direction
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Customer: replied 2 years ago.
Relist: Incomplete answer.
Expert:  Dr. David replied 2 years ago.
Hello, this is Dr. David. I have read your question and am ready to help.

I think gastritis could be causing your right abdomen pain. taking advil will worsen gastritis. stress can worsen gastritis. gastritis is inflammation of the stomach. it will take sometime with taking the Tecta which is Protonix in the USA to decrease acid in the stomach to allow the inflammation to calm down. and it will also take you to decrease your own anxiety to help decrease stomach acid. what do you do to decrease stress? do you exercise? you should try some exercise or yoga or meditation or stretching or something to decrease stress. stress and anxiety increase stomach acid production and worsens gastritis. during the upper scope procedure for the ERCP they will travel down the esophagus and into the stomach and into the duodenum and see if there is any inflammation of the stomach or ulcers or anything in the duodenum as well. if not, they can do ultrasounds of the pancreas and a little bit of the liver as well and check the bile duct as well.
Customer: replied 2 years ago.
Thank you for your help. Would this also explain why I've been having almost daily episodes of excess belching? When I get this pain I usually take a few Tums and then within a few minutes, I start burping a lot (for quite a while) but then the pain goes away faster.
Expert:  Dr. David replied 2 years ago.
yes, this does.

when acid is nutralized in the stomach, carbon dioxide gas is producted and this causes burping. increased stomach acid is often the cause of gastritis.

maybe Tecta is not the best antacid for you. maybe you would do better with something like mylanta or maalox or tums extra strength regularly for acid control.

Dr. David, Board Certified Physician
Category: Medical
Satisfied Customers: 30415
Experience: Experienced Physician trained in New York City. I'm ready to help.
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Customer: replied 2 years ago.
Thank you. I will discuss this with my doctor.
Expert:  Dr. David replied 2 years ago.
you are welcome.

best of luck on the ERCP. let me know how it goes.

let me know if you have other questions

please leave + feedback

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