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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 10341
Experience:  14 years as clinician in the field of Family Practice
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Upper abdomen pain that goes into my chest after meals....it

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upper abdomen pain that goes into my chest after meals....it feels like acid reflux but no medicine really helps, very concerned. i cant take dexilant cause it causes me to have severe diahrrea. can anyone help?
Anthony Bray, MD : Hello!
Anthony Bray, MD : it sounds that you may have a step beyond reflux as problem--- you may have esophagitis ( irritation of the wall of the esophagus)
Customer:

hi again doctor

Customer:

i have spoke to you before

Anthony Bray, MD : you may benefit to try Zantac ( over the counter is 75 mg twice a day but prescription is 150mg twice a day)
Anthony Bray, MD : Zantac is different class of medicine than Dexilant ...
Customer:

ive taken zantac

Customer:

150

Customer:

it helps, but not like i want it to

Customer:

im concerned

Anthony Bray, MD : It might be combined with a second agent such as Carafate--- good to speak with you again!!....
Anthony Bray, MD : observe reflux precautions.... Wait 1.5 hours after you eat before you lie down ... Evate head of bed with blocks 4 to 6 inches under bedposts....
Customer:

well, if you recall

Customer:

i was the young male concerned about pancreatic cancer

Customer:

and now that i get pain in the upper abdomen after meals, im scared

Anthony Bray, MD : With you taking Zantac and still having problems you should follow up with a gastroenterologist...
Anthony Bray, MD : the poor response to treatment is reason to evaluate the problem further... You should probably have upper endoscopy to check the esophagus!!
Customer:

i had that done in march

Customer:

everything was fine

Customer:

like right now, i just had dinner about 30 mins ago

Customer:

and i dont feel much of anything

Anthony Bray, MD : Ok I see... Yes I remember ...
Customer:

i took a zantac 150 after lunch and it did help

Customer:

it just has been a constent for almost 2 weeks now....like comes and goes

Anthony Bray, MD : evaluation with Ct scan of chest / abdomen might be considered with ongoing symptoms.... They can check amylase and lipase levels to look for inflammation of the pancreas ...
Anthony Bray, MD : ruling out gallstones may be worthwhile as well...
Customer:

i had a abdominal ct scan on september 7th with contrast

Customer:

came back normal

Anthony Bray, MD : if doctor tries GI cocktail ( Mylanta and viscous lidocaine which numbs up tissue that it contacts) then pain relief with this helps to ascertain diagnosis as well....
Anthony Bray, MD : Ok well that is good....
Anthony Bray, MD : reflux would not show on the tests except that it MIGHT be observed to occur with endoscopy ....
Anthony Bray, MD : reflux could have led to further irritation since your endoscopy for example...
Customer:

im having a hard time believing that something wasnt missed in that CT scan

Anthony Bray, MD : Well the CT scan would pick up problems of certain nature BUT not others!!
Anthony Bray, MD : it would not have detail to see tissue irritation of the esophagus or stomach for example ...so esophagitis or ulcers would not show on a Ct scan.... Gallstones or tumors of enough size would show...
Anthony Bray, MD : Your fear with pancreatic cancer should be alleviated if normal CT scan/ amylase/ lipase...
Customer:

well i had blood work done in march too on my pancreas and that came back normal

Anthony Bray, MD : Ct scan good at picking up structural problems but microscopic level and very small such as tissue irritation it can't detect...
Customer:

so your saying that this not cancer realted?

Customer:

something else?

Anthony Bray, MD : That is good. That is very reassuring that you do not have pancreatitis or pancreatic cancer...
Anthony Bray, MD : Right there is no evidence to suggest cancer at this time!!
Anthony Bray, MD : We can never have absolute guarantees in this regard... You or I could POSSIBLY harbor cancer cells but this is always true...... It is VERY UNLIKELY IN YOUR CASE ... I would be at much higher risk due to my age (51) vs you...
Anthony Bray, MD : your age corresponds with very low risk if most cancers...
Customer:

yes i know that

Customer:

there are never gurantees

Anthony Bray, MD : It sounds like reflux and possible esophagitis.... Possible gastritis... Esphogeal spasms could relate to your pain...
Customer:

could reflux like this happened since march

Customer:

since i had that endo down in march, could this have developed since then?

Anthony Bray, MD : So trial of continuing Zantac and may ask about Carafate from doctor ....
Anthony Bray, MD : avoid GI irritants--- no alcohol or coffee... Avoid too much caffeine...
Anthony Bray, MD : avoid hot spicy foods and acidic foods ... Especially for maybe next two months and hope to see healing and improvement...
Anthony Bray, MD : certainly possible to have worsening if condition such as ulcer disease in the months since your endoscopy
Anthony Bray, MD : Watch out for tomatoes, onions, peppers, citrus fruits....
Customer:

ok

Customer:

thank you for all your advice

Anthony Bray, MD : You are very welcome!
Anthony Bray, MD : i hope that you feel better soon !!
Anthony Bray, MD : Take care and best regards ***** *****!
Anthony Bray, MD : let me know if you have further questions!
Customer:

i will

Customer:

thank you

Anthony Bray, MD : you can reach me any time at my profile page on this site--- http://www.justanswer.com/medical/expert-anthonybraymd/..... Then type question or comment in the box on that page and it will come to me....
Anthony Bray, MD : Take care!!
Anthony Bray, MD : Anthony Bray MD
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