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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Medical
Satisfied Customers: 6707
Experience:  MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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I have dull gnawing feeling under left rib cage and upper

Customer Question

I have dull gnawing feeling under left rib cage and upper stomach
JA: How long has this been bothering you? Are you experiencing any vomiting or nausea?
Customer: I've had it for 4 months, over the last 2 weeks I have also had nausea on and off
JA: Anything else in your medical history you think the doctor should know?
Customer: I was diagnosed with a sliding hiatus hernia 5 years ago
Submitted: 2 months ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 2 months ago.

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about your symptoms. Now from what you are describing there are some conditions which may be causing these symptoms. The first one which comes to mind is that you could ahve developed a stomach ulcer which is causing the problem. Since you already have a sliding hiatus hernia, it si very possible that you could have developed a stomach ulcer as well. This would give rise to pain in the region which may worsen on either an empty stomach or after eating. It can also give rise to burning in the chest or the stomach or even nausea/vomiting. The diagnosis can be made with the help of a clinical examination and also with the help of a endoscopy. Once diagnosed it can be treated with the help of medications like OTC prilosec, you can start this at a dose of 20 mg twice daily for 3 days and then drop down to 20 mg once a day. Additionally you could have an infection of the stomach caused by H.Pyroli, this would be treated with the help of antibiotics after being diagnosed with stool for antigen tests or urea breath tests.

Another cause of this could be associated with inflammation of the lining of the stomach. This again would be diagnosed with a endoscopy and then treated with drugs like rabeprazole or pantoprazole.

Lastly this can also be due to heart related issues which can sometimes cause the pain to radiate into teh stomach. A simple EKG and a echocardiogram would be diagnostic in most cases and it is important to rule this out as a cause here as well.

I would suggest that your try the OTC prilosec but do see your doctor for a final diagnosis.

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