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Why do I have persistent stomach pain?

Dr Sanjiv Saigal
Consultant Gastroenterologist,
Sir Ganga Ram Hospital,
New Delhi

Q: I am a 50 years old man having stomach pain While travelling to India. So I got the ultrasound done, which was normal. However the pain persisted. I had terrible bloating, feeling of fullness and pain in the middle of my chest. The doctor diagnosed it as gastritis and gave me Miracid for about a month. However the symptoms persisted so he gave me Pariet and Librax daily for 3 weeks. But I was not cured completely then the doctor did a gastroscopy and found mild erythematous mucosa, at terminal ileum, ileitis and same mucosa at antrum; diagnosis - gastritis. After that he prescribed – Pariet daily and Gnaton thrice daily, Librax twice daily. But the problem still persisted. I still have the pain in the middle of my chest. I mostly have it in the morning along with gas when I wake up. Do I need to get some more tests? Is this problem serious? What should I do?

A:I note that your main symptoms are related to gaseous distension, bloating of abdomen and retrosternal discomfort. Additional points to be noted in your history is your recent travel to India and a significant amount of stress that you have.

I note that you have already undergone some tests including endoscopy, which does not reveal any sinister disease in your case. I think that part of your symptoms is related to stress, and the main component is due to an acid-peptic disorder. You also have fatty liver, which can also add to your symptoms of discomfort in upper abdomen.

You should continue taking the acid-suppressants such as Pariet. Take a high fibre, low fat diet, and during plenty of fluids. You can also take a small dose of anti-anxiety medication at bedtime, which your doctor can prescribe there.