Stomach ulcer pain on right side: Duodenal ulcer accompanied by intractable right lateral chest pain (T6/T7 dermatomal segments)

09.03.197618.10.2021 by alexxlab

Содержание

Duodenal ulcer accompanied by intractable right lateral chest pain (T6/T7 dermatomal segments)

JA Clin Rep. 2016; 2(1): 12.

and

Yoshimichi Namba

Sapporo Medical University School of Medicine, Sapporo, Japan

Michiaki Yamakage

Sapporo Medical University School of Medicine, Sapporo, Japan

Corresponding author.

Received 2016 May 16; Accepted 2016 May 31.

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Abstract

A 48-year-old man who complained of a severe throbbing pain in his right lateral chest was referred to our department. His chest computed tomography (CT) and X-ray, abdominal CT and ultrasonography had revealed no abnormalities. Four days after admission to our ward the patient vomited and he requested upper gastrointestinal (GI) endoscopy: this showed duodenal ulcer. Treatment with omeprazole and sucralfate improved the duodenal ulcer; concurrently, the symptoms of chest pain were relieved.

Keywords: Duodenal ulcer, Right lateral chest pain

Background

Most commonly, the pain of peptic ulcer is referred to the epigastrium [1]. In some patients, the pain of duodenal ulcer is referred to the right upper quadrant, but chest pain is rare [2, 3]. We present a case in which the indicated drug treatment of duodenal ulcer drastically improved a severe right lateral chest pain.

Case presentation

A 48-year-old man (150 cm, 45 kg) who complained of intractable right lateral chest pain (T6 to T7 dermatomal segments) was hospitalized. Relationship of pain and digestion (oral intake), and time in a day, were variable. The character of pain was “throbbing”. No abnormalities were shown in his chest CT, chest X-ray, abdominal CT, abdominal ultrasonography, rib X-ray. He didn’t have gastroesophageal reflux either. As neither pentazocine nor buprenorphine was able to relieve the pain, the patient was referred from gastroenterology department to our department.

An epidural catheter was inserted at the T6-7 interspace. A continuous infusion of 2 ml of 0.125 % bupivacaine was utilized with bolus dose of 2 ml of 0.25 % bupivacaine for pain control. Effective area of epidural anesthesia was not determined, but epidural block relieved his pain. Results of further investigations using spinal magnetic resonance imaging, intravenous pyelography, renal CT, cardiac enzyme determination were within their normal ranges.

The patient vomited four days after epidural catheterization, and one of the authors was called to see the patient. He had been considering upper GI endoscopy on his way to see the patient, but the patient requested it by himself. The character of pain was changing from “throbbing” to “stabbing or stinging”.

The endoscopy revealed a duodenal ulcer and so the patient was moved to the gastroenterology ward. Omeprazole (proton pump inhibitor) 20 mg daily (orally, once a day) and sucralfate (mucosal protective) 3 g daily (orally, three times a day) were prescribed for 2 weeks. This treatment relieved the patient’s symptoms of chest pain, together with providing the cure for the duodenal ulcer. Fourteen days after commencing the treatment, the patient was discharged and followed as an outpatient for recovery.

Discussion

The pain of duodenal ulcer is described as “gnawing” or “burning” [3]. The patient described his pain as “throbbing” to “stabbing or stinging”. Most commonly, the pain of duodenal ulcer is referred to the epigastrium [1]. In some patients, the pain is referred to the right upper quadrant. Duodenal ulcer causes pain that radiates to xiphoid process but not higher [2, 3]. Chest pain could be due to peptic ulcer disease if acute ischemic heart disease, pulmonary embolism, aortic dissection and spontaneous pneumothorax were excluded [4]. The patient didn’t have any of the above diseases. Search results through PubMed and UpToDate have not found reports of duodenal ulcer combined with chest pain either.

Since the location of the pain was in the right lateral T6 to T7 dermatomal segments, upper GI endoscopy had not been performed before being referred to our department. Nociceptive impulses from the duodenum are transmitted to the spinal cord through the T5 to T12 [3]. Therefore, pain from the duodenum could radiate to thoracic segments.

Conclusions

We report a rare case in which the indicated drug treatment of duodenal ulcer drastically relieved a severe pain in the right lateral chest. This case demonstrates that comprehensive examinations are necessary for elucidation of the cause of severe pain.

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Authors’ contributions

All authors read and approved the final manuscript.

Competing interests

The authors declare that they have no competing interests.

Consent

Written informed consent was obtained from the patient’s brother for publication of case report and any accompanying images.

References

1. Vale JD. Peptic ulcer disease and related disorders. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s principles of internal medicine. New York: McGrow-Hill; 2005. pp. 1746–62. [Google Scholar]2. Bonica JJ, Graney DO. General consideration of pain in the chest. In: Loeser JD, editor. Bonica’s management of pain. Philadelphia: Lippincott Williams & Wilkins; 2001. pp. 1113–48. [Google Scholar]3. Tobin RW, Kimmey MB. Painful diseases of the gastrointestinal tract. In: Loeser JD, editor. Bonica’s management of pain. Philadelphia: Lippincott Williams & Wilkins; 2001. pp. 1269–92. [Google Scholar]4. Lee TH. Chest discomfort and palpitations. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s principles of internal medicine. New York: McGrow-Hill; 2005. pp. 76–81. [Google Scholar]

Duodenal ulcer accompanied by intractable right lateral chest pain (T6/T7 dermatomal segments)

JA Clin Rep. 2016; 2(1): 12.

and

Yoshimichi Namba

Sapporo Medical University School of Medicine, Sapporo, Japan

Michiaki Yamakage

Sapporo Medical University School of Medicine, Sapporo, Japan

Corresponding author.

Received 2016 May 16; Accepted 2016 May 31.

Abstract

Keywords: Duodenal ulcer, Right lateral chest pain

Background

Case presentation

Discussion

Conclusions

ᅟ

Authors’ contributions

All authors read and approved the final manuscript.

Competing interests

The authors declare that they have no competing interests.

Consent

Written informed consent was obtained from the patient’s brother for publication of case report and any accompanying images.

References

Duodenal ulcer accompanied by intractable right lateral chest pain (T6/T7 dermatomal segments)

JA Clin Rep. 2016; 2(1): 12.

and

Yoshimichi Namba

Sapporo Medical University School of Medicine, Sapporo, Japan

Michiaki Yamakage

Sapporo Medical University School of Medicine, Sapporo, Japan

Corresponding author.

Received 2016 May 16; Accepted 2016 May 31.

Abstract

Keywords: Duodenal ulcer, Right lateral chest pain

Background

Case presentation

Discussion

Conclusions

ᅟ

Authors’ contributions

All authors read and approved the final manuscript.

Competing interests

The authors declare that they have no competing interests.

Consent

Written informed consent was obtained from the patient’s brother for publication of case report and any accompanying images.

References

9 Right Upper Quadrant Pain Causes & Everything You Need to Know

Gallstones

Gallstones are small, round deposits found in the gallbladder, the organ where bile is stored. Gallstones can be subclassified a number of ways. Oftentimes, gallstones will be referred to as either cholesterol stones or pigment stones depending on the makeup of the gallstone.

Gallstones can also be class…

Gall bladder infection (cholecystitis)

Gallbladder infection, also called cholecystitis, means there is a bacterial infection of the gallbladder either with or without gallstones.

The gallbladder is a small organ that stores bile, which helps to digest fats. If something blocks the flow of bile out of the gallbladder – gallstones, damage to the bile ducts, or tumors in the gallbladder – the bile stagnates and bacteria multiplies in it, producing an infected gallbladder.

Risk factors include obesity, a high-fat diet, and a family history of gallstones.

Symptoms include fever; chills; right upper quadrant abdominal pain radiating to the right shoulder; and sometimes nausea and vomiting. A gallbladder infection is an acute (sudden) illness, while the symptoms of gallstones come on gradually.

Untreated cholecystitis can lead to rupture of the gallbladder, which can be life-threatening.

Diagnosis is made through physical examination, ultrasound or other imaging, and blood tests.

Treatment involves hospitalizing the patient for fasting with IV fluids, to rest the gallbladder; antibiotics; and pain medication. Surgery to remove the gallbladder is often done so that the condition cannot recur.

Rarity: Uncommon

Top Symptoms: abdominal pain (stomach ache), nausea, loss of appetite, diarrhea, constipation

Symptoms that always occur with gall bladder infection (cholecystitis): abdominal pain (stomach ache)

Symptoms that never occur with gall bladder infection (cholecystitis): pain in the upper left abdomen, pain in the lower left abdomen

Urgency: Hospital emergency room

Stomach ulcer

A peptic ulcer is a sore in the lining of the stomach or the first part of your small intestine (the duodenum), which causes pain following meals or on an empty stomach.

Rarity: Uncommon

Top Symptoms: fatigue, nausea, loss of appetite, moderate abdominal pain, abdominal cramps (stomach cramps)

Symptoms that never occur with stomach ulcer: pain in the lower left abdomen

Urgency: Primary care doctor

Hepatitis a

Hepatitis A is a contagious infection of the liver caused by the hepatitis A virus (HAV). HAV causes swelling and inflammation of the liver that impairs its normal function. Hepatitis A can cause gastrointestinal upset, fever, malaise and other symptoms, and the infection can last from weeks to months….

Hepatitis b

Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). There are other hepatitis viruses (A, C, D, E) that may behave and be transmitted differently. HBV causes swelling and inflammation of the liver that prevents its normal function. HBV can cause a short-term, acute illness t…

Acute hepatitis c

Acute Hepatitis C is a liver inflammation caused by Hepacivirus C. The acute form of the disease means that it arises suddenly, within six months of exposure.

Hepatitis C is spread through infected blood, usually through sharing hypodermic needles for intravenous drug use or from sharing personal items such as toothbrushes or razor blades. It can also be sexually transmitted.

Most susceptible are intravenous drug users; hemodialysis patients; HIV patients; and babies born to infected mothers.

Early symptoms may mild, with fatigue, fever, pain in the upper right side of the abdomen, and loss of appetite. Some patients will develop dark urine, pale white stools, and jaundice, which is yellowing of the eyes and skin.

Diagnosis is made through patient history, physical examination, and blood tests.

About half of all cases clear spontaneously, but it is still important to see a medical provider to prevent further liver damage from inappropriate medicines, supplements, or alcohol.

Otherwise, treatment involves antiviral and other medications. In severe and complicated cases, a liver transplant may be necessary.

Rarity: Ultra rare

Top Symptoms: fatigue, nausea, loss of appetite, muscle aches, fever

Symptoms that never occur with acute hepatitis c: pain in the upper left abdomen, pain in the lower left abdomen, pain in the lower right abdomen, pain around the belly button

Urgency: Primary care doctor

Acute pancreatitis

Acute pancreatitis is the inflammation of the pancreas, which creates and releases insulin and glucagon to keep the sugar levels in your blood stable. It also creates the enzymes that digest your food in the small intestine. When these enzymes accidentally get activated in the pancreas, they digest the pancreas itself, causing pain and inflammation.

Rarity: Rare

Top Symptoms: constant abdominal pain, nausea or vomiting, being severely ill, severe abdominal pain, fever

Symptoms that always occur with acute pancreatitis: constant abdominal pain

Urgency: Hospital emergency room

Appendicitis

Appendicitis refers to inflammation of the appendix, a small finger-like structure in the lower right corner of the belly. Appendicitis is extremely common, occurring in about five to 10 percent of people at some point in their lifetime. While it can occur at any age, the most commonly affected group…

Indigestion (dyspepsia)

Indigestion, also called upset stomach, dyspepsia, or functional dyspepsia, is not a disease but a collection of very common symptoms. Note: Heartburn is a separate condition.

Common causes are eating too much or too rapidly; greasy or spicy foods; overdoing caffeine, alcohol, or carbonated beverages; smoking; and anxiety. Some antibiotics, pain relievers, and vitamin/mineral supplements can cause indigestion.

The most common symptoms are pain, discomfort, and bloating in the upper abdomen soon after eating.

Indigestion that lasts longer than two weeks, and does not respond to simple treatment, may indicate a more serious condition. Upper abdominal pain that radiates to the jaw, neck, or arm is a medical emergency.

Diagnosis is made through patient history and physical examination. If the symptoms began suddenly, laboratory tests on blood, breath, and stool may be ordered. Upper endoscopy or abdominal x-ray may be done.

For functional dyspepsia – “ordinary” indigestion – treatment and prevention are the same. Eating five or six smaller meals per day with lighter, simpler food; managing stress; and finding alternatives for some medications will provide relief.

Rarity: Common

Top Symptoms: nausea, stomach bloating, dyspeptic symptoms, bloating after meals, vomiting

Symptoms that always occur with indigestion (dyspepsia): dyspeptic symptoms

Symptoms that never occur with indigestion (dyspepsia): vomiting (old) blood or passing tarry stools, rectal bleeding, bloody diarrhea, fever

Urgency: Self-treatment

Specialist Answers on Digestive Health Issues

Q1. Every time I eat, I have horrible gas and excessive bloating. Are these the signs of an ulcer?

The most common sign of an ulcer is a burning pain that is either made better by eating or aggravated between one and three hours after a meal, when food can no longer neutralize the acid produced by the stomach. Other ulcer symptoms include vomiting, gastrointestinal bleeding, and severe abdominal pain or bloating, brought on by a penetrating ulcer that has perforated and needs emergency surgical repair. Horrible gas and excessive bloating are more likely to be associated with gallstone-related disease, dyspepsia, or irritable bowel syndrome. I advise you to see your doctor and discuss your symptoms so you can be properly diagnosed.

Q2. I have Crohn’s disease. A few months ago during a flare, my stomach and right side were hurting. The CT scan didn’t pick it up, but an endoscope picked up that I had two large perforated ulcers in my stomach. The biopsy of the ulcers was not taken on the diseased tissue but on normal tissue to the side of the diseased tissue. I have been on Prevacid (lansoprazole) and Carafate (sucralfate), and the stomach pains and ulcer-like symptoms have not retreated after four months. I am thinking that it is the Crohn’s in the stomach now and not just in the small intestine. I am on Imuran (azathioprine) and Humira (adalimumab), but it doesn’t help my stomach, just my lower gut. Shouldn’t the GI doc be thinking that it is not just regular ulcers but Crohn’s in the stomach at this point, since that is what I think? I do not drink alcohol or coffee or smoke and am eating a bland diet. How else is Crohn’s of the stomach treated?

Upper gastrointestinal Crohn’s disease is rare and only seen in less than 5 percent of Crohn’s disease patients. While ulcers in the stomach may be due to Crohn’s disease, more commonly they are due to non-steroidal anti-inflammatory drug (NSAID) use (such as aspirin, ibuprofen or naprosyn) or to infection with bacteria called Helicobacter pylori. The biopsies taken of the normal tissue next to the ulcers were done to rule out H. pylori.

If H. pylori has been ruled out and you are not taking NSAIDs, then it is reasonable to assume that Crohn’s disease is the cause of the ulcers. Upper gastrointestinal Crohn’s disease is best treated with proton-pump inhibitors, like the Prevacid that you are taking, and anti-inflammatory medications, like the Humira and Imuran you are taking.

Q3. What are the signs of a stomach ulcer?

— Fern, New Jersey

Peptic ulcer remains a common problem in the United States — 10 million Americans are estimated to be affected. There are two main causes of ulcers: the bacterium Helicobacter pylori, and too many non-steroidal anti-inflammatory drugs (NSAIDs). H. pylori, which infects the stomach, mostly causes ulcers in the duodenum, the first portion of the small intestine after the stomach. H. pylori-associated ulcers usually cause burning or sharp abdominal pain one to two hours after meals, on awakening in the morning, and at night. These symptoms are often relieved by food or antacids.

NSAIDs, such as aspirin, naproxen, and ibuprofen, usually cause ulcers in the stomach and often do not result in ulcer-like pain. While NSAID-induced ulcers may not cause traditional symptoms, they reveal themselves through gastrointestinal complications like bleeding (which leads to darkening of the stool), vomiting of fresh blood or older blood that resembles coffee grounds, or, rarely, passing fresh blood in the stool. These signs may indicate a perforation of the stomach or duodenum, which is a surgical emergency. If you notice such symptoms, call your doctor immediately.

Q4. What kinds of foods are safe to eat with an ulcer (caused by H. pylori) and gallstones?

— Gail, New Jersey

For patients with peptic ulcer disease, all foods are safe to eat, although eating small meals more frequently helps to decrease symptoms and improve ulcer healing by neutralizing acid. However, once the ulcer is healed and Helicobacter pylori is eradicated, there are no specific dietary restrictions. In contrast, fatty foods are poorly tolerated by patients with gallstones and can cause abdominal pain and bloating known as biliary colic. All patients with gallstones should avoid fried foods and foods with high fat content as much as possible.

Q5. Can you share your thoughts on the relationship between stress and ulcers?

— Nidya, Connecticut

For centuries, stress was thought to be the major factor in forming ulcers (“You’re giving me an ulcer!”). By the early twentieth century, we thought that acid was important in ulcer formation, although stress was thought to increase acid production and cause ulcers that way. In the mid-1980s, the medical world recognized that a bacterium, Helicobacter pylori (along with aspirin and non-steroidal anti-inflammatory drugs such as ibuprofen), caused the vast majority of ulcers of the stomach and duodenum. That discovery downplayed the importance of stress or acid.

Severe stress, however, such as that experienced by patients with substantial burns or critical illness in intensive care units, creates a very high risk for the development of specific stress ulcers of the stomach, known as Cushing’s and Curling’s ulcers, respectively. These forms of acute stress are thought to cause ulcers by reducing blood flow, also called ischemia, to the stomach.

Regarding the more common type of peptic ulcers, cigarette smoking has clearly been shown to be a cofactor in the formation of ulcers in patients infected with H. pylori. The evidence is much less clear that “everyday stress” and stress-prone personality traits are cofactors in causing peptic ulcer disease.

Q6. I have been constipated lately, and my bowels aren’t regular. I have very bad breath and I am gaining weight. What could be going on?

Because you have developed abdominal bloating, bad breath, and a change in your bowel habits, you should be referred to a gastroenterologist as soon as possible. While many disorders could be causing your symptoms, including peptic ulcer disease, dyspepsia, and irritable bowel syndrome, the change in bowel habits and weight gain may signify difficulty in moving food through your gastrointestinal tract. Your bad breath may be a reflection of bowel contents that are not moving — meaning that the odors could be coming up from your bowel and being released from your mouth. Starting with your colon, your gastrointestinal tract should be examined by colonoscopy, upper endoscopy, or barium X-rays to make sure that you do not have a structural lesion that is causing these symptoms.

Learn more in the Everyday Health Ulcer Center.

An Abdominal Burning Sensation Could be a Stomach Ulcer

A stomach ulcer, sometimes referred to as a gastric ulcer, occurs when the acids in the stomach slowly eat away at the lining of the stomach resulting in sores. They can be very painful in some cases, and at other times some people will have no symptoms at all.

There are two main causes of stomach ulcers. One is taking too many pain relievers over a long period of time. This slowly destroys the mucosa lining found in the stomach. The other main cause of a stomach ulcer is caused by a bacteria called Heliobacter pylori ( H. pylori) . This bacteria increases the amount of acid in the stomach which eats away at the stomach lining. Other causes of stomach ulcers are smoking, alcoholic beverages, stress, and spicy food.

Symptoms of a stomach ulcer include:

Burping
Feeling bloated
Nausea
Blood in stool
Vomiting
Heartburn
Unexplained weight loss
Change in appetite

Having an empty stomach may increase the symptoms.

A stomach ulcer may be accompanied by complications. These can include internal bleeding and infection.

Diagnosing a stomach ulcer is done by taking a thorough medical history and then drawing blood, breathing into a special device, and stool samples.

Treating a stomach ulcer depends on what is causing it. If it is a pain medication issue, then you may have to cut back or reduce the dosage. If it is H. pylori related an antibiotic may be prescribed and then medication to reduce the production of excess stomach acids. Some people get relief by taking antacids or medications that protect the lining of the stomach. Reducing stress may help the symptoms as can eating a healthy diet full of fruits, nuts, and whole grains, eating aged cheese, yogurt, and taking probiotics.

If you are experiencing pain in your abdomen, speak to your physician about possible causes. You can also schedule an appointment with a gastroenterologist at Flushing Hospital Medical Center by calling 718-670-5486.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

What are the causes of rib pain?

Right-sided pain under ribs

Gallstones

Gallstones are small stones that can form in the gallbladder (a small organ under the liver). They are usually made up of cholesterol and don’t tend to cause symptoms. Sometimes they get stuck in the entrance of the gallbladder, which can cause severe pain under your ribs on the right side.

Gallstones can cause complications. If this happens, you may also experience:

a high temperature
constant pain
a fast heartbeat
jaundice
itchy skin
diarrhoea
chills or shivers
confusion
a loss of appetite

If you think you might have gallstones, visit your doctor. You should seek immediate medical help if:

you develop jaundice
you have abdominal pain for more than eight hours
you have a high temperature and/or chills
your pain is severe and cannot be relieved by changing position

More information

Find out more about gallstones

Kidney stones and infections

Kidney stones are the result of a build up of minerals on the inner lining of the kidney. They are most common in people aged 30-60. While they can be caused by different medical conditions they are also often caused by dehydration.

They can cause severe pain under the right-hand side and left-hand side of your rib cage or your back and sometimes this pain can spread to the front of your tummy area. Other symptoms you may experience include:

a high temperature
feeling clammy
nausea or vomiting
blood in your urine
urine infections

Kidney stones can often pass on their own without medical intervention, but sometimes they may need to be removed surgically.

You should visit your doctor if you think you have kidney stones, and seek emergency help if:

the pain is severe
you have a high temperature
you experience shivering or shaking
there is blood in your urine

More information

Find out more about kidney stones

Kidney infections are usually the result of a bladder infection that travels up to your kidneys.

If you have a kidney infection you may experience pain under your ribs in your back as well as:

a fever
nausea
needing to pee more than usual
needing to pee suddenly
pain when peeing
smelly or cloudy urine
blood in your pee

You should visit your doctor if you have symptoms of a kidney infection.

More information

Find out more about kidney infections

Shingles

Shingles is caused by the same virus that causes chickenpox, so if you’ve previously had chickenpox you can develop shingles. But if you’ve never been exposed to the chickenpox it’s not possible to develop shingles.

The area underneath your right or left ribs is a common place to experience symptoms, however you can develop shingles on other parts of the body including your chest, tummy and less commonly face, eyes or genitals.

Shingles often begins with a tingling or painful area of skin which can then become sharp or burning in nature. It then typically causes a rash that tends to develop two to three days after the pain begins.

You should visit your doctor if you think you have shingles. They will be able to diagnose you and provide the appropriate treatment.

More information

Find out more about shingles

Liver problems

If you have a problem with your liver it can cause pain under the right side of your ribcage. Your liver plays an important role in digestion and fighting infections, so if it is not functioning properly it can have serious implications.

Common liver diseases include:

Liver problems can be caused by a number of different factors, including alcohol consumption and diet. But there are ways to prevent some liver diseases, such as losing weight if you are overweight and cutting down on your alcohol intake.

If you think you are suffering from liver disease you should see your doctor.

When to worry

If you have persistent pain on the right side of your rib cage you should visit a doctor. You should seek immediate medical attention if you:

have yellow skin
have severe pain
have lost weight without trying to
are vomiting blood or there is blood in your poo
have a high temperature and you are shaking
feel breathless

Or if your urine is darker than usual and your poo is lighter.

Left-sided pain under rib

Gut problems

Stomach ulcers

Stomach ulcers are sores that occur on the lining of your stomach and they cause a burning pain in your abdomen, which can be felt under the left side and right side of your ribs.

Anyone can get a stomach ulcer, but they are most common in men over the age of 60. They are usually either caused by the Helicobacter pylori (H.pylori) bacteria or by taking non-steroidal anti-inflammatory (NSAIDs) for an extended period of time.

It takes around one to two months to recover from a stomach ulcer.

If you think you have a stomach ulcer, visit your doctor.

Seek immediate medical attention if you start vomiting blood, your poo is sticky and dark, or you have sudden and severe abdominal pain which gets increasingly worse.

More information

Find out more about stomach ulcers

Indigestion

Indigestion can feel extremely painful, and since the pain occurs in your chest and ribcage it can be worrying. But indigestion is not usually serious, and can be treated at home.

If you have indigestion you may experience:

heartburn
bloating
nausea
excessive wind
acid reflux

You can usually treat indigestion by:

reducing your intake of tea, coffee, cola, and alcohol
sleeping with your head and shoulders propped up
maintaining a healthy weight (check your BMI here)

You should visit your doctor if you experience:

persistent indigestion
severe pain
losing weight without trying
trouble swallowing
vomiting frequently
iron deficiency anaemia
the sensation of a lump in your stomach
blood in your vomit or stools

Or if you are over 55.

More information

Find out more about indigestion

Gastroenteritis

This is a gut infection, which can cause diarrhoea and vomiting. It can cause pain on the right and left side of your rib cage.

If you have mild gastroenteritis then you don’t need to visit a doctor, but seek medical advice if you experience:

dehydration
excessive vomiting
severe pain
persistent high temperatures
vomiting for more than 1-2 days
diarrhoea for more than 3-4 days
an infection that was obtained abroad
if you have a weakened immune system
if you are pregnant
if you are elderly or have an underlying health condition

More information

Find out more about gastroenteritis

Other gut problems that can sometimes cause pain under your ribs include:

diverticulitis
Crohn’s disease and ulcerative colitis
constipation
irritable bowel syndrome

Aorta problems

The aorta is the main blood vessel which goes from the heart down to the tummy. It can cause pain on the left side of your rib cage if it becomes swollen. This is known as an abdominal aortic aneurysm or AAA (pronounced triple-A).

Aortic aneurysms can be dangerous, and if they burst they can be life-threatening.

You’re more at risk of developing an AAA if you:

As well as rib pain, aortic aneurysms can cause:

a pulsing feeling in your tummy
persistent abdominal pain
lower back pain

You should get immediate medical help if you experience the symptoms of a burst AAA. These include:

severe pain in your tummy or lower back, which comes on suddenly
feeling dizzy
sweaty and pale skin
your heart beating faster than usual
feeling short of breath
passing out

Pancreatic problems

Your pancreas helps your gut digest food and regulate blood sugar. Sometimes your pancreas can become inflamed, causing pain in your upper left abdomen which can be felt under your ribs.

You may also experience:

Pancreatic problems can be caused by acute pancreatitis, chronic pancreatitis, or pancreatic cancer.

You should see a doctor if you experience sudden and severe abdominal pain. You should also see a doctor if:

your skin becomes yellow (jaundice)
you are persistently vomiting
you experience unexpected weight loss
you have back or stomach pain that is worse when you lie down or after eating
you have indigestion
you have a fever or are shivering
you experience changes in your bowel movements

Problems with your spleen

Your spleen is located under your lower left ribs. If it becomes enlarged, is damaged or it ruptures then you will experience pain under your left lower ribs.

Sometimes your spleen can become enlarged if you have an infection, such as glandular fever.

You should see your doctor if you have symptoms of glandular fever, such as:

a high temperature
an extremely sore throat
swollen glands
extreme fatigue
tonsillitis that isn’t improving

Your spleen can also be damaged during a sickle cell disease crisis, or if you experience trauma.

When to worry

If you have persistent pain on the left side of your rib cage you should visit a doctor. Seek emergency medical help if you experience:

difficulty breathing
mental confusion
sweating more than usual
lightheadedness or dizziness

Other causes of rib pain

Angina

Angina is a type of heart pain that is caused by narrowing of the arteries, which provide the heart muscle with blood.

At first it may only be noticeable when you exercise because the additional blood needed can’t pass through the narrow arteries. This can cause chest pain.

Heart attack

Severe chest pain is the most common and well-known symptom of a heart attack. It is caused by the coronary artery suddenly becoming blocked and so cutting off the heart’s blood supply.

Gastro-oesophageal reflux disease

Gastro-oesophageal reflux disease is an umbrella term for a number of different conditions, such as acid reflux heartburn, and oesophagus inflammation (oesophagitis).

This disease can cause chest pain.

Costochondritis

Costochondritis causes sharp and severe pain, which gets worse when you move, breathe deeply, or exercise.

It is caused by inflammation of the soft cartilage between the bony rib cage structure.

Strained chest wall muscle

Your rib cage is surrounded by lots of different muscles to enable it to move when you breath. Sometimes heavy lifting, stretching, or a sudden movement can strain one of these muscles which causes pain in the affected area.

Usually this time of rib cage pain is worse when you move or breath.

Anxiety

Anxiety is an extremely common cause of chest pain, sometimes so severe it is mistaken for heart disease.

Less common causes of rib pain

For more information on some of the less common causes of rib pain, click the links below:

90,000 How to treat ulcers in children? Where does it come from and 3 ways to cure

Peptic ulcer disease in children today is a frequent occurrence. Ulcers can appear in both a teenage child and a toddler. What is this disease and how to treat ulcers in children – about this in a new article.

What is a peptic ulcer?

Peptic ulcer is a violation of the integrity of the inner walls of the stomach or duodenum. Ulcers of various sizes affect these organs.They appear due to the negative effect of acids, digestive enzymes or bacteria on the stomach wall.

Physicians distinguish between stomach ulcers and duodenal ulcers. The disease can be diagnosed in both organs.

Why does peptic ulcer disease occur?

Until recently, doctors believed that the main causes of ulcers in children are stress and poor nutrition. Later studies showed that most ulcers develop due to infection with the bacterium Helicobacter pylori.Helicobacter pylori lives and multiplies in the stomach and other organs of the gastrointestinal tract. It can enter the body if a person drinks dirty water, washes fruits and vegetables poorly, or does not follow the rules of hygiene.

But don’t blame the ill-fated bacterium entirely. A combination of factors becomes the reasons for the development of ulcers in children. Experts divide them into two groups – external and internal.

External causes

the child’s food intake occurs at long intervals;
eats a lot of fast food;
There are a lot of fried, spicy, salty or smoked foods in the children’s diet.

Internal causes

hereditary predisposition to peptic ulcer disease;
there is stress and sleep disturbance;
, Helicobacter pylori infection was diagnosed;
the child’s stomach intensively produces gastric juice;
the stomach has impaired motility.

Internal causes of peptic ulcer disease are revealed after laboratory tests. Their patient can only be prescribed by a specialist doctor.

How to recognize a peptic ulcer in a child? 5 symptoms

To treat ulcers in children, it is necessary to accurately recognize the symptoms of this disease. It is important for parents to know that the main symptom of an ulcer is abdominal pain. This pain is very strong, burning and cutting, felt below the ribs to the right or left.

With a stomach ulcer, the pain increases with food intake. Therefore, children with this disease often lose weight by refusing to eat. A duodenal ulcer causes pain when the stomach is empty.These children rarely lose weight and may even gain weight.

Other symptoms of peptic ulcer disease include:

nausea, sometimes vomiting;
belching with a sour taste;

90,019 bloating

sleep disturbance.

Dangerous complications are due to illness. They are expressed in the form of internal bleeding, which is formed due to large ulcers. The child may vomit blood. In such cases, you should immediately seek medical attention.

How to treat ulcers in children?

Treatment of peptic ulcer disease in children is carried out in a complex – taking medications and strict adherence to the diet. Of course, the duration of treatment will depend on the symptoms, age and general condition of the baby. Severe and advanced cases are resolved only with surgery.

Drug therapy for peptic ulcer

The mandatory regimen for the treatment of stomach ulcers or duodenal ulcers includes medication.Usually, the doctor prescribes several types of drugs for the patient.

Antibiotics – kill bacteria;
Sedatives – sedatives;
Probiotics are medicines containing live bacteria and microorganisms.

Diet for peptic ulcer

An important point in the treatment of ulcers in children is diet. Doctors-gastroenterologists recommend excluding foods that can cause stomach irritation from the baby’s diet. These are spicy, salty, smoked and fried foods, fast food, carbonated drinks, snacks, sauces.Prepared food for the baby should be served neither too hot nor too cold.

Peptic ulcer disease in children is more complex than in adults. Therefore, a stricter diet is prescribed. A special diet must be adhered to for at least a week. After that (if there are no signs of illness, as well as with the permission of a doctor), steamed lean meat, dairy products, and grated fruits are gradually added to the children’s diet.

If the child’s condition improves, then after 2-3 weeks the patient is transferred to a standard dietary food required for peptic ulcer disease.

Sanatorium ulcer treatment

How to treat ulcers of children, they know in the sanatorium “Mashuk Aqua-Therm”. The health resort is located in a unique natural place – Caucasian Mineral Waters. Experienced specialist doctors, pediatricians and gastroenterologists will develop an individualized treatment program for your child. The basis is made up of mineral waters of suitable composition, physiotherapy, hydrotherapy and other procedures aimed at improving the child’s body.

90,000 8 body signals that can warn of stomach ulcers / AdMe

About 500,000 new cases of peptic ulcer disease are registered every day in the world.Stomach ulcer, fortunately, is treated, but if diagnosed late, it significantly impairs the quality of life. However, if you listen to the signals that the body gives, you can recognize peptic ulcer disease at an early stage and avoid serious health consequences.

Bright Side will tell you about the first signs of a stomach ulcer. Read and save!

1. Heartburn

Heartburn occurs in everyone, and often there is nothing serious behind it. But if you began to experience a burning sensation and pain behind the breastbone constantly, then you should worry, because regular heartburn is one of the main symptoms of the development of peptic ulcer disease.

2. Incessant thirst

Unquenchable thirst and dry mouth are a symptom of several diseases at once, including stomach ulcers. If you notice that you are drinking much more water than before, then it’s time to make an appointment with your doctor.

3. Attacks of sharp pain

Stomach problems are felt primarily by acute abdominal pain. Cuts in the lower abdomen or under the ribs are no longer a “bell”, but a whole “bell”, having heard which you should immediately undergo a medical examination.

4. Disorders of the intestines

It is also worth thinking about visiting the hospital if you suffer from frequent bloating and constipation: they signal a malfunction in the intestines, which, in turn, may be a consequence of the onset of peptic ulcer disease.

5. Feeling of heaviness after eating

An ulcer developing directly in the stomach makes itself felt with heaviness and painful sensations in the abdomen after each meal.If you notice similar symptoms in yourself, contact your gastroenterologist as soon as possible.

6. Pain on an “empty stomach”

Sometimes the feeling of hunger is accompanied by pain that subsides after eating – this has happened to everyone at least once. But when this happens regularly, it’s worth considering whether it’s time to take care of your own health.

7. Nausea

Another sign of a developing ulcer is nausea. If you feel nauseous for several days without any reason, and even more so if nausea is followed by vomiting, do not hesitate – go to the hospital.

8. Weight loss

If you suddenly lost weight in a short time, do not rush to rejoice. It is better to get tested, because sudden weight loss is a bad signal and may mean just a stomach ulcer.

We wish none of these symptoms bother you. Be healthy!

90,000 Stomach and duodenal ulcer

Stomach and duodenal ulcer – symptoms, treatment

Peptic ulcer of the stomach and duodenum is a chronic disease associated with the appearance of an ulcer on the mucous membrane of the stomach or duodenum.

Ulcers appear for various reasons. Here the provoking factor is nervous stress and seasonality (spring-autumn). An important basis for the appearance of an ulcer is a bacterium (compilor-bacterpylori), for which the author of this bacterium was awarded the Nobel Prize. Until 10 years ago, surgeons often operated on peptic ulcer disease, now it has become a rarity, thanks to good new methods of conservative treatment to suppress this stomach bacteria.

Peptic ulcer complaints are very diverse and an accurate diagnosis can be made only after gastroscopy.

pain in the “spoon” after eating, “hungry” pains, pains can occur immediately after eating, or begin in 40 minutes.
heartburn
nausea, sometimes vomiting
night pain
seasonal pain in the epigastrium “under the spoon”
pain can radiate under the scapula, left or right hypochondrium.
a terrible symptom – vomiting of blood or “tarry” stools – a sign of a bleeding ulcer. Here you can not hesitate, you need to urgently call an ambulance and to the surgical hospital on duty.

Bleeding is the most dangerous symptom, if not treated urgently ends in death.

Currently, gastric and duodenal ulcers are very well treated. If pain in the upper abdomen appears, it is necessary to perform a study of the stomach (gastroscopy) with taking a smear on a bacterial compiler, come to a gastroenterologist or therapist and you will be prescribed treatment.

If peptic ulcer disease is not treated or self-medicate, the following complications may occur:

Narrowing of the stomach – surgical treatment required
Penetration – germination of an ulcer into the pancreas with the development of pancreatitis
Perforation of the ulcer – the ulcer bursts and the gastric contents enter the abdominal cavity and an urgent operation is required otherwise death
Rebirth into cancer – surgical treatment

When the above complaints appear, you need to contact our center as planned, perform a gastroscopy and visit the attending doctor (gastroenterologist, therapist) and the problems will be resolved.Do not self-medicate.

GAUZ “Yelabuga Central District Hospital”

ULCER DISEASE

ULCER DISEASE – a chronic recurrent disease, the main symptom of which is the formation of a defect (ulcer) in the wall of the stomach or duodenum.

Duodenal ulcers are much more common than stomach ulcers. The predominance of duodenal localization of ulcers is most typical for young people and especially for men.The most susceptible to peptic ulcer disease are people whose work is associated with neuropsychic stress, especially in combination with irregular meals (for example, drivers of vehicles).

Many factors play a role in the onset of the disease, including disturbances in the regime and nature of nutrition (for example, systematic consumption of spicy and rough food, hasty food and dry food, long breaks between meals), smoking, abuse of alcoholic beverages, strong coffee, psycho-emotional overload (insufficient rest and sleep, irregular working hours, stressful situations), physical overstrain.An important place is given to hereditary and constitutional factors. Long-term use of drugs that adversely affect the mucous membrane of the stomach and duodenum (acetylsalicylic acid, glucoorgicoids, reserpine, caffeine, etc.) can provoke the development of peptic ulcer disease. It is believed that an important role in the development of peptic ulcer disease and its recurrent course is played by Helicobacter pylori, which parasitizes the gastric mucosa and increases its sensitivity to the effects of gastric acid hydrochloric acid.

Peptic ulcer disease is based on an imbalance between the aggressive properties of gastric contents and the protective capabilities of the mucous membrane of the stomach and duodenum. The reasons for the increase in acid-peptic aggression may be an increase in the secretion of hydrochloric acid and a violation of the motility of the gastrointestinal tract, leading to a prolonged delay of acidic contents in the outlet of the stomach, too rapid its entry into the duodenal bulb, duodenogastric reflux of bile.The weakening of the protective properties of the mucous membrane can occur with a decrease in the production of gastric mucus and a deterioration in its qualitative composition, inhibition of the production of hydrocarbons that are part of the gastric and pancreatic juice, impaired regeneration of epithelial cells of the gastric mucosa and duodenum, a decrease in the content of prostaglandins in it, a decrease in regional blood flow …

Clinical presentation and course. The leading symptom of peptic ulcer disease is pain that occurs more often in the epigastric region to the left of the midline (with ulcers of the body of the stomach) or to the right of it (with ulcers in the pyloric canal and duodenal bulb), often radiating to the left half of the chest, the xiphoid region sternum, thoracic or lumbar spine.Pain is usually clearly associated with food intake. So, with ulcers of the body of the stomach, they appear, as a rule, 30 – 60 minutes after eating (early pain), with ulcers of the pyloric canal and duodenal bulb – after 2-3 hours (late pain), as well as on an empty stomach (“hungry pain “). Close to the mechanism of occurrence of “hungry” pains are night pains (usually occur in the period from 11 pm to 3 am), which are observed more often when the ulcer is localized in the duodenum. The pains are usually relieved by antacids, antispasmodics, with the action of heat, late and “hungry” pains also stop after eating, especially milk.

A typical symptom of peptic ulcer disease is vomiting of acidic gastric contents, which occurs at the height of pain and brings relief, and therefore patients sometimes cause it artificially. Other dyspeptic disorders (heartburn, nausea, belching, constipation) are often noted. Despite a good, and sometimes even increased appetite, weight loss may be noted due to the fact that patients often limit themselves to food, fearing the onset or intensification of pain. On the other hand, asymptomatic forms of peptic ulcer disease are often found; in such patients, the disease is discovered by chance or its first clinical manifestations are complications, which is especially typical for young and old people.

Peptic ulcer disease usually proceeds with alternation of exacerbations and remissions. Exacerbations are often seasonal, occurring mainly in spring and autumn; their duration is from 3 – 4 to 6 – 8 weeks or more. Remissions can last from several months to several years.

However, with a prophylactic purpose, many factors can be avoided, which means that such a serious ailment as peptic ulcer and 12 duodenal ulcer can be avoided. To do this, you must comply with the listed requirements:

– sleep 6 – 8 hours;

– give up fatty, smoked, fried foods;

– during stomach pains, it is necessary to be examined and eat food 5 – 6 times a day, pureed, easily digestible: cereals, jelly, steam cutlets, sea fish, vegetables, omelet;

– to treat aching teeth so that food can be chewed well;

– avoid scandals, since after nervous overstrain, stomach pains intensify;

– do not eat very hot or very cold food, as this can contribute to the occurrence of esophageal cancer;

– no smoking;

– do not abuse alcohol.

– It must be remembered that gastric ulcer is not only local damage to the stomach. This is a painful disease of the whole organism, which is easier to prevent than to adapt to it and treat it all your life

90,000 Affects the stomach and liver. How Coronavirus Affects the Digestive Organs | HEALTH: Medicine | HEALTH

The stomach and intestines are often gateways for the coronavirus. The infection enters the body, clinging to the epithelial cells of the mucous organs of the respiratory, digestive systems, and from there – into the bloodstream and further through the body.For the stomach and intestines, such a meeting does not pass without a trace, with what consequences of the coronavirus people who have undergone covid face, – in the material “AiF-Tyumen” .

Double impact

In some patients, the first signs of covid are not sore throat and cough, but nausea and gastrointestinal upset. Symptoms are similar to rotavirus and can be easily confused, but this is how the coronavirus also begins. Getting into the body through the gastrointestinal tract, the infection causes inflammation – gastritis, enteritis.Chronic diseases, such as cholecystitis, pancreatitis, may worsen.

“In addition to the coronavirus itself, the treatment of covid also seriously affects the organs of the gastrointestinal tract. Antibiotics, antiviral and hormonal drugs exert a great strain on the gastrointestinal tract, – says Maria Lyapina, a gastroenterologist at the Tyumen Cardiological Research Center, . – As a result, drug hepatitis, dysbiosis, diarrhea develop, patients complain of pain in the right side. And if someone has already had problems with the digestive system, then exacerbations occur. “

Recovery from coronavirus must be supervised by a physician. It is very important to protect the stomach and intestines from the load and exclude for a while too hot or cold food, as well as spicy and salty. Fatty and fried will make the liver and pancreas work hard, which also need rest after the illness suffered by the body. Sometimes doctors recommend avoiding dairy products and fiber, which cause fermentation in the intestines.

Good or Bad?

After taking any antibiotics, doctors recommend taking care of the intestines and restoring the beneficial microflora.But taking good bacteria at random is not a good idea. Without the competent appointment of a specialist, you can make things worse, because first you need to find out what bacteria in the intestines are missing. Perhaps conditionally pathogenic people live there, they will be happy with food – prebiotics, fibers, acids, which they feed on and from which they grow. And if you “add” probiotics – beneficial bacteria, when the intestines are ruled by conditionally harmful ones, it will be useless. Conditionally pathogenic simply will not leave them a chance for life.

“Dysbacteriosis is a rather complex condition, sometimes it is necessary to extinguish the growth of pathogenic microflora with the help of special preparations and only then to populate the beneficial microflora.As long as there is a large growth of bad bacteria, intake of good bacteria is not effective, ”explains Maria Lyapina.

Symptoms of dysbiosis – abdominal pain, bloating, rumbling. At this moment, undigested food ferments in the intestines and sours to the delight of pathogenic bacteria. Often, dysbiosis is formed against the background of pathologies of the pancreas and liver due to a deficiency of enzymes.

Due to intestinal problems, the absorption of nutrients and vitamins is impaired. And this can cause dry skin, hair loss, bleeding gums.

What does the plaque on the tongue say?

Say “ah-ah” and stick out your tongue may be asked not only to examine a sore throat, but also in order to understand what is happening with the gastrointestinal tract. The color, shape, presence or absence of plaque on this organ can tell a lot.

Photo: pixabay.com

Wet or dry. In a healthy person, the tongue should be moist, dry – indicates dehydration of the body.

Plaque on the tongue can be of different colors.

White, thick, cheesy – indicates the presence of candidiasis.

Just white – about inflammation in the stomach, small intestine and can be a symptom of gastritis, duadenitis, stomach ulcer.

Yellow, green, brown – pathologies of the biliary system: liver, gallbladder, disorders with bile secretion.

Gray or black – it happens with intestinal oncology.

Normally, there should be no plaque in the language.

Teeth prints on the lateral surfaces of the tongue are symptoms of inflammatory diseases in the gastrointestinal tract.

The papillae located on the surface of the tongue can also tell a lot. If they are not on the entire surface, this indicates their atrophy. Most likely, the same changes will be in the stomach or in the duodenum.

90,000 Does your lower back hurt? Do not postpone your visit to the doctor – FSBI “NMITs TPM” of the Ministry of Health of Russia

Usually, back pain is associated with the words “sciatica” or “osteochondrosis”. Indeed, these diseases lead to pain syndrome, but they are by no means the main ones.The head of the neurological department of the Federal State Budgetary Institution “National Medical Research Center of Preventive Medicine” of the Ministry of Health of Russia, Ph.D. Sofia Gennadievna Zhdanova.

In more than 50% of cases, the cause of pain is problems with the muscles and ligaments surrounding the spine, such pains are usually moderate, aching or pulling in nature, aggravated by movements that put a load on the diseased muscle. The predisposing moments for the appearance of such pains are hypothermia, unusual physical activity, sedentary work, poor posture, scoliosis.

BACK OR …

Of course, you can treat your back with home remedies, but it’s still better to consult a specialist. First of all, to a neurologist. But it is worth remembering that often pain occurs in connection with various lesions of the internal organs located at the level of the sacrum and lower back.

Diseases of the urinary system (cystitis, pyelonephritis, and especially urolithiasis) are most often manifested by pain in the lower back. Moreover, the pain can be so acute that you hurry to call an ambulance without our recommendations.

People with gastric ulcer and duodenal ulcer in 75% of cases are concerned about pain in the lumbar region. Another disease of the gastrointestinal tract that can cause back pain is acute pancreatitis. The pain is girdle in nature, localized in the area of the right or left hypochondrium, radiating to the back.

Sometimes back pain radiating to the lower back appears in acute appendicitis. This is mainly the case when the appendix (appendix) is located behind the cecum.Of course, this is just one of the complaints, and the main symptoms are fever, irritation of the peritoneum, and upset stools.

In diseases of the female genital organs, along with pain in the lower abdomen, pain in the sacro-lumbar spine may occur. Moreover, it can bother you periodically during menstruation, during sexual intercourse, or be prolonged and become chronic.

In most cases with low back pain, it makes sense to do an ultrasound of the pelvic organs.For example, painful sensations can be provoked by masses of the ovaries located behind the uterus.

In uterine myoma, the nature and place of pain depend on the location of the node in the uterus, its size, and are caused by stretching of the peritoneum, compression of the nerve plexuses of the small pelvis. Often, severe and prolonged pain in uterine fibroids is associated with its rapid growth.

However, acute pain may indicate a violation of the blood supply to the myomatous node and requires emergency medical attention.

In endometriosis, pain occurs as a result of inflammation, adhesions and tissue fibrosis during the growth of endometrioid foci.

With the prolapse of the internal genital organs, the patients are worried about the pulling pain in the lumbosacral region, which increases with walking, physical exertion and lifting weights. The mechanism of pain in this pathology is associated with a violation of the anatomical location of the pelvic organs, which leads to a violation of the venous and lymphatic outflow .

Thus, there are a large number of reasons for the occurrence of back pain.