Pain under the inside of my Rib Cage

   Hello all;
     I have been having severe pain for approximately 1year now with my stomach.I am 22year old female.  The doctors said it was Acid Reflux or GERD. I was prescribed Nexium 40mg, has not worked even up'd the dose. Prilosec 25mg up'd the dose of that too, and Previcid 25mg with a up'd dose (all Okay'd by doctor & my mom who is a RN). I have had the H Pylori (spelling sorry) test done for ulcers and come back negative also have had my gallbladder checked for any stones or inflammation all normal. This month I have been keeping track of what I eat thinking perhaps I am Lactose..but no doesn't seem to be true. There is no pain going up my sternum into my throat only under my breasts under the rib cage and across it into my back even. At time the pain is so severe that my chest and neck and stomach will break out in red blotches and I have to curl over in pain. Apparently the Doctors think it is just GERD/Acid Reflux...the ONLY thing I have found to help my pain is by Drinking ORANGE JUICE! I do not understand, my doctor does not know what else it could be except keep switching medications on me to see if something works and I am getting tired of all the failures. Does anyone with medical knowledge or similar experiences know what this could be if it does not have to do with GERD/Reflux???

   Thank you very very much!

[Ratnakar Kini, MD]

Hi,
If it is GERD then you would get relief with PPI.
Lifestyle modifications are also important.
If there is no relief in spite of medications and lifestyle modifications, then evaluation has to be done with 24 hours pH monitoring test and esophageal manometry.
Sometimes it could be due to bile reflux which can be confirmed with upper GI endoscopy and Bilitec test. The treatment for bile reflux is different from acid reflux.