Burping, stomach soreness

Hope you can help.. I sometimes have involunatary burping and a feeling of pressure/soreness in my middleupper stomach just below breastbone. There is no pain just a pressure that sometimes wraps around the chest and back on either side.Feels like hands wrapped around my midsection and squeezing.This pressure seems to move around. Sometimes on the left or right. It leaves as fast as it comes and is intermittant all day. I have stomach grumbling, little bit of gas, bloating which may go down a little further. This is all on the mild side, no severe pain. It is just noticeable enough to cause a little discomfort.It could last a few minutes or be there all day. It always seems to go away at night. This all seemed to start with anxiety problems. My doctor told me it could be "GERD" Protonix did not seem to calm it although, I do not feel the exact symptoms everyday. It seems to come and go. Does gerd act like this? I went to see a Gastro doctor and he suggested at first to go on the Protonix again, but it did not completely disappear. He than decided to put me on Elavil because this all seemed to start with anxiety about 8 months ago. I still have the symptoms, but a calmer version of it. I was wondering if this sounds like something other than an acid problem. Eating does not seem to bother me. This starts in the morning with only coffee which makes my stomach grumble. I do not have the classic heartburn symptoms. No acid taste either. I had blood tests and tested for H-Pylori-Negative so far. Dr. wanted me to see him in a couple of month's.

[Kevin Pho, MD]

Hello - thanks for asking your question.

What you are describing may be referred to as dyspepsia.  Dyspepsia is defined as pain or discomfort centered in the upper abdomen (mainly in or around the midline as opposed to the right or left hypochondrium). Discomfort is a negative feeling that the patient does not interpret as pain, which can be characterized by or associated with fullness, early satiety, bloating, or nausea. Dyspepsia can be intermittent or continuous, and may or may not be related to meals.

There are many of causes other than heartburn or H Pylori gastritis.  This can include functional dyspepsia (non-ulcer dyspepsia), peptic ulcer disease, GERD, gastric or esophageal ulcer, biliary tract disease, gastroparesis, pancreatitis, malabsorption, medications (i.e. NSAIDs, potassium supplements, digitalis, oral antibiotics), or metabolic disturbances to name a few.

It seems you have undergone empiric antisecretory therapy (protonix) and H Pylori testing.  A reasonable next step would be a gastroscopy to evaluate for any other causes that can cause dyspepsia (i.e. ulcers).

I strongly suggest followup with your personal gastroenterologist.

I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[surgeon]

gallbladder disease is a possibility.

[karrie2020]

ALWAYS HAVE YOUR DR.  RULE OUT HEPATITIS A, AND H.PYLORI...Bacteria!!!!!!!!!!!!!!!!!!!!!!!!!!!!