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Gastroenterology (Expert Forum)
Hiatal Hernia & GERD Or Something Else?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Hiatal Hernia & GERD Or Something Else?
by Dawn67, May 09, 2007 12:00AM
First off, thank you so much for taking the time to answer my questions.
I am a 39 year old female. Former pack a day smoker for 20 years(quit in Jan 2007). I was diagnosed with a hiatal hernia 10 years ago from a barium x-ray.
The end of January I began having rib pain on my right side. It moved around and was sore to the touch and at times was stabbing. Went to my doctor and he took a chest x-ray and blood work which was all clear. Diagnosed me with Costochondritis, prescribed steroids and it went away.
Two weeks ago, I started having severe chest pains in the middle of my chest. My upper back and chest burned. I went to my doctor and he said my hiatal hernia was acting up and I had GERD. Took another chest x-ray which was clear. Gave me a Nexium which I took and since have been taking Prilosec OTC.
A week ago I started having stabbing pains behind my right shoulder blade towards the front of my chest. constant. My ribs are sore again, mainly on the right side and back, sometimes in the front with occasional stabbing. These pains are not constant. Also, I awake every morning and I have yellow, runny stools. My GERD has let up but I still have chest pressure and pains in the middle and the upper body burning sensation mainly after activity. When I bend over my chest hurts worse and I feel like there is a lump in my chest when I swallow. Sometimes it feels like my right breast area is being squeezed.
My questions:
1) I am scared to death of lung cancer. After two x-rays in three months if that is what was wrong would it have shown up?
2) Is all of this upper body pain really caused by GERD and a hiatal hernia? It's so hard for me to believe acid indigestion can wreak such havoc on the body.
3) Does Costochondritis ever go away?
I am uninsured right now. I will not have insurance again for 60 days. I need some peace of mind. I cry everyday because of the pain and the fear that something is really wrong(like lung cancer) and that I am dying.
I am a 39 year old female. Former pack a day smoker for 20 years(quit in Jan 2007). I was diagnosed with a hiatal hernia 10 years ago from a barium x-ray.
The end of January I began having rib pain on my right side. It moved around and was sore to the touch and at times was stabbing. Went to my doctor and he took a chest x-ray and blood work which was all clear. Diagnosed me with Costochondritis, prescribed steroids and it went away.
Two weeks ago, I started having severe chest pains in the middle of my chest. My upper back and chest burned. I went to my doctor and he said my hiatal hernia was acting up and I had GERD. Took another chest x-ray which was clear. Gave me a Nexium which I took and since have been taking Prilosec OTC.
A week ago I started having stabbing pains behind my right shoulder blade towards the front of my chest. constant. My ribs are sore again, mainly on the right side and back, sometimes in the front with occasional stabbing. These pains are not constant. Also, I awake every morning and I have yellow, runny stools. My GERD has let up but I still have chest pressure and pains in the middle and the upper body burning sensation mainly after activity. When I bend over my chest hurts worse and I feel like there is a lump in my chest when I swallow. Sometimes it feels like my right breast area is being squeezed.
My questions:
1) I am scared to death of lung cancer. After two x-rays in three months if that is what was wrong would it have shown up?
2) Is all of this upper body pain really caused by GERD and a hiatal hernia? It's so hard for me to believe acid indigestion can wreak such havoc on the body.
3) Does Costochondritis ever go away?
I am uninsured right now. I will not have insurance again for 60 days. I need some peace of mind. I cry everyday because of the pain and the fear that something is really wrong(like lung cancer) and that I am dying.
Doctor's Answer
by Kevin Pho, MD, May 10, 2007 12:00AM
, May 10, 2007 12:00AM
To answer your questions:
1) If lung cancer is a concern, a CT scan can be considered to rule this out.
2) GERD is certainly possible. An upper endoscopy would be the next step for more comprehensive imaging. A 24-hr pH study can also be considered to evaluate the severity of GERD. I would also consider an abdominal ultrasound. A colonoscopy can also be discussed if there are bowel movement changes.
3) Costochondritis can be treated with appropriate physical therapy or a physiatry referral. If the pain continues, you can consider a referral to a pain management center.
Followup with your physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
1) If lung cancer is a concern, a CT scan can be considered to rule this out.
2) GERD is certainly possible. An upper endoscopy would be the next step for more comprehensive imaging. A 24-hr pH study can also be considered to evaluate the severity of GERD. I would also consider an abdominal ultrasound. A colonoscopy can also be discussed if there are bowel movement changes.
3) Costochondritis can be treated with appropriate physical therapy or a physiatry referral. If the pain continues, you can consider a referral to a pain management center.
Followup with your physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Thank you