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Hunger pangs, back ache

A couple times in the last few weeks I've had hunger pangs, progressing into ache under my right ribs and progressing to a pain in my back below right shoulder blade.  My doctor suggested I take prilosec,and this has helped a little, but I still often feel a hunger pang like sensation or mild ache under my right ribs.

This was especially bad one day when I skipped breakfast and ate a late lunch.  Doesn't seem to happen after I eat, so I don't think it is gall bladder, but I don't know for sure.

I'm not really noticing what I would call heartburn or a feeling of bringing up stomach acid.  Could this still be GERD?  Am I developing a peptic ulcer maybe?
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1760304 tn?1316457159
Dear DPM111,

Thanks for writing in.

Hunger prangs with pain in the right upper quadrant especially with delayed meals is classical of acid peptic disease - ulcer or gastritis. Not all people have heartburn or epigastric pain.

However, pain below the shoulder blade is rare in acid peptic disease but is classical of gallstone disease. But symptoms of gallstone disease are classically seen after a meal.

It is difficult to differentiate clinically which of the two is the cause of the problem  I would suggest you to get an endoscopy and ultrasound abdomen to clarify the issue.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Poorna Chandra
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