GERD or ulcer?

[02SmithA]

I have had GERD and a hiatal hernia for a long period of time. I am currently having a big flare up of some kind which seems a little different. Normally my pain is in the breastbone area, now I am having pain in the upper abdominal area between the chest and the navel. What are the differences in the symptoms of an ulcer and GERD? I continue to have a lot of belching and indigestion constantly as I do with GERD, but the different area for pain had me wondering if this could be an ulcer. Thanks.

[Ratnakar Kini]

Hi 02SmithA,

There are two types of ulcer - gastric and duodenal. Duodenal is more common.
Duodenal ulcer causes pain in the epigastric area ( the area you have mentioned). The pain is relieved by food. Pain usually disturbs sleep and you wake up in the middle of the night because of pain (though not in all cases).

GERD produces heart burn, excessive salivation,chest discomfort, which are worsened by bending down, by alcohol, smoking, after meals and uncommon symptoms like asthma, sore throat, stickiness in throat, cough, dental erosions.

An upper GI endoscopy is done to diagnose ulcer.
24 hours pH monitoring is done to diagnose GERD.
================================================================

The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.
- Ratnakar Kini M.D.

[Ratnakar Kini]

Hi 02SmithA,
Hiatus hernia can cause discomfort in the upper abdominal area.

Barium xray will nicely show hiatus hernia. But for ulcer though barium can show, endoscopy is the best method to diagnose it.
================================================================
The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.
- Ratnakar Kini M.D.

[02SmithA]

Thank you for the answer Dr. Kini. My pain is not relieved by eating. When I eat I get very bloated and have a lot of belching. My pain is worsened when sitting or laying down as compared to standing up. Is it possible to have hiatal hernia or GERD cause pain in the upper abdominal area and it not be associated with an ulcer or does this area typically mean there is an ulcer present? Also, does a barium xray test show hiatal hernias and ulcers? Thanks.