Treatment For Constipation, Ulcer, And Spot On Pancreas?

Posted on Fri, 14 Feb 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 14 Feb 2014 Answered on

Sun, 9 Mar 2014 Last reviewed on

Question : I have been having pain underneath my right breastbone on and off for 3 months. It started after I had an asthma attack and was on Prednisone. I have also been suffering on and off from constipation. I have been to my gastric surgeon --had a Roux en Y in Dec 2011-- and my PCP several times. Initially, they ruled it muscular because my stomach didn't hurt. Went to ER two weeks ago in immense pain. Another CT scan --along with blood work and a urine sample-- came back negative; however, they said there was a spot on my pancreas. Blood work did not show irregularities in that area. I'm currently being treated for an ulcer (Kerfate, Omeprazole and Rantinidine) and am scheduled for a endoscopy on Tuesday. Having problem with constipation again. What are your thoughts, doctor? Thank you.

Answered by Dr. Dr.Raju.A.T (4 hours later)

Brief Answer: referred pain due to the ulcer Detailed Answer: Hi, Thanks for your query. Sorry for the delay in answering. I am Dr Raju an associate in Department of Gastroenterology, working with an experienced Gastroenterologist. I answer on his behalf. Pain under the right breast bone can be due to defects in liver, gallbladder or stomach if the pain is deep and dull. In case of sharp and superficial pain the cause could be musculoskeletal. Problems in pancreas usually presents with pain in the back rather than under the breastbone. Hence, evaluation of the stomach, liver and gall bladder would be essential. Since you have got the CT scan done I believe liver and gallbladder pathology are ruled out. Now, the focus of the pain could be considered to be due to the ulcer in the stomach. I would wait for the endoscopy report. Once you get the report please do inform me the same. I shall discuss further management based on the finding so of endoscopy. Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Raju.A.T (4 minutes later)

I have had pain in my lower back and buttocks, as well as under my R breastbone. I have pain/soreness in both areas at different times. I had my gallbladder removed in 12/01. Does this provide you with more information? Are there any foods I can avoid within the next few days? I seemed to be better with the Carafate, Omeprazole and Rantindine. Would you kindly recommend what I should and/or should not eat and drink to help improve my condition? Thank you for your help, Dr. Raju!

Answered by Dr. Dr.Raju.A.T (26 minutes later)

Brief Answer: Can continue Omeprazole Detailed Answer: Hi, Thanks for the information. The lower back and buttock pain you get could be purely musculoskeletal. Pancreatic pain usually is seen in the upper back radiating to the front. Also the pain is seen more, soon after a high carbohydrate or high fat diet. If Omeprazole is comforting you, I would consider taking it for few more days would solve the issue completely. Diet restrictions play a vital role in treating your suspected condition. Low fat, spice free and faulty food timings should be avoided. Spice and oil are known to stimulate the enzymes and chemical mediators which increase the acid output which is the base cause for the pain. Hence, avoiding the above foods will surely help to heal the ulcers and its effects. Wish you good health. regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Raju.A.T (40 hours later)

Dr. XXXXXXX Thank you, again. One last thing before we conclude. . .Do you think it is possible that I have pancreatitis? I still am having pain underneath my R breastbone (somewhat better) but it radiates to my lower back and buttocks. This does hurt and has been happening on and off for 2 months. For several months, I was drinking 5 Hour Energy shots because my iron was low. (The doctor knows this.) Might this have contributed to my problem? Again, my endoscopy is Tuesday. What should I say to my doctor AND how is pancreatitis treated? Thank you so much for your help. XXXX

Answered by Dr. Dr.Raju.A.T (1 hour later)

Brief Answer: can't be pancreatitis Detailed Answer: Hi, I do not think you have pancreatitis.The energy shots may not contribute to such an complication. get the endoscopy as routine. Pancreatitis is treated with a course of antibiotics and strict restriction of carbohydrate and fat foods. regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Raju.A.T (1 minute later)

But can an ulcer cause pain underneath my R breastbone AND pain in my back/buttocks?

Answered by Dr. Dr.Raju.A.T (1 hour later)

Brief Answer: Pain is chest Detailed Answer: Hi, Ulcer can cause pain in the chest under the breast bone but the pain in the buttock and lower back is entirely different. It can be caused by musculoskeletal problems. Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar