Q. I have on and off sharp pain in my chest. Is it an ulcer or my gastritis that is flaring up?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 14, 2022

Hello doctor,

For the past few weeks, I have had on and off sharp pain on the left side of my chest below my left nipple and just below the bottom left ribs. My doctor advised an ECG, which did not show any heart-related complications, and I have been diagnosed with GERD and mild gastritis. The pain is getting sharper; some days, I do not notice it, but it is very intense on other days. Other symptoms are burping more than usual and diarrhea at times. I am taking tablet Nexium 40 mg daily. Could this be an ulcer or just a flare-up of gastritis? And how should I treat it?

Please help.



Welcome to

I have read your query and can understand your concern. The symptoms you mention seem to be gas-related due to stomach fullness.

GERD (Gastroesophageal reflux disease) has different symptoms, the main symptoms being acid reflux (stomach acids coming up to the esophagus frequently) with burning in the chest and throat.

Usually, the on and off pain that you have noticed might occur after taking meals, like within three to four hours of meal intake, and decreases in intensity after burping.

I suggest you take the following medicines for it and see if it helps. If not, you will require some tests to confirm the diagnosis.

1) Tablet Rifaximin 200 mg thrice daily.

2) Tablet Itopride 50 mg thrice daily half an hour before meals.

3) Tablet Vonoprazan 20 mg once daily.

Take all these tablets for two weeks and avoid foods that trigger gas, such as potatoes, chickpeas, raw salads, milk, and beef; avoid fresh fruit juices, and instead have whole fruits.

I hope this helps.

To revert after two weeks.

Hello doctor,

Thank you for the reply.

Also, does it seem like something else and not an ulcer, as per your opinion?



Welcome back to

Yes, you are right. It does not seem like an ulcer to me, as it would have resolved entirely with tablet Nexium (Esomeprazole Magnesium Trihydrate) 40 mg if it were an ulcer. I suspect it to be gas that appears as pain. Take the prescribed medications and see if they improve your symptoms; then, the diagnosis can be made retrospectively.

Revert in case of further queries.

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