Why does my mom repeatedly have pain under the breastbone?

Q. What can be the reason for my mom's repeated pain under breastbone?

Answered by
Dr. Sadaf Mustafa
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 12, 2016 and last reviewed on: Jul 31, 2023

Hello doctor,

My mom is 63 years of age. She is getting pain under her right breastbone followed by acid reflux and burning in her stomach with a sour taste in her mouth. They did an ultrasound, which showed three gallstones. She had her gallbladder removed three months ago. Now, she is getting the same symptoms again and taking Omeprazole twice a day. But, it does not seem to be helping. Everything she eats turns to acid. She went to the ER last week and did a CBC, chest x-ray and ultrasound, which came back normal. Now, she has an appointment with gastroenterologist. She has a history of GERD and asthma. Please let me know your opinion doctor.



Welcome to icliniq.com. The initial presentation of your mom was consistent with dyspepsia and I am not surprised that her symptoms are back. The issue that needs further investigation is the fact that she is not responding to the conventional therapy with Omeprazole. To better understand the situation, I have a few questions for you. Could you please share the dosage of Omeprazole she is taking and how she is taking it, whether with food or before food? Additionally, has she ever been tested for Helicobacter pylori infection, as this can be a potential cause of treatment resistance? Also, does she use Ibuprofen, Aleve (Naproxen), or any other pain medication, and if so, how often does she take them? Gathering this information will help in evaluating her condition more comprehensively and guide further recommendations.

Thank you doctor,

I would also like to note that the pain under her breast bone radiates towards her right shoulder blade and her sugar was slightly elevated to 6.5. She is on Omeprazole 20 mg in the morning and 20 mg at night. Sometimes, she will take her medication with food. She takes Advil occasionally. She is also not sure if she got tested for H.pylori. What could this be?



Welcome back to icliniq.com. My few suggestions are here. To improve her condition, it's essential for her to completely avoid Advil (Ibuprofen) and other NSAIDs (nonsteroidal anti-inflammatory drugs). Instead, she can use Tylenol for pain, but not exceeding 1 g twice daily. For optimal effectiveness, she should take Omeprazole 40 mg 45 minutes before meals and avoid consuming sweet and spicy foods. Considering her symptoms and treatment resistance, I recommend an upper GI endoscopy to investigate and rule out conditions like ulcers, gastritis, and Helicobacter pylori infection. Additionally, please let me know the medications she is taking for managing her sugar levels, and if possible, share her liver and kidney function test reports, as they could provide valuable insights into her overall health.

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