What could be the cause of pain in the lower abdomen?

Question

Hi doctor,

I have had a migraine for the past three days and have difficulty breathing. I also have severe pain in the lower abdomen and under the chest bone area. On consulting a doctor, it was said that it was a pulled-back muscle in the lower abdomen, and he gave me a tablet of Naproxen 500 mg. The symptoms started four days ago. Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Cardiac and gastric symptoms often mimic each other. Sometimes recurrent heartburn can be a sign of stable angina and can lead to myocardial infarction. So some tests should be done to rule out the possibility of coronary artery disease. I suggest you do the following tests:

1. A stress test is to check if the blood supply to the coronary artery is normal while exercising. Ischemia is reflected as changes in the ST and T waves in an ECG (electrocardiogram).

2. 2-D (two-dimensional) echocardiography is done to rule out any abnormality in movements of the heart walls or any leakage in the valves. It can also be used to calculate the left ventricular ejection fraction. Angina compromises the blood supply and is shown as an abnormality in the regional wall motion.

These two tests are 85 percent sensitive and can rule out the cardiac causes of chest pain. I also suggest you do the following:

1. Fasting and postprandial blood sugar.

2. Lipid profile.

If these tests are found to be normal, gastritis and heartburn are the diagnosis of exclusion, and treatment can be given accordingly. You have mentioned taking the tablet Famotidine 20 mg. It is a very weak drug. I suggest you take the tablet Pantoprazole 20 mg. Consult a doctor and take the medicine accordingly.

I hope this information will help you. Please revert in case of further queries.

Thank you.