Breathlessness with muscle pull in abdomen during flight.

Resolved question:
Dear Doctor,

In January of this year I took a long haul flight (13 hours). In the last hour of the flight I was sitting scrunched up (leaning my head on a pulled down tray table) and experienced what felt like a muscle pull in my abdomen. This was a sharp and unpleasant sensation, which was relieved somewhat by standing up and straightening out my abdomen. The exact same thing happened about 3 weeks later whilst I was doing push ups at the gym.

Fearing an abdominal hernia, and went to a doctor and ended up getting a CT scan – no hernia was detected.

Meanwhile, since this time (about 3 months now), I’ve been feeling a general discomfort in my abdomen when sitting (I have a desk job), which is generally relieved by standing or lying down. In the past couple of months, I’ve also started getting a much more upleasant tightening sensation around my solar plexus, and this has been getting worse to include a feeling of breathlessness. Also, any pressure my abdomen increases this sense of breathlessness. This means I have had to stop doing all sport.

All this is a bit worrying for the following reasons:

- I am 27 (male)
- Generally healthy
- Drink very little alcohol (1 drink a month, max), don’t smoke, don’t drink coffee

Symptoms are worse if I have a heavy meal.

Any ideas about what is going on, and how best to treat?

Thank you.

Submitted: 4 Days
Category: Gastroenterologist, Medical

Expert:  Dr. Ratnakar Kini replied 4 Days.

Hello,
Thanks for posting your query at DoctorSpring.com
I am Dr.R.K and I am pleased to assist you.
There are three possibilities - Muscular pain, peptic ulcer disease and pancreatitis.
Since CT scan of the abdomen was normal, pancreatitis is ruled out. Since it worsens after taking food, muscle pain is also less likely. So the most likely cause is peptic ulcer disease.
An upper GI endoscopy may be done for confirmation.
Meanwhile you can take prilosec. If it is due to peptic ulcer disease, you will find relief.
I hope that answers your query.
Let me know if I can assist you further.
Regards,
Dr.R.K.

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Patient replied :

Dear Dr. Kini,
Thank you for your response. I work in China where patients are generally expected to "self-refer" themselves to a specialist if they visit a clinic. Since I will probably do so if the symptoms worsen, which type of specialist do you recommend I request to see?
Secondly, will prilosec cause the ulcer to go away, or just provide temporary relief?
Finally, any thoughts on how to modify one's diet to reduce the discomfort (apart from removing alcohol, obviously).
Many thanks.


Expert:  Dr. Ratnakar Kini replied 3 Days.

Hi,
Thanks for getting back to me with more questions.
If symptoms persists, consult a gastroenterologist.
If it is a simple ulcer or gastritis, it will go away with prilosec. But if the ulcer is due to H.pylori infection, prilosec will provide only temporary relief. You need to treat the infection for complete relief.
In addition to avoiding alcohol, avoid smoking (If you smoke) and avoid coffee, citrus, tomatoes, chocolates, fatty food.
Regards.

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