Thank you for asking your query at DoctorSpring.
The symptoms are unlikely to be because of a duodenal ulcer, especially in view of lack of symptomatic response to Omeprazole. If it was related to to an Ulcer there would have been at least an improvement in the symptoms, if not complete resolution.
A musculoskeletal cause is more likely . The distribution of pain is non specific (by non specific ,I mean not pointing towards a single diagnosis). Considering the possible musculoskeletal etiology you can take an OTC anti inflammatory medication like Ibuprofen 400mg twice daily in consult with your Doctor. There is a possible nerve compression in view ofthe tingling. However as of now you may lbserver the response to mediation and proceeded further.
Please feel free to ask followup questions.
Patient replied :
I will try to take some ibuprofen over the next few days and see if that helps. What would you suggest as my next step if I see no improvement? Should I return to my MD and request some specific tests (x-rays, MRI, etc.) to determine if there is a musculoskeletal concern? Or should I try a chiropractor or other type of doctor? I'm just really frustrated with my current MD and I have to pay a $95 insurance copay every time I visit him so I want to have a plan of action for my next visit.
As I said earlier the distribution of pain is bit non specific. As first step taken Ibuprofen. You can continue Omeprazole along with it. You can wait and watch (provided there are no new symptoms / worsening symptoms) for a couple more days. Still if there is no improvement you will need to go to a MD as you will need 1. A complete physical and neurological examination , in view of the tingling. 2. An Xray Left shoulder.
I will keep this consult open. So please feel free to get back to me anytime.