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Cause for pressure in chest, abdomen with GASTRITIS.

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I have pressure under my left abdomen and chest. pressure extends to the bottom of my rib cage. GP thinks I have GI issue. UBT showed positive for HP, treated with antibiotics, showed positive again, treated with antibiotics (quad therapy now), afterwards, endoscopy showed bile reflux gastritis and hpylori. Second endoscopy with a different GI showed gastritis and doc thought HP infection. However biopsy showed negative.

I have had a chest x-ray, lungs were clean. I had an ultrasound, nothing except for spleenule. Barium UGI showed nothing.

Im confused. I have gastritis but no HP. Can this pressure be due to something not GI related?

Category: Gastroenterologist, Medical

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Category: Hepatologist
 27 Doctors Online

Thanks for your query at
I am Dr.R.K and I am pleased to assist you.
It looks like you have GI related symptoms only.
As per your endoscopy report, you still have gastritis which could cause these symptoms.
I presume you do not have any bowel symptoms.
The chest Xray, ultrasound scan and barium study are all normal which has ruled out most of other causes discomfort in that body part.
You can continue with the quadruple therapy.
I hope that answers your query.
Let me know if i can assist you further.

Patient replied :

I am negative for h pylori

As I told you, gastritis which you have can cause all those symptoms.
You can take PPI medication like Nexium.
If the symptoms are due to gastritis, then you will get good relief.

Patient replied :

What is this gastritis caused by though? You said to take quadruple therapy, I don't think you take antibiotics when your biopsy is negative doctor. I am not asking you what to take for gastritis, I have tried lansoprazole and pantroprazole before and neither improved my symptoms, I am asking what could be the underlying cause of the gastritis.

I am sorry for the confusion caused in this conversation.
In your first post you mentioned about undergoing H.pylori tests multiple times. I didnt realize that the last test was negative. That is the reason why I told you to 'continue' quadruple therapy.
But you clarified in your first follow up question that your H.pylori negative. That's why I DID NOT emphasize in my second answer about the quadruple therapy.
I am sorry for the confusion. You do not need quadruple therapy if you are negative for H.pylori.
Now coming to the cause of gastritis.
There are multiple causes of gastritis other than H.pylori. Some of the other causes are - Infections, granulomatous diseases, reactive gastritis.
Reactive gastritis is more common and can occur due to alcohol intake, pain killer medications, stress, bile reflux etc.
In your first post you have mentioned that during one of the endoscopy tests you had bile gastritis.
Bile should not be present in stomach. However in bile reflux, bile enters the stomach. Bile is an irritant and can cause gastritis.

Patient replied :

Ok thanks
The second endoscopy didn't report any bile reflux but the symptoms are still there. I do not drink alcohol frequently, wasn't taking any pain medications, symptoms actually started when I did not have much stress, and they've persisted for so long anyways.
I have tried domperidone for bile reflux but it did not help. Are there better treatments for bile reflux?

There are no proper guidelines for treating bile reflux.
You can take PPI along with domperidone and sucralfate and look for improvement.

Dr. Ratnakar Kini
Category: Hepatologist
Fellowship - DM - TN Dr.MGR Medical UniversityResidency - TN Dr.MGR Medical University Medical School - Stanely Medical College, TN Dr.MGR Medical University
Dr. Ratnakar Kini and 4 other Medical Specialists are ready to help you

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