Seeking Answers for Persistent Upper Abdominal Discomfort
I'm a 54-year-old individual, weigh 70 kg, and do not smoke. Currently, I'm on sertraline. For the past year, I have been experiencing persistent pain beneath my sternum, particularly on the right side, just under the rib cage. Despite undergoing two ultrasound examinations that revealed no abnormalities in my internal organs, I initially suspected my gallbladder, but it turns out there are no issues there either. I've also had a comprehensive range of blood tests, covering liver and kidney functions, to no avail. I’m starting to feel like a burden at my healthcare provider’s office, and I'm at a loss for what to do next. I even pondered whether the discomfort could stem from stress, but after two months on antidepressants, there hasn't been any improvement. I actively go to the gym, which led me to consider whether it might be muscular-related, yet my doctors remain unable to identify the cause. I attempted a course of proton pump inhibitors (PPIs) to rule out acid reflux, but I lack other associated symptoms. The pain manifests intermittently throughout the day, characterized as a dull ache, and the area in question tends to be sensitive when pressed. I've found myself searching for answers online, which typically leads me down troubling paths—like worries about pancreatic conditions. However, I’m simply seeking clarity on my situation. I've also thought about issues related to the xiphoid process or costochondritis. Nevertheless, my only symptom remains the pain itself. What steps might I take to uncover the source of this discomfort? It has profoundly impacted my daily life, and I'm uncertain about what further inquiries to pursue or how to effectively address this ongoing problem. Thank you for any guidance you can offer! 🙏
Answers (1)
2/4/2026, 2:01:00 PM
OpenHealth AI
It sounds like you have been dealing with a challenging situation regarding your upper abdominal discomfort. Given your thorough medical evaluations and the persistent nature of your symptoms, it’s important to continue seeking clarity. Let’s break this down.
Main Points:
- Persistent Pain Assessment: You have undergone extensive testing without a clear cause, leaving you frustrated.
- Possible Sources of Pain: While stress and muscle-related issues might play a role, other non-organic reasons could also be contributing.
- Next Steps: Focus on monitoring your pain, exploring lifestyle contributions, and implementing self-care strategies.
Explanation:
Your symptom of dull, intermittent pain beneath the sternum, particularly on the right side, is concerning for a few reasons:
- It could potentially relate to muscular strain, especially if you’re active at the gym.
- Stress and anxiety can manifest as physical symptoms, but since you’ve been on medication for two months without relief, that may be less likely the primary cause.
- Conditions like costochondritis, which is inflammation of the cartilage in the rib cage, could also cause similar sensations.
Since your ultrasounds and blood tests have returned normal results, it’s understandable to feel discouraged. However, this is not uncommon, and often, it takes time and a multifaceted approach to pinpoint such discomfort.
Next Steps:
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Keep a Symptom Diary: Track your discomfort, noting when it occurs, its intensity, and any related activities (like specific exercises or stress levels). This can help identify patterns that might assist your healthcare provider in understanding your condition better.
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Physical Activity Adjustments: Consider revising your gym routine. Incorporate flexibility and core-strengthening exercises. Sometimes, specific movements can exacerbate pain. It may also help to give your body some rest to see if symptoms improve.
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Self-Care Practices:
- Mindfulness and Stress Reduction: Engage in stress-relief techniques such as meditation, yoga, or deep-breathing exercises. These can sometimes alleviate physical symptoms linked to stress.
- Dietary Considerations: Since you've tried PPIs without improvement, focus on observing any food-related triggers. Eating smaller, more frequent meals can sometimes help reduce gastrointestinal discomfort.
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Consider Alternative Causes: Since you’ve suggested conditions like costochondritis or issues with the xiphoid process, discuss with your healthcare provider about the possibility of considering other non-invasive tests or referrals (e.g., to a gastroenterologist or rheumatologist) if the pain persists.
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Limit Online Research: While it’s natural to seek information online, it can often lead to increased anxiety. Try to limit this, focusing instead on documented responses from healthcare professionals or trusted medical sources.
Reassurance:
It's commendable that you’re actively seeking answers about your health. Persistent discomfort can be incredibly taxing both physically and mentally, but it’s essential to approach it systematically. Stay hopeful and patient; sometimes it takes time to connect all the dots. If at any point the discomfort worsens or new symptoms arise, it’s vital to inform your healthcare provider right away.
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