Pernicious Anaemia Society
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Still have pain in chest and ribs

Hello again

I know others have been suffering with severe pain around/under rib cage back and front and also pain in chest too.

I have been seeing physio since last October and have had loading b12 injections and currently monthly injections. Had iron infusion and am on vit d too. Doctor put me on ranitidin tablets for stomach after gastro showed have chronic gastric atrophy and reflux.

Physio is shocked at how tense/fixed my muscles are... thorax, pelvis, shoulders on and on. Although physio helps reduce pain short term, it returns over over and never goes completely. I presented at doctors with unexplained shoulder pain shoulder blades!

Any explanations and recommendations please?


4 Replies

Ranitidin is an antacid, which will block absorption of B12 from your food. Reflux in a low B12 situation is usually a condition of too little acid, not too much. You may do better taking hydrochloric acid tablets or betaine with your meals.

The pain you describe sounds awfully like what I had when I was on sub-optimal thyroid medication. Have you been tested for hypo-T? Low B12 could be causing your pain, but bear in mind that if you're having intensive physio this can also deplete your B12, and you may need more of it.


kelsam21, are you replying to me or the OP?


Hi Robson957.

I get exactly the same kind of pain (under ribs back and front, through neck extensively in right shoulder and arm) and my Physio says that the muscles around my left shoulder, back and the back of my neck are rock solid!

I have also been diagnosed with achlorhydria, intercostal neuralgia, gastric parisis, gastritis, duodenitis and multiple duodenal, I have gastric problems too! Awaiting biopsy results.

I was on PPI's for gastric reflux for several years. These had no effect whatsoever, in fact I got worse, had the dose increased, and continued to get worse! Not surprising as I had LOW gastric acid and these were making matters worse by making whatever gastric acid I had even LOWER!

I note that Fbirder has replied to one of your other posts and given a really good explanation about gastric atrophy, reflux and achlorhydria (no stomach acid), which, he explains, you will have because of the gastric atrophy.

The Ranitidine prescribed by your GP (an antacid, as Hillwoman points out) is likely to make your lack of acid situation worse (see fbirders previous explanation about gastrin) and so Hillwoman's advice is spot on.

I think I mentioned, in one of your previous posts, that I have been following the advice of Gambit, Fbirder, Polaris and others (SAUKRAUT, lime juice or HCL tablets etc), - also in one of your other posts - and there has already been some improvement. Others also recommend Symprove or Bio Kult for gastric problems.

Have you asked your GP to prescribe something for pain?

I was originally prescribed GABAPENTIN, by the private gastrologist I saw (to hurry things up), the NHS gastro I eventually saw told me not to take it, and a neurologist has recently prescribed pregabalin! I haven't been on it long enough to see if it will work but I am getting slightly more sleep.

As to the shoulder pain and stiffness, and host of other neuro 'stuff', this is currently under investigation by the neurologist and I'm continuing with Physio, so we'll see.

It's not unusual to get referred pain in the shoulder from gastric problems and also stiffness and tight muscles from B12 deficiency so I think if you could tackle these two issues and get some decent pain relief, you will hopefully see some improvement.

But it's not a quick job and it can take these things quite a while to improve, so don't despair 😀

Hope things begin to get better for you soon.

P.s. You were right, the gastroscopy and endoscopy were not too bad. I avoided the nitrous oxide and had light sedation and muscle relaxant for the biopsies. Watched it on screen - very interesting. They must have thought I was as mad as a box of frogs - for some very odd reason, kept exploding with hysterical laughter every time I say the biopsy snappers nibbling at my poor old insiders 😊😊


Check out costochondritis- it is a painful condition of the muscles of the rib cage


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