instruction: hello doctor I have been experiencing upper left abdominal pain just beneath lower ribcage and on the opposite side in the back I have intermittent dull and deep chronic pain I am 43 years old nonsmoker but consumes alcohol not for the last four months my blood pressure is 120 80 my hg I am currently on omeprazole 20 my daily one month I am diagnosed with pneumonia and pulmonary embolism it is confirmed by chest it I was prescribed pradaxa for three months stopped taking medication on mark 26 I have a history of acid reflux sleeps on a inch wedge pillow to manage the symptoms tests I underwent are abdominal it with contrast unremarkable mild diverticulosis not considered relevant to pain chest it with contrast unremarkable pe and pneumonia cleared blood tests all normal no sign of pancreas or kidney trouble my primary care physician suggests pain is associated with pe my pulmonologist says it is very unlikely to be associated with pe and recommends to confer with a gastroenterologist could this be an ulcer or some other issue within the stomach or gi tract perhaps caused by the pradaxa medication would the abdominal it have uncovered peptic cancer or other serious gi issues what further testing would you recommend should I wait to see if things get better or act soon if it is safe to wait how long should I give it
output: hello I must appreciate the detail history you provided which is very helpful in diagnosing your condition after reviewing your history in my opinion this pain is not related to pulmonary embolism it looks like to be associated with some gastritis and stomach issue now coming to your queries the it abdomen has ruled out serious abdominal issues such as malignancy but it could not rule out peptic ulcer disease you can just wait for it and take the medications which I am prescribing I do not think that waiting is going to cause any further issues as it does not look like to be something serious take the following treatment for two weeks and if no improvement then we can consider end none at the moment gastritis peptic ulcer disease esophagitis gastritis continue omeprazole but increase it to twice daily before meals syearup gaviscon alginate 10 my three times daily after meals both these for two weeks if no improvement will consider end