### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi Ive had a pain/ uncomfortable feeling  in my upper abdomen for the past 5 days. It started happening at night maybe an hour or two after my dinner and I felt it under my right rib.  For the first three nights it lasted only about 1 hour, but then the pain moved to just under the base of my sternum and feels like a constant dull tightness, like someone resting their head on me. I tried an antacid tablet cos my doctor told me it was probably reflux. But it had no effect. I can feel the heaviness has moved slightly to the centre-left just under my breast. Ive had blood tests, abdomen and  pelvic ultrasound and CT scans but no significant findings. Any ideas on what it could be?

### output:

HI. Thanks for your query and an elucidated history. What you need an urgent investigation in such a case is an ECG. We have to rule out Heart Attack. If the ECG is normal, this has to be treated as Hyperactivity with HERD. I would advise you the following:: Santa 12 hourly. Pepcid every 3 to 4 hours when on empty stomach. Add Risperidone or such motility regulators. Soft bland diet. No aerated colas / soda/ Chat Doctor. Early dinner. No late nights. Treatment for anxiety (as prescribed / needs a prescription by your Doctor)Lying in a reclining positional around after dinner. Think of the factors which increased the present problem, HERD, anxiety and try to avoid. If no relief, get Upper GI endoscopy done and get prescription for added Medicines. EKG for the heart n a safer side to rule out cardiac problems. This helps all my patients and should help you hopefully