<s>[INST] I have been having sharp pain in my lower chest under my rib cage lately. I was wondering if it was anything to worry about. I do have a hiatal hernia. I also have suffered from kidney stones and have a cat scan done every year to make sure they dont get too large. I also have asthma, and esphophagal reflux disease and have had my gallbladder removed. Should I  be worried about this pain? I am on oxycontin for pain for interstitial cystitis and have to take milk of magnesia every day for bowel movements. [/INST] Hello dear, The symptoms are related to the acid reflux & secondary to hiatal hernia. Management consists of: 1. Lifestyle modification- like weight reduction, sleeping on the left side, or with upper body raised. 2. Dietary modification- avoid consuming irritating substances such as acidic & rich foods, caffeine, nicotine, and alcohol.3. Medical management-Proton pump inhibitors like Omeprazole, Pantoprazole, etc. (which prevent acid formation in stomach) & Risperidone 10 mg twice a day(to be taken 30 min before meal)If symptoms still persist, kindly consult a Gastroenterologist for proper clinical examination. Investigation like upper GI endoscopy will be helpful. There is no need to worry...you will be fine. Take care. </s>