I have pain in below sternum in below costal...

How to treat pain below costal margin

An electrocardiogram must be done to exclude the presence of coronary artery insufficiency and if any, its treatment will be according to the severity of the narrow by insertion of stents, surgical intervention or drug treatment, and the cause may be a viral infection in the skin such as a fiery belt and the treatment of acyclovir and the cause may be due to muscle strain or bone inflammation or Cartilage in the chest, the treatment of which is anti-inflammatory drugs, such as ibuprofen, and the cause may be inflammation in the airways or allergies on the chest, and its treatment should be with bromchodilators like albuterol and antibiotics, and the reason may be the reflux in the esophagus, and its treatment will be using drugs such as pantoprazole, embrazole, or gaviscon . The cause of pain may be esophageal spasm and treatment of drugs such as diltiazem or isosorbide dinitrate, as these drugs work to expand the esophagus  and there may be a hiatus hernia in the diaphragm and is treated with omeprazole and in cases that Do not respond to pharmacotherapy surgical intervention may be done

How to diagnose pain below costal margin

An echocardiogram should be done  exclude the presence of narrowing in the coronary arteries and x rays should be made on the upper digestive system with the barium swallow dye where the patient swallows a specific dye and then imaging is done to exclude the presence of a hernia in the diaphragm and a endoscopy may be made on the upper digestive system to exclude the presence of inflammation in the stomach or esophagus and to take a sample from the stomach if necessary to rule out the presence of a h pylori  or tumors in the stomach and make a measurement of the strength of the contraction  in the esophagus by manometry

What are the causes of pain below costal margin

hiatus hernia
    Diffuse esopgageal spasm
    inflammation in the bone or cartilage or muscle
coronary artery disease
bronchitis
    Irritable bowel and associated disorders in the esophagus

What are the symptoms associated with pain below costal margin

    In the case of esophageal spasm , there will be difficulty in swallowing, and reflux of food to the mouth and pain during eating or drinking
    Muscle or bone inflammation leads to pain while moving the arms
    In the case of irritable bowel, there is abdominal pain, constipation or diarrhea

gastroesophageal reflux disease and hiatus hernia may cause these symptoms and to diagnose it tou may need barium swallow test and its treatment is by omeprazole 40 mg once daily and decrease spicy food and soft drinks and rise the head of the bed