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- Fri Nov 17, 2006 9:43 am
im a 40 yrld male with a 10 year history of drinking
i stoped dinking for as long as a few months but my systoms don't seem to go away
systoms are upper chest pain both sides
ive been to er had my heart looked into but was told cadiac was ruled out saw my doctor he gave me some asic reflux type meds didnt help...
i know these systoms are drinking related and i have stoped smoking and drinking now and i am wondering if there are any medications or are these conditions reversiable
| Dr. Tamer Fouad
- Mon Nov 20, 2006 3:46 am
Heartburn (pyrosis) is an extremely common symptom, occurring in 7% of Americans on a daily basis and in approximately one-third on a monthly basis.
Heartburn is usually defined as a feeling of burning below the sternum that radiates toward the neck from the epigastrium. Patients may use other terms including "indigestion" and "acid regurgitation." Heartburn commonly occurs within an hour of meals or within 2 hours of reclining, especially if the patient has eaten a late snack.
Heartburn is commonly caused by the regurgitation of gastric acidic contents into the esophagus.
Pregnant women are commonly affected. Heartburn may be precipitated by foods that either decrease the lower esophageal sphincter pressure or cause direct mucosal irritation of the esophagus. It may also be precipitated by maneuvers that increase intraabdominal pressure (eg, lifting, bending, straining at stool, and exercise). Cigarettes potentiate heartburn by lowering the lower esophageal sphincter pressure and through relaxation of the sphincter during air swallowing.
Patients with a dominant complaint of heartburn are likely to have gastroesophageal reflux disease (GERD). However, in patients who complain of a number of symptoms including heartburn and other associated dyspeptic symptoms (eg, pain, bloating, nausea), the diagnosis of GERD is less certain.
Empiric antisecretory drug therapy can be initiated in patients that are not considered at high risk of dangerous disease (such as GI cancer, peptic ulcer).
In all patients, management includes avoidance of ulcerogenic agents (including alcohol), patient reassurance, stress reduction and smoking cessation. All empiric drug trials should be stopped after 6 to 8 weeks, and endoscopy should be performed if symptoms return or continue.
If you have stopped drinking, avoid other ulcerogenic substances and are not smoking then I would strongly recommend that you pay another visit to your doctor and let him know that the antisecretory medication has not been useful. He may recommend further investigations. Once properly diagnosed the condition is reversible in most cases.
1. Talley NJ, Silverstein MD, Agreus L, Nyren O, Sonnenberg A, Holtmann G. AGA technical review: evaluation of dyspepsia. Gastroenterology 1998; 114:582-95.