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Doctors Lounge - Gastroenterology Answers
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| CraigH
- Tue Nov 23, 2004 9:54 am |
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Dear Doctor,
I am a 38 yo white male that suffers from GERD. 2 years ago I had an esophagal expansion do to scarring from reflux. I have been on 40mg of Protonix for 2 years now.
For the last month I have been having a pain right below my breastbone, where my stomach meets my chest, directly the center. It kind of like a squeezing sensation, and it usually is accompanied by a 'lump in the throat' sensation. Often this lasts all day long, sometimes it is worse at night. The pain leaves when I eat and for a while afterwards. The pain also is lessened by laying on my stomach (I have a beer gut) in bed, and usually only starts after I have been up for awhile. Sometimes the pain is rather pronounced, othertimes it is very mild. My appetite has been regular during this period.
I am wondering if this could possibly be a flare-up of my GERD or esophagitus or perhaps an esophigal spasm? I do not have any heartburn, however I am frequently 'gassy' and belch alot during these episodes. Sometimes I also seem to have more saliva and/or mucous in my mouth during these episodes. I might add that I was treated w/ angioplasty & stents 6 months ago for 2 blockages. I take 50mg of atenolol daily (as well as asprin, plavix, lipitor 80, zetia lorezepam and enalapril)and I have read that this beta blocker can weaken the LES. I have had 2 negative thallium stress tests in the past 8 weeks and I am relatively certain the pain is not cardiac related.
I realize that you cannot diagnose me in this forum. My gastroenterologist is booked solid for the next two weeks, and I would appreciate any insight you might have about my symptoms.
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| Dr. Tamer Fouad
- Tue Nov 23, 2004 7:44 pm |
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 Dear CraigH,
Your symptoms are rather vague. You say you are feeling pain in the chest as well as a lump in the throat. You also say that it is releaved by swallowing. You mentioned flatulence. I am glad you excluded cardiac pain. Some long standing cases of GERD are complicated by esophageal strictures. I honestly cannot be sure if this is a stricture or spasm as this would need investigation. What I can tell you is that your symptoms seem signifcant enough to warrant further investigation.
Please seek medical attention as soon as possible.
Best regards,
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