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Chest pain, headache disturbed bowel movements affecting everyday.

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Hi,
I have been suffering with chest pain for some months - like a crushing tightness in the centre - like something is stuck in m throat - heartburn - headaches - neck ache and a constant pain in left side breast. Constantly lethargic and slight depression mood even though i feel ok.
My sleep is up and down - as are my moods - and bowel movements one day normal next day liquid like.
My last cholesterol test was 6.4 - blood pressure and ecg were normal.Liver count ok. iron levels back to normal. etc.
I was treated some months ago for anxiety and panic attacks, but non medical and counsellor treated - this has eased now so i know not anxiety as hospital and doctor keeps telling me, as i feel better now for that.
i was treated a month or so ago for gastro enteritis and said to just let it take its course, and giving anti cramps and 0meprazole for acid.

What do all these symptoms sound like, as very disheartening, affecting every day life, and think i am having heart attack/about to die.
Please help.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 31 Doctors Online

Hello.
Thank you for your query at DoctorSpring.com.

I understand your concern and will do my best to help you.
You seem to have Gastro-oEsophageal Reflux Disease (GERD) where there is reverse flow of stomach acid into the food pipe causing heartburn, chest tightness and/or pain, throat irritation etc. The good thing is, with appropriate measures you will soon find relief. You will need to get an upper gastrointestinal (Upper GI) tract endoscopy done to look at your gullet and stomach, and to assess the signs of GERD.
You shouldn't worry about a heart attack as you have a normal ECG. Normal ECG during chest pain rules out a heart attack.
The lethargy, low mood, irregular sleep etc all points towards increased stress and possibly some depression. If these symptoms have been persistent for more than 2 weeks, it is best to see a psychiatrist to evaluate for clinical depression.

I have the following suggestions.
1. Please consult a gastroenterologist to get an upper GI endoscopy done and for prescription strength medications.
Meanwhile continue the Omeprazole 20 mg, once daily, at least 30 minutes before breakfast. You can also take an antacid like OTC Gelusil 10 ml, 3 times a day for a week.
Lifestyle changes are very important in the treatment of GERD. These include:
- head elevation of your bed
- refraining from assuming a supine position after meals
- avoiding meals 2-3 hours before going to bed
- avoidance of reflux-inducing foods (fatty foods, chocolate, peppermint, and excessive alcohol)
- Weight reduction if overweight or obese.
2. Please consult a psychiatrist if the other symptoms have been present for more than 2 weeks.


I hope this was helpful. Feel free to ask queries.

Thank you.


Patient replied :

Thank you for your help/advice. I did read up on this and think it was this. however another online doctor has suggested the same, also pre menopause, suggested taking lexapro?..and order a thyroid test. he is confident it is not heart attack or family history relatef to multiple sclerosis cancer or angina?


Hello.
Yes. It is definitely not a heart attack, angina, multiple sclerosis or cancer. Please do not worry in this regard.
You can get your thyroid levels tested.
As for starting Lexapro, it is best to do it under the guidance of your doctor or a psychiatrist after a thorough evaluation.
Meanwhile, please do follow the lifestyle changes and other advised measures diligently.
Let me know if I can assist you any further.
Thank you.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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