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Hello Wendy, I am Dr. Arun and will be helping you today.What did your esophageal motility study and CT scan of chest show?Any history or anxiety or panic?Thank you for using Just Answer.
You are very welcome, Wendy.I am sorry about the recurrent undiagnosed attacks. Following would be the further work up to diagnose the issue (if not yet done);1) Esophageal manometry evaluates esophageal motor pattern, contraction amplitude, and LES (lower esophageal sphincter, where stomach meets stomach) pressure and function.2) CT scan and MRI of the neck. A spondyloarthrpathy is common with the Crohn's disease which can cause nerve radiculopathy symptoms in chest and upper limbs.3) Nerve conduction velocity study and electromyography of the chest and upper limbs.4) Ambulatory esophageal manometry:and High-resolution manometry:; this will further confirm the high pressure in LES (hypertensive LES) and esophageal motility disorder.5) Chest CT scanConsulting at a teaching hospital where gastroenterologist, rheumatologist and neurologist work under a single roof and have more opportunities to discuss your case would be recommended, as this need an integrative approach for the diagnosis. Crohn's disease can involve spine and nerves and initial changes in these are subtle to cause definite symptoms and thus may remain unrecognizable unless thorough investigations are done in all the organ systems in the vicinity.Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
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