Hello Dave, I am Dr. Arun and will be helping you today.What did your Esophageal manometry, Ambulatory 24-hour pH monitoring show?Any significant past medical history or surgery?
Do you drink alcohol? If yes, how much and how frequently?Are you anxious / stressed?
it showed had a little errosion not much to worry about and biopsi showed nothing no medical history i drink only 5 beers per week
Hello Dave,Your symptoms are suggestive of non cardiac chest pain. The commonest causes for it are;
1) Esophageal (food pipe) spasm
2) Hiatal hernia
3) Gastroesophageal reflux disease (GERD)
4) Chest wall problem
Your doctor may get an endoscopy (camera exam) and food pipe motility study to confirm the cause. Please read this resource;
Noncardiac chest pain is defined as recurrent chest pain that is indistinguishable from heart pain after a reasonable workup has ruled out a cardiac cause.It may affect almost 25% of the adult men. The main underlying causes as discussed are gastroesophageal reflux, esophageal dysmotility (movement disorfder of the food pipe) and esophageal hypersensitivity. Gastroesophageal reflux disease is likely the most common cause of non cardiac chest pain. Esophageal hypersensitivity also is seen in many patient with the chest pain. Psychological issues such as panic disorder, anxiety, and depression are also common in non cardiac chest pain patients and often modifies and affects perception of disease severity.
The mechanism by which acid reflux causes heartburn in some patients and chest pain in other patients remains poorly understood, and is complicated by the fact that a subset of patients with NCCP complain of both heartburn and chest pain symptoms. You may try following;
1) antacids; Maalox
2) acid blocker; Prilosec
3) loosing weight, if overweight.
4) avoiding alcohol, citrus fruits and juices, chocolate, and tomato based products
5) avoiding large meals. Eat 5 small meals in a day.
6) wait three hours after the meal before you sleep.
7) elevate head end of the bed by 8 inches.
Following also would be helpful;A. Herbs;1) Cranberry2) PeppermintB. Homeopathy1) Nux Vomica2) PulsatillaC. Nutrition and supplements;1) Multivitamin; vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium. 2) Probiotic supplement3) Omega 3 fatty acid4) Avoid; cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.5) Also avoid; white breads, pastas, and especially sugar, red meats,6) Eat lean meats, cold water fish, tofu, beans, olive oil
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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