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25, smoker, I woke up this morning with a sharp pain in my…

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25, smoker, I woke...

25, smoker, I woke up this morning with a sharp pain in my lower left portion of my chest. Pain doesn't increase but is more noticeable when I breath. I've felt some pain in my upper right lung before due to smoking and this is a new type of pain.

Doctor's Assistant: Have you ever dealt with this before? Are you having any shortness of breath?

No but my chest feels heavy as I breath

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Otherwise healthy body, not obese but maybe 15 pounds heavier than I should

Submitted: 7 months ago.Category: Medical
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Answered in 8 minutes by:
11/25/2017
Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 38,784
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

Do you have shortness of breath, cough, tenderness on chest?

Do you have increased urinary frequency, urinary burning, heartburn, diarrhea/constipation, nausea, vomiting, fever, loss of appetite, bloating, gas, tenderness on abdomen?

Any anxiety issue?

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Customer reply replied 7 months ago
I have had stomach reflux for years and it gives me slight nausea sometimes, and I've gained about 10 pounds in 2 months. Other than normal job stress and stress with relationships, again, all normal, no other problems are persisting
Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

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Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

Pain in lower left chest can occur due to;

1) Heart, lung, esophagus (food pipe diseases; esophageal spasm).

2) Chest cage

3) Upper abdominal organs; Gastritis, peptic ulcer, acid reflux, hiatal hernia.

In your age group; with history of reflux; esophageal spasm is the most common cause.

Having said that; if the pain is moderate to severe; it is essential that you get an EKG and chest x-ray for the evaluation at urgent care or emergency room.

I would consider following for your symptoms;

1) Esophageal spasm
2) Esophageal motility disorder
3) Esophagitis / acid reflux.

Following treatment may help you;

a) Calcium channel blockers (diltiazem, nifedipine) decreases the spasm and improves the movements of the esophagus.
b) Relaxation techniques.
c) Noncardiac chest pain in the setting of esophageal spasm and esophageal movement disorder (dysmotility) often shows good response to antireflux therapy, even in the absence of typical gastroesophageal reflux symptoms.
d) Reassurance and control of anxiety is extremely important.

Anti reflux therapy is;

1) antacids; Maalox

2) acid blocker; Prilosec

3) loosing weight.

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) Cranberry
2) Peppermint

B. Homeopathy

1) Nux Vomica
2) Pulsatilla

C. Nutrition and supplements;

1) Multivitamin; vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
2) Probiotic supplement
3) Omega 3 fatty acid
4) 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

Helpful investigations to establish and confirm the diagnosis are;

1) Esophageal manometry; evaluates esophageal motor pattern.
2) Esophagram / Barium swallow
3) Ambulatory esophageal manometry
4) CT scan of the chest.

5) Upper GI endoscopy.

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Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

Was this information helpful to you? I would be glad to answer any further questions.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

Please consider a positive 5 star rating if this interaction has been satisfactory, as this is the only way we experts are credited and compensated for the time and work. You are not charged again for giving a rating.

The rating button is on the left upper side of this thread.

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Thank you.

Wishing you all the very best in life.

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