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Gastroenterology (Expert Forum)
Finding the cause
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Finding the cause
by Stratfordf, Jul 31, 2003 12:00AM
Symptoms: I find that my throat feels constricted, which at worse can create feelings of nausea and can stop me from speaking. Moving head up or to the right can increase throat constriction.
At worst, this is accomponied by pain at the top of my chest, pressure at the the top of the forehead, and also general skin
irritation, especially in the car or at night. Whole package tends to come in waves - usually worst at night.
Eating and drinking will stop nausia symptoms; will normally be ok first thing in morning and then it will progressively get worse. Can breathe ok through all this.
Bouts of skin irritation started last year. Somtimes they were so bad I could not sleep. Other symptoms have built up slowly and progressively this year.
Skin specialist did blood test with no obvious alergies; found no cause; gastro specialist did endoscopy and barium swallow and found all clear. Have now been referred to ENT specialist, who has prescribed antacids (I used to have a stomach ulcer but have been clear 10 years). My guess it is some kind on infection?? but until we find the cause we can't treat the problem. Any ideas?
Am 41, regular weight, non smoker, take regular exercise and have regular diet.
At worst, this is accomponied by pain at the top of my chest, pressure at the the top of the forehead, and also general skin
irritation, especially in the car or at night. Whole package tends to come in waves - usually worst at night.
Eating and drinking will stop nausia symptoms; will normally be ok first thing in morning and then it will progressively get worse. Can breathe ok through all this.
Bouts of skin irritation started last year. Somtimes they were so bad I could not sleep. Other symptoms have built up slowly and progressively this year.
Skin specialist did blood test with no obvious alergies; found no cause; gastro specialist did endoscopy and barium swallow and found all clear. Have now been referred to ENT specialist, who has prescribed antacids (I used to have a stomach ulcer but have been clear 10 years). My guess it is some kind on infection?? but until we find the cause we can't treat the problem. Any ideas?
Am 41, regular weight, non smoker, take regular exercise and have regular diet.
Doctor's Answer
by Kevin Pho, MD, Jul 31, 2003 12:00AM
, Jul 31, 2003 12:00AM
Hello - thanks for asking your question.
You note a variety of symptoms including throat constriction and have been evaluated with an endoscopy and barium swallow. An ENT specialist suggested antacids.
One consideration would be a type of allergic reaction, urticaria or angioedema. The ENT specialist should be aware of these diagnoses and suspect them if indicated.
Measurement of the complement components C4, C2, and C1q and antigenic C1-Inh protein and a functional assessment of C1-Inh protein will help in the diagnosis of hereditary angioedema. These tests can be discussed with your personal physician.
Another consideration would be referral to an allergy specialist who can further evaluate and suspicion of urticaria or angioedema.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
FYI - I will be away from August 1-9th. I will look forward to answering your questions when I return.
You note a variety of symptoms including throat constriction and have been evaluated with an endoscopy and barium swallow. An ENT specialist suggested antacids.
One consideration would be a type of allergic reaction, urticaria or angioedema. The ENT specialist should be aware of these diagnoses and suspect them if indicated.
Measurement of the complement components C4, C2, and C1q and antigenic C1-Inh protein and a functional assessment of C1-Inh protein will help in the diagnosis of hereditary angioedema. These tests can be discussed with your personal physician.
Another consideration would be referral to an allergy specialist who can further evaluate and suspicion of urticaria or angioedema.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
FYI - I will be away from August 1-9th. I will look forward to answering your questions when I return.
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Thanks,
Kevin, M.D.
i have chest pain and constriction at nite,sometimes during the day if i sit and crouched my stomach for too long.
i have been on prevacid for 28 days and now i am on zantac75 twice a day.before i go to bed,i take one zantac 75 with a full glass of water and my situation is improving.
i also stacked my pillows up while i sleep.
have you tested for h pylori bacteria?/
One other thing I never mentioned.......burping can also temporarily clear things for a few minutes. Strange, eh?