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Gastroenterology (Expert Forum)
chest pains, gas, sweats and nausea
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
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.
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chest pains, gas, sweats and nausea
by soccermom1321, Sep 08, 2004 12:00AM
About 1 month ago I began having tightness in the center of my chest that was not accompanied by any other symptom. I went to see my doctor who immediately did an EKG and blood work up...all came back normal, including cholesterol. My blood pressure was elevated 140/100 which is very high for me. I am about 100 pounds over weight so I had reason to worry it was heart related. He sent me home with no explanation and no further testing. He stated if the pain persisted to call and they would schedule a stress test. The pain continued over the weekend but this time was accompanied by burping. I called the nurse to say the pains were still there but I was now burping and had a lump in my throat. She said she had thought it was reflux and wondered why the doc didn't discuss that with me. She spoke to the doctor and he decided I should start on 150mg ranitidine BID. Well that worked for all of a week, then the pains came back. This time accompanied by sweats and sometimes nausea. And not to mention panic and a ton of anxiety on my part. I did notice that while at our summer home I did have it more after eating certain fatty foods such as mayo or hotdogs. And I had to have several bowel movements during the episodes. Now I just seem to have the pain all the time. It appears to come within a 1/2 hour of eating, which would make me agree with the doctor's diagnosis. I am unable to eat anything without having the pains. Every once in a while I do get pain in my left arm but it is always on the outside of the arm or on the back...never on the inside.
Over the past couple of days it has all gotten much worse. My pains last all day, I have loose stools, a lump in my throat, gas, severe sweats, nausea and occasionally it feels a little harder to breath. I am not winded as I am exercising, but almost the same feeling I get when my asthma starts to kick in. I don't breathe any faster or heavier but feel the need every once in a while to take a bigger breath to better fill my lungs. Sometimes I think the breathing is due to me stressing out over all this. Today I was walking around Walmart when suddenly my chest became uncomfortable, I began breaking out in a huge sweat and nauseaus. I also experienced the breathing I described earlier. Seemed to be classic heart problems. I am so worried that it is my heart but my doctor nor my nurse seem to listen to my concerns. They keep saying they are sure it is GERD even though they did not run any tests for it. Should I seek a second opinion or does it sound like my doctor is on the right path?
Over the past couple of days it has all gotten much worse. My pains last all day, I have loose stools, a lump in my throat, gas, severe sweats, nausea and occasionally it feels a little harder to breath. I am not winded as I am exercising, but almost the same feeling I get when my asthma starts to kick in. I don't breathe any faster or heavier but feel the need every once in a while to take a bigger breath to better fill my lungs. Sometimes I think the breathing is due to me stressing out over all this. Today I was walking around Walmart when suddenly my chest became uncomfortable, I began breaking out in a huge sweat and nauseaus. I also experienced the breathing I described earlier. Seemed to be classic heart problems. I am so worried that it is my heart but my doctor nor my nurse seem to listen to my concerns. They keep saying they are sure it is GERD even though they did not run any tests for it. Should I seek a second opinion or does it sound like my doctor is on the right path?
Doctor's Answer
by Kevin Pho, MD, Sep 11, 2004 12:00AM
, Sep 11, 2004 12:00AM
I would certainly seek another opinion. If the symptoms continue, more testing is needed. Other causes can include an ulcer, inflammation of the upper GI tract, and of course, GERD that is inadequately trated.
An upper GI series or upper endoscopy (the latter being the more comprehensive test) would be next to consider. I would also discuss whether going on a PPI (i.e. Prilosec or Protonix) would be an appropriate step for your case.
If all the tests are negative, an ultrasound can be considered to evaluate the gallbladder, or a 24-hr pH study to conclusively evaluate for GERD.
With obesity and high blood pressure, there is certainly increased risk for heart disease. A stress test to evaluate for heart disease would not be unreasonable.
I would discuss these options with your personal physician.
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.
Kevin, M.D.
Medical Weblog:
kevinmd_b
An upper GI series or upper endoscopy (the latter being the more comprehensive test) would be next to consider. I would also discuss whether going on a PPI (i.e. Prilosec or Protonix) would be an appropriate step for your case.
If all the tests are negative, an ultrasound can be considered to evaluate the gallbladder, or a 24-hr pH study to conclusively evaluate for GERD.
With obesity and high blood pressure, there is certainly increased risk for heart disease. A stress test to evaluate for heart disease would not be unreasonable.
I would discuss these options with your personal physician.
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.
Kevin, M.D.
Medical Weblog:
kevinmd_b
I have similar problems at first i thought i have a heart problem and i went to see a cardiologist,now i know i have acid reflux.
You need to see a gastro doc.
As for the gastro doc, I can only do that with a referral from my primary physician who thinks this is nothing but simple reflux that will be cured with the Protonix I am now taking.
It is just very frustrating for me because no matter what I eat the pains come. This morning I had two pieces of wheat bread and some applesauce and as I type this I feel the pains coming back. Yesterday I had a bagel for breakfast with a slice of cheese and it was worse than ever. Last night my family had pizza and I thought, what the heck, I have pain no matter what and I had 2 pieces. The funny thing is that the pains that came after eating pizza were less than when I had the bagel.
I am more and more convinced that it is gastro related and not my heart because it happens after every meal. However the severe sweats and nausea I had yesterday coupled with the pains while walking around Walmart scared the heck out of me. But I now remember popping a piece of peppermint gum in my mouth as I headed to the store and wonder if that increased the pains. I have read to avoid peppermint and spearmint but didn't think of it when I put the gum in my mouth. Those are the symptoms my doc initially told me to watch out for. So when I called the doctors office and spoke to the nurse about it, she seemed very disinterested and asked if I had any headaches or vision problems with it. And since I didn't it wasn't heart related. Not sure where she got her nursing degree from...I have a feeling she bought it online somewhere. And my doctor is losing his credibility more and more every day. I should have gotten a new doctor the minute I told him about the excrutiating pain I have in my right shoulder when I move certain ways and all he did was say, "Hmmmm" and went on to the next subject. He never did address it or tell what I can do about it. I guess I will just go around with my arm at my side at all times and never move it...that is only way to stop the muscle pain I feel. What a bozo!
oh,spicy food also and soda drinks