Is this related to my Hiatal Hernia/GERD?

[shell1925]

Hello,
I am a 29 yo female, light smoker (5-7 cigarettes a day), VERY social drinker (maybe 1-2 drinks a month), 148 lbs and 5'4.  I gave birth to my son August 2006.  During my pregnancy I started experiencing severe chest pain (like I was being stabbed in my chest) and I was told it was heartburn.  After I delivered him (via c-section) I still had the chest pain and I then developed abdominal tenderness in my LUQ and RUQ.  I was told this was related to the pregnancy and c-section.  Other symptoms have since developed since then, listed below.

Symptoms:
Chest pressure (primarily when sitting/laying)
Jaw pain
Left arm pain
Left shoulder pain
Back pain
Abdominal pain (RUQ/LUQ) when pressed
Diarrhea (at least once a day, very loose stools otherwise)
Constant stomach gurgling/cramping
Dizziness

Tests:
Had cardiac workups to r/o heart problems
2 abdominal ultrasounds
CT scan of abdomen
HIDA scan
Endoscopy
Colonoscopy

Diagnoses:
Hiatal hernia (tried Protonix, but causes increased diarrhea)
GERD (esophageal erosions, not Barrett's)
Inflammed GB (removed Sept. 2007)
Vasovagal syncope

My questions:

Could my pains on my left side be related to my hiatal hernia/GERD?

Is the vasovagal syncope related to my hiatal hernia?

The fact that all cardiac workup is negative can I r/o my heart?

Is there any other routes I should look into to figure out the cause of my problems?

Thank you very much for your time.  I am really at a loss anymore, I don't know where to turn...I just want to feel normal again!

[Ratnakar Kini, MD]

Hi Shell1925,
Endoscopy and 24 hours pH monitoring will not rule out esophageal spasms.

For diagnosing esophageal spasms, you need either barium swallow test or esophageal manometry.
Manometry is the ideal one.
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The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.

- Ratnakar Kini M.D.

[shell1925]

I also forgot to mention that the chest pressure awakes me in the middle of the night and the dizziness is mostly when I bend over at the waist.  Thanks again!

[shell1925]

Does anyone have input on this?  I just don't know where to turn anymore.... :-(

[shell1925]

I went to my GI doctor today.  He is sending me for a repeat endoscopy and doing a 24 hour pH monitoring test.  Will these r/o esophageal spasms?  What on hearth could cause me to be having heart attack like symptoms?  I am really scared and I really hope you will answer this.  Thank you!

[Happy2girls]

I don't really have any answers for you but wanted to let you know that you are not alone.  My ordeal began at least a year ago maybe two with cardiac symptoms.  I had near constant chest pressure, palpatations, constriction of the throat, cough, urge to clear my throat and pain in between my shoulder blades.  My doctor sent me to the cardiologist who said my heart was sound.  The doctor decided to treat me for generalized anxiety disorder and put me on xanax which did nothing for the chest pressure and throat constriction.  It was so bad that I felt like I couldn't breathe (I still feel that way).  Anyway, my primary finally sent me to the ENT who diagnosed me with LPR (silent reflux) and vocal cord nodules due to the damage from the reflux.  He put me on 20 mg Aciphex a day but still that has had little effect on my throat constriction.  Now I am having pains on my left side under my breast bone which sometimes extends to my back.  It feels almost like a gas bubble or maybe like the cramps you get when you've been running too long.  The ENT referred me to a gastroenterologist for an upper GI endoscopy to check for damage further down my esophagus.  That is scheduled for May 20.  I hope you get your answers, please share them if you do.