Extreme Gastritis - chest pain w/ heart palpatations

10 years ago I was Dx w/hiatal hernia. In Oct had an endoscopy and diagnosed w/extreme gastrits and given Rx of 30mg Prevacid daily.  In first week of Feb began to experience extreme discomfort and pressure at the xiphoid process of the sternum and along the entire diaphram (side to side).  It kind of feels like something is 'folding' or pushing up under the sternum & ribs.  My GP adv me to take 30mg of 2x daily for 12days and then 1x a day. On day 3 of returning to the 1x dosage, I began to exp palpatations/shortness of breath in addition to the extreme sternum pressure. GP put on a holter for the 24 hours. Told GP about the experience on the Prevacid and questioned if the 30mg was too much and she decreased my Rx to 15mg per day. I had not taken any Prevacid for over 48 hours and was beginning to feel better palpatation wise, however the reflux acid was up and pressure the same, so after having the new Rx filled took one 15mg of Prevacid.  Within 45 minutes the palpatations were back with a vengance.  GP refered me to an Internist who mentioned that only one episode was noted on the Holter of a heart rate incrase to 145bpm. I talked to her about the Prevacid and she advised me to quit taking it and manage the reflux w/Pepcid AC or Pepcid Complete over the counter, she advised 1 in AM and 2 in PM.   The package insert says not to take more than 2 in 24 hour period.  For 6 days followed package and did not take more than 2/24 hrs and slowly noticed a decrease of the palpatations but the sternum pressure has not lessened but was managing acid fairly well (sleep upright).  Today there was increase of acid so I followed the Internists directive that I could take 3/24hrs one in AM and two PM... the palpatation/shortness of breath are back along with a feeling of 'distortion of reality'... i.e. like when you have 'medicine head' from taking cold medications. Stopped Pepcid and now on Rolaids and Maalox.

As I had had the palpatations with two different 'types' of acid reducing drugs, research on the net found that Protonix, Prevacid, Prilosec, Nexium and Pepcid all have the advisment in thier package inserts that 'adverse experiences occurring in < 1% of patients' included Cardiovascular  System disruptions -angina, arrhythmia,  bradycardia,  cerebrovascular  accident/cerebral  infarction,  hypertension/hypotension,
migraine,  myocardial  infarction,  palpitations,  shock  (circulatory  failure),  syncope,  tachycardia, vasodilation.

I am scheduled for an Upper GI series as well as an echocardiogram.  Is it possible that the medications are the underlying cuase of the palpatations? When I press 'firmly' and downward from the sternum towards my pelvic region, the pressure under the ribs/sternum is releived.   Does that sound like the hernia may be worse?  Can there be problems with someones diaphram that would cause this type of feeling under the sternum?  I have lost 10lbs since this began and there seems to be less pressure pushing upwards.

[Kevin Pho, MD]

Hello - thanks for asking your question.

Please understand my limitations over the internet as I have neither met nor examined you. This information is for patient education only. Please see your personal physician for further evaluation.

There are many causes for palpitations.  Medications could definitely be a cause - vasodilators and anticholinergics are common medications causing palpitations.  Any cardiac arrhythmia, valvular heart disease, an enlarged heart, psychogenic causes (i.e. anxiety or depression) are other causes.  An EKG to evaluate basic cardiac function and blood tests for anemia and thyroid function are reasonable.  Further tests including a Holter/event monitor can also be considered to evaluate your palpitations.  

It is also possible that your hernia has worsened.  Make sure that you evaluate for cardiac causes for this pressure under the sternum - an EKG and stress test would be reasonable.  After cardiac causes have been excluded, further tests including the upper GI series (which you are scheduled for), upper endoscopy and esophageal manometry/24hr pH study would be helpful tests to evaluate your sternal discomfort.  

If H Pylori testing has not been performed, they certainly should be done and appropriately treated if positive.  

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.

[nadia]

I have a hiatus hernia and chronic gastritis.  I also have palpitations  that have been described as paroxysmal tachycardia.  My heart starts to speed up for no apparent reason.  I was fine until I developed the gastritis and began a course of panteloc.  I was also on elavil and don't know which had a worse effect on my heart.

My most significant symptom is chronic pain underneath my sternum. It sometimes feels like a tight band wrapped around my lower chest.  I have had a ekg and am set to fly out to another province for a complete stress evaluation. I also developed high blood pressure.  I am taking atenolol and it controls the palpitations during the day, but strangely enough I still experience palpitations severe enough to wake me in the early morning hours.  This and the pain are quite frightening when they wake me from a sound sleep. Anxiety has been ruled out as the source of this with a holter study.

I have given up on a cure for this and am learning to live with this disabling condition.  I take Pariet for the gastritis and it helps a little. All doctors have told me that a hernia and gastritis would not cause this much pain.  So I am at a loss. I hope you have better luck with your symptoms!

[Pain7yrs]

Hi,
I am 34 1/2 yrs old female and have mentioned this pain to 7 doctors and received no treatment or something totally unrelated to my problem, except for my last two gastros.

Your problems sound so similar to mine, except I have been suffering with 'bellyaches' waking me up during the middle of the nights.  My gastro has run every test there is, and yes, I too, have a hiatal hernia and excessive acid production in my stomach.  But the nexium I have been on has not alleviated the bellyaches.  

I have had the right rib cage area pain that pulsates into my back for nearly 7 years.  It is only getting more painful and I have been very passive about my treatment in regards to this pain, because I always thought the doctors new what they were talking about.  For two years I had experienced vague pain in right side and into my back. Then two years later, which was

Dec. 1998 when my first bellyache began rather suddenly, I ended up in the emergency room, because it turned into a searing pain by that night.  I was given a GI cocktail to drink, didn't phase the pain.  So, doctors assumed a possible Gallbladder attack; every test they done showed no stones.  Then I began having temps of 103.5 and had a high white bloodcell count and peritonitis.  They had me on cipro IV, which wasn't helping to reduce the infection in four days.  A couple of possiblities were mentioned by the surgical team that was over me, such as, appendacitis, ulcer, but no one ever mentioned my colon.  Never occured to me then, either.  My gyno was called in and he changed my antibiotic to a better broad spetrum and I was much better the following fifth day, Thank God.  

Anyway, the doctors did nothing to me and left my records with no diagnosis.  Two years down the road, I was still having pain in right side and into right back, no vomiting, though I suffered from constipation periodically.  My gastro had a HIDA scan done on me and it showed a non functioning gallbladder, so I think, Yeah, maybe this is the cause of my pain, though my gyno said that adhesions from the previous peritonitis could help contribute to the pain, so I asked the surgeon that was removing my GB, to seek out adhesions, also.  She found none, removed GB and I hoped for no more pain.  Too bad, pain still there and belly aches become more frequent.  My surgeon tries to find the right acid meds for me, thinking it a stomach problem, but none work.  

The bellyaches can also feel like hunger pangs, except that the false hunger pangs occur when I have a full stomach, too.  This left me real cunfused.  Then the heart palps started and I still am having them today.

I quit the surgeon and went back to my gastro. He has been down my throat twice. I don't have ulcers, or h. pylori.  I don't get sick or vomit from anything I eat, and never did before I started any acid reducing meds.  So, I honestly don't believe it is my stomach that is causing my bellyaches, but my colon, or 'transverse colon' to be exact.

So, I am finally not going to be passive about my healthcare anymore.  My Gastro, after I told him that I have been suffering with constipation really bad for the last couple of months with some narrow stools, stated that I was probably suffering from Irritable Bowel Syndrome with Extreme Constipation and gave me some  Zelnorm (6mg daily) to take to help with the constipation and to eat more fiber, drink more water, and walk and exercise.  Well, I have been doing so, but it is not helping the constipaiton.  The zelnorm  made my bellyaches worse, but it felt like something scraping from the right side of my abdomen to my left side.  I guess it was stool mass moving finally.  I am still taking it with the hopes it will help.  The gastro did say it would take 3-6 wks to work effectively.  He has scheduled me for a colonoscopy on April 21 and hopefully this will determine if my colon is the cause of my right back pain under my rib area, as well as the bellyaches.  

So, if you suffer from some mild bowel problems in the past, be it diarreah (diarrhea) or constipation, you may want to discuss having a colonoscopy with your doctor.  I never connected any of my pains to my colon before, but considering that the 'transverse colon' does come up under the stomach area and runs horizontally across our abdomens, it only makes sense to check it out for problems too.   It has to be a COLONOSCOPY, because it checks all of your colon.  Believe me, I don't want to endure this procedure, but it can't be any worse than the pain and past procedures I have been submitted to.....

I will hopefully let everyone know my results and I pray that the results are not anything to be of great concern.  

Goodluck
Pain7yrs  and want it to stop!

[HansFromHolland]

Dear all,

I have read your stories.
A couple of years ago I starting feeling strange everytime I layed down. I thought I was too stressed (from working in my own company and having problems with my wife (depression)) and thought my heart was not OK, though I did not have any other heartrelated problems, and my condition was OK. I had a complete check, my heart was fine. The doctor told me he didn't have to see me again for at least 10 years.

But the problems lasted and got worse. I started to develope oesophagitis symptoms, later it turned out to be H.Pyloris. It was eredicated, but it didn't change anything. Finally I was diagnosed to have a problem with the valve of my oesophagus, so the acid goes up. They gave me Zantac, it gave me palpatations.
I tried Losec and I experienced every single side-effect. I tried Nexium, same problems. I tried Pariet, and it seemed to be a little better. But after a couple of months all the side-effects returned: headache, musclepains, flew-like feeling, fever (38 C), abdominal pains.

But I learned to live with it, because i am waiting for an operation, that is now being performed in the US. They will use a laser technique to repair the valve.

It worries me now that I have started to develope heart problems: palpitations and heart-rate disruptions.

I am convinced there is a connection between the two problems, perhaps due to the medication. I searched the internet for a long time, but didn't find anything. Untill I queried: palpitations and pariet. That's when I found your forum.

I am a bit desperate, and very eager to solve my problems. Hope to find help!?

[HansFromHolland]

Dear all,

I have read your stories.
A couple of years ago I starting feeling strange everytime I layed down. I thought I was too stressed (from working in my own company and having problems with my wife (depression)) and thought my heart was not OK, though I did not have any other heartrelated problems, and my condition was OK. I had a complete check, my heart was fine. The doctor told me he didn't have to see me again for at least 10 years.

But the problems lasted and got worse. I started to develope oesophagitis symptoms, later it turned out to be H.Pyloris. It was eredicated, but it didn't change anything. Finally I was diagnosed to have a problem with the valve of my oesophagus, so the acid goes up. They gave me Zantac, it gave me palpatations.
I tried Losec and I experienced every single side-effect. I tried Nexium, same problems. I tried Pariet, and it seemed to be a little better. But after a couple of months all the side-effects returned: headache, musclepains, flew-like feeling, fever (38 C), abdominal pains.

But I learned to live with it, because i am waiting for an operation, that is now being performed in the US. They will use a laser technique to repair the valve.

It worries me now that I have started to develope heart problems: palpitations and heart-rate disruptions.

I am convinced there is a connection between the two problems, perhaps due to the medication. I searched the internet for a long time, but didn't find anything. Untill I queried: palpitations and pariet. That's when I found your forum.

I am a bit desperate, and very eager to solve my problems. Hope to find help!?

[hilda01]

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[miserableme]

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