GERD with Back Pain/Pressure

F, 52, trouble with severe heartburn for three years, using Nexium daily.  In addition to the substernal burning, now have started with a sensation pressure on my back, as if someone is sitting on it x3 months.  Also have a sensation that something is twisted inside my stomach area.  This is annoying to say the least.  It comes and goes day to day and effects doing the things I like to do.  I am trying to heal myself by cutting the caffeine, losing that 10 lbs., etc.  Endo and colonoscopy scheduled, but not until Sept. 10.  What could this be?  My gastroenterologist didn't seem too worried about it and ordered no additional tests. Thank you for your valuable service.

[Kevin Pho, MD]

Of course uncontrolled heartburn can lead to your symptoms, as well as other causes of dyspepsia - including ulcers, inflammation of the upper digestive tract, and gallbladder disease.  

Before attributing it to these causes, you may want to ensure that the heart isn't involved.  A simple exercise stress test can be considered to evaluate this.

If negative, then the focus can return to the GI tract.  The endoscopy and colonoscopy would be the best tests, but other things to consider would be an upper GI series (which can evaluate for ulcers, and can probably be scheduled sooner than an endoscopy), tests for H Pylori (a bacteria associated with ulcers and inflammation), as well as a 24-hr pH study (a definitive test for GERD).  If negative, an ultrasound can be considered to evaluate the gallbladder and liver.  

You may want to discuss these options with your personal physician.

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

**Note: I'll be away until August 14th - The forums will re-open then.**

[yoshi]

as we age,we produce less stomach acid.the symptoms are similar -less acid,too much acid.
if you have been on nexium for 3 years,you may want to find out if you are having problem due to not enough acid.

[kevinmd]

**Note: I'll be away until August 14th - The forums will re-open then.**

[Varv]

I had my gall bladder out two months ago and I still have acid reflux.  The symptoms change form constantly.  Sometimes I get tingly, prickly feelings in my chest, with sharp chest pains on the left, sometimes burning.  Today I have pressure and feelings of gassiness, and have been belching all day.  I started back about 4 months ago with the chest pains, did the upper GI (found a teeny hiatil hernia that the doc said should not be a problem because it was so small), had upper endoscopy and it came back negative, stomach biopsy - negative, did a ultrasound found a sludgey gallbladder and bloodwork came back with high liver enzymes.  I also had severe burning and pressure in my chest after I ate.  I lost 30 pounds because I couldn't eat anything.  Now I am just maintaining the weight I am at.  120 is too thin for my frame.  I had the gallbladder out and I still have the pains.  The only thing I can seem to get down for liquids is Gatorade.  I can't eat certain dairy foods.  I haven't tried to eat raw veggies yet for fear that they won't digest properly. Eatting has become an absolute issue!  I have been taking Nexium for 4 weeks, symptoms have gotten a little better but still not 100%.  Also, I have become anxious and panicky over this and that stress does not help me at all.  Could the reflux been brought on by the sludgey gallbladder?  Have other people felt like this after they have had their gallbladder out.  A friend of mine told me it took her 6 months to feel "back to normal".  HELP!!!  My doctor is being so non-chalant over this and it is scarey when you are constantly anticipating pain everyday.

[yoshi]

best is to start a new thread to get the doc to answer your question and for others to respond.

[dianelle]

Thank you Yoshi, I have never heard of low acid.  Is there a name for such a condition?  Web search didn't reveal much.  Thank you, Diane

[yoshi]

http://www.diet-and-health.net/Diseases/Hypochlorhydria.html
side effects of nexium-
http://www.rxlist.com/cgi/generic3/esomeprazole_ad.htm

[workaholic]

I went through the same thing after I had my gallbladder removed.  I had it removed on November 20,2003 and in February 2004 I was still having loose stools, lots of gas, was nauseous alot and couldn't eat much.  A new symptom I got was a fluttering feeling in the right side of my chest and throat.  When I went to my doctor she said it was GERD and put me on Priolsec.  I took that for about a month and was still having the same symptoms but to a lesser degree.  I was still losing weight and not able to eat much.  She continuted to insist that it was GERD and that I should quit smoking and put me on Zyban (which made my mouth incredibly dry, caused restlessness and headache). The fluttering did finally go away for the most part after about 2 months on Prilosec.  She did suggest that I start taking Metamuclie for the loose stool, which I did and it worked great!  It was finally in about May 2004 that I started feeling back to my old self.  So it was about 6 months post op.  I did stop taking all of the medications about that same time and have not started up again and feel fine.  I do still have a few symptoms when I eat a heavy meal and I can't drink coffee but if I control it with Maloxx and diet.

It is very frusterating and I totaly sympathize with you.  They treat you like it is no big deal but you are scared and I did have some symptoms of anxiety before it was confirmed that I needed to have the surgery.  For example, when I would feel the pain I would get nautious then I would get light headed, dizzy and short of breath.  I was pretty sure I was dying and very scared.  Even when I would feel the fluttering I would have some of these symptoms.  Finally I just convinced myself that they had done all of the tests (upper GI, EKG, HIDA scan, ultrasound) and everything was fine so it must just be the GERD but I don't like to take drugs and I would like to have a family soon so I took myself off the drugs.  It is a long road to recovery which they don't tell you until later when you are not getting better.  My surgeon told me 4-6 weeks after surgery I would be good to go.  They my doctor says it can be 6 months to 1 year.  Well for me it was at least 6 months.  

Sorry to ramble but I thought it might give you comfort to know that you are not alone.  Hang in there it will get better.

[mesayhi]

Hi there,
  Did you get the cholesectomy with laparoscopic procedure ? How was the postop pain (1-10 VAS scale) ? How much did the pain reliever work ?