Please provide an explanation for chest pains...

  A while back I suffered some chest pains while entering data into a computer.  I have a hiatal hernia, so attributed the pains to that condition and took some antacids.  The pains eventually left. (The pains were a lot more uncomfortable than any I have previously experienced.)  A couple of days after that, I had the pains again.  The pains were in the middle of my chest and radiated outward over the chest-area of both breasts.  It also radiated up into my neck and jawbone.  It was extremely uncomfortable.  The second time it happened I again took some antacids.  The pains got worse.  I began feeling a little ill so decided to leave the room.  When I stood up I felt like I was going to pass-out.  I was able to make it out of the room, but had to sit down on the floor in the hallway because I could get no further.  
  An ambulance was called.  They checked my blood sugar and said it was extremly low.  They gave me some sugar water and I felt much better after a while.  Before the sugar water, I also had chills, slight sweating,  and some slight shaking.
  Since heart problems run in my family, the hospital kept me overnight and checked periodically for something in my blood to indicate heart attack.  I also had to do a tread-mill test the next day.  Everything came back just fine.
  My physician diagnosed me as "breathing wrong."  He said it was really common in people with spastic colons (i.e., IBS).  Can you please explain to me why this is so?  How does it happen?  And is there anything I can do to prevent this from happening again.  My doctor's advice is to take a break and get up and walk around.  
  Have you ever heard of this complication of a spastic colon?  Could the symptoms have been caused by low blood sugar?  (I was fasting -- maybe 12-14 hours or so -- at the time.)  Is it possible the hiatal hernia had something to do with this?  
  I have had this problem start up a couple of times since then, but do some controlled deep-breathing and the pain goes away after a while (10-15 minutes).  
  Can you please explain to me what is happening when I feel these pains?  I have been diagnosed with a hiatal hernia, IBS, and diverticulosis, to name a few.  I am 43 years old and am about 70 pounds overweight, if any of these things matter for your diagnosis.
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Dear Barbara,
When I first read your letter, I thought that a cardiac condition was the cause of your symptoms. The normal stress test, however, argues against that explanation.  I am unfamiliar with "breathing wrong" as an explanation for chest pain, but if relaxation by slow breathes works for you I would continue with this treatment whenever the chest pain recurs.
Spastic colon is a general term that refers to abdominal pains that are not due to organic diseases of the colon.  Many physicians use spastic colon as another term for irritable bowel syndrome.  Although irritable bowel syndrome can include pains from the esophagus and small intestine, I am unfamiliar with an association with breathing.  Low blood sugar can cause sweating, weakness, and the sensation of impending faint, but this is not a manifestation of irritable bowel syndrome.
I wonder if your chest pains are related to an esophageal motility disorder, which can be part of the irritable bowel syndrome.  I suggest that you ask your physician to refer you to a gastroenterologist so that the appropriate tests can be done.
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by your physician.
If you want, we would be happy to see you in the Division of Gastroenterology at Henry Ford Hospital and perform the appropriate investigations after we have had the chance to meet you and to review your history in greater detail. You can arrange an appointment with Dr. Zonca, one of our experts in the diagnosis and treatment of esophageal pain by calling the Henry Ford Physician Referral Line at [phone].
HFHSM.D.-rf
*keywords: irritable bowel syndrome, chest pain
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