Hello - thanks for asking your question.
As you can imagine, GERD may present in many different ways. Regarding the epigastric discomfort specifically, GERD-related chest pain may mimic angina pectoris, and is typically described as squeezing or burning, located substernally and radiating to the back, neck, jaw or arms, lasting anywhere from minutes to hours, and resolving either spontaneously or with antacids. It usually occurs after meals, awakens patients from sleep, and may be exacerbated by emotional stress. The preponderance of patients with reflux-induced chest pain also have typical reflux symptoms.
GERD needs to be distinguished from gastritis, infectious esophagitis, pill esophagitis, peptic ulcer disease, non-ulcer dyspepsia, biliary tract disease, coronary artery disease, and esophageal motor disorders. Unexplained chest pain should be evaluated with an electrocardiogram and exercise stress test prior to a gastrointestinal evaluation. The remaining elements of the differential diagnosis can be evaluated by endoscopy or biliary tract ultrasonography.
If you are still having symptoms despite being on Nexium, ambulatory pH monitoring is useful in evaluating patients with atypical reflux symptoms or those who have not benefited from a trial of antireflux therapy. This is something you may want to consider to see whether your symptoms are related to GERD or not.
I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Thanks a lot
The current consensus is to consider the percentage time with the intraesophageal pH below 4 as the most useful outcome measure in discriminating between physiologic and pathologic esophageal reflux.
You may want to ask your personal physician to see if this test would benefit you.
Thanks,
Kevin, M.D.
insisting to be tested, it didn't show on an upper gi test,
and have been treated for allergies (which I do have ) and Astma
for the last six years or so...the only symptoms I had was coughing and back pain...I would wake up everynight coughing and often cough during and after a meal.My doctor kept inisiting that I didn have GERD/ACID REFLEX..for I didn't have heartburn or food coming up into my throat like most GERD patients do.I went to a Gastrointerologist and had the Esophageal Manometry that measures the muscle pressure in the upper digestive tract and found the test to be positive. I was also sent home with a 24 hr esophageal test that measured the (PH) levels. It also showed that most of my episodes were a night while sleeping and some lasted more than 25 minutes.....My concern is because I went for so long with the symptoms before being diagnosed is
there a great risk of permanent damage that I can't reverse.
I'm now asking my doctor for an EGD test.I'm now on 40mg of Protonex twice a day...Is anyone else out there having luck with this med. My husband also elevated our bed up 8 inches and this helps the coughing episodes at night....
thanks
I too have been recently diagnosed with hypo and I experience alot of burning sensations, chest pain/burning some stabbing type pain in the back on occasion which I am thinking may be due to acid, and weird feelings in my throat. It is very unsettling for me too as I dont know if these symptoms I am getting are from being hypo or GERD.