Chest Discomfort with no relieft

[dhpennington]

I have a history of episodes with reflux and ibs.  6 months ago I had a bad episode of indigeston which, after it subsided, within a week or so I had chest pain and discomfort.  My general practitioner gave me an ekg and chest xray - all normal.  The discomfort comes and goes - no reasoning behind this.  I have been to my GI Dr and he prescribed Protonix and Carafate - I have taken this for the past 4 months and as usual - the episodes come and go still.  It has been hard to describe my symptoms - the best way I can describe the discomfort is upper substernum - I can reach a certain way with my arm and you can feel it "tug" whether I have discomfort or not.  I'm beginning to think it may not be my esophagus however - I still have reflux symptoms as well.  I have been treated with Zelnorm for IBS as well - I have recently stopped taking this, hoping to try to treat the bloating I have by diet.  
As I said - I have good days and bad days - today - a bad one.
I was a little frustrated with my GI Dr on my last visit - I have called since then and the nurse has pretty much told me to see my primary care physician.  I have had upper endoscopies - last one 4 years ago; colonoscopy 4 years ago.  Hiatal hernia was the outcome on the upper; normal on the colonoscopy.  I would like to be referred to a physcian in North Carolina - i.e. at Duke University Med or UNC Medical or Bowman Gray that might can address my problem more thoroughly if you think necessary.
Thank you.......

[Kevin Pho, MD]

To further evaluate the heart, you can consider some kind of stress test or echocardiogram.  This will be more comprehensive than an EKG.

If heart disease has been ruled out you can further evaluate the GI tract.  This can include repeating the upper endoscopy, as well as more specialized testing like a 24-hr pH study, esophageal motility studies, or an ultrasound to evaluate the liver and gallbladder.

Disease to consider would be GERD, an ulcer, inflammation of the upper digestive tract, liver or gallbladder disease.  

These options can be discussed with your personal physician.

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.

Kevin, M.D.
kevinmd_b

[yoshi]

does it have anything to do with what you eat?
the symptoms of too much stomach acid and too little stomach acid are often similar.

[dhpennington]

Don't know - I'm not the best eater in the world - I have tried to increase my whole grains (for IBS)but had been doing that before all of this transpired.  I did have Mexican last night but very little spicy, mostly chicken, lettuce, cheese, sour cream and very little salsa.  I failed to mention I had a gall bladder ultrasound back in July - everything was normal on that as well.  Thanks for the comment

[yoshi]

you did not mention testing for H Pylori bacteria,it can be done thru a breath test in your doctor's office.
If you have acid reflux or gastritis,you better google and find out what food to avoid-dairy products,tomato,chocolate,peppermint,greasy food,spicy food,caffeine,soda etc.
for temporary relief,you can take alka selzer,extra strength gas x or baking soda to see if it will neutralise all the gas in your system,if it is indeed gas which is causing the problem.

[dhpennington]

Thanks for the suggestions - I'll try those in the meantime!

[dhpennington]

Thank you for your comments - I failed to mention that I had a gallbladder ultrasound in July - normal.

[Natures_Way]

Have you considered a fungal infection?  Have you taken steroids or antibiotics lately?  Maybe worth looking into this.  Talk to your docor.

[rzdave]

I have been suffering with the exact same symptoms now for over 2 years.  Had upper and lower endoscopy, negative, lots of Gas, have taken Protonix now for 8 months. Some days are fine, other days lots of pain right under the sternum.  All blood tests are normal. Eating habits are normal.

So, I can relate to your frustration. I am going to have a CT scan of the area to rule out hernia although my gastro indicated he did not feel it was a hernia.  Is yours tender to the touch, in other words, does the pain radiate further when you touch the area affected, or does it hurt more when you move or bend your body on those days you refer to as bad days?

[georgie430]

I also have pain under sternum, mine is mostly right behind lower sternum, but sometimes can feel it midway. I too have a hard time explaining the symptoms, have been for ekg, echo, stress with the injection(resting and excecise)pulm fuction test,chest ct scan and abdomen ct scan) so far they really dont think its heart or lungs, so we are just starting the gastro work-up, but I'am very concerned, if you want to email me
   ***@****  maybe you'll get some answers alot sooner then I'am........georgie

[dobe911]

Sounds like esophageal spasms - I have this and it is very painful.  I am symptom free as long as I take Singulair everyday at the same time.  If I miss it by over a hour - the pain returns.  Funny, because this medicine is not really for that.