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Gastroenterology (Expert Forum)
Chronic chest pain
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Chronic chest pain
by Trisch__0, Sep 09, 1998 12:00AM
10 years ago I had my gall bladder removed and I have experienced severe chest pains
ever since. After a multitude of tests, the doctors have decided
that I have esophagus spasms. I use nitro spray for the spasms and
take prilosec and adalat for maintenance. When the spasms get severe, I use
Stadol, a nasal spray pain killer. Is this the correct treatment?
I have seen several references to a 24 hr PH monitor and an esophagus motility
test? what are these? what do they involve? I have had an upper GI and
endoscope, what other tests are available for this and what do they involve?
_________________
Dear Trisch,
Esophageal spasm is a specific abnormality of esophageal muscle function in which there are high pressure simultaneous contractions occuring concurrently at several levels of the esophagus. This is in contrast to the normal situation in which a muscle contraction starts in the upper esophagus and then progresses down the esophagus. Although the diagnosis can be suspected by an upper gI x-ray, confirmation often requires an esophageal motility study. In this study a tube is placed into the esophagus via the nose. The tube contains small pressure transducers at different levels. The tube is advanced into the stomach and then gradually pulled out. As the pressure transducers pass through the lower esophageal sphincter they record an increase in pressure. Whwn all the transducers are back in the esophagus the patient is instructed to take sips of water. The pressure transducers record the timing of the esophageal contractions at different levels in the esophagus, the height oof the contraction and the duration. Based on these characteristics esophageal spasm can be diagnosed.
A 24 hr pH probe study is often done at with the motility study. After the motility study is complete the pressure transducers are removed and another tube containing an electrode that can recorde pH is placed 5 cm above the GE junction. Normals will have the pH above 4 during most of the recording period. In contrast, patients with esophageal reflux have regurgitation of acid into the chest and a pH that is less than 4. This test is used to assess the duration and frequency of acid reflux into the esophagus.
This information is presented for educational purposes only. Always consult your personal physician for specific medical questions.
HFHSM.D.-rf
*keywords; esophageal reflux
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