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Gastroenterology (Expert Forum)
Pain in esophagus
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Pain in esophagus
by beerhoch, Nov 23, 2004 12:00AM
Dear Doctor,
I am a 38 yo white male that suffers from GERD. 2 years ago I had an esophagal expansion do to scarring from reflux. I have been on 40mg of Protonix for 2 years now.
For the last month I have been having a pain right below my breastbone, where my stomach meets my chest, directly the center. It kind of like a squeezing sensation, and it usually is accompanied by a 'lump in the throat' sensation. Often this lasts all day long, sometimes it is worse at night. The pain leaves when I eat and for a while afterwards. The pain also is lessened by laying on my stomach (I have a beer gut) in bed, and usually only starts after I have been up for awhile. Sometimes the pain is rather pronounced, othertimes it is very mild. My appetite has been regular during this period.
I am wondering if this could possibly be a flare-up of my GERD, esophagitus or perhaps an esophigal spasm? I do not have any heartburn, however I am frequently 'gassy' and belch alot during these episodes. I might add that I was treated w/ angioplasty & stents 6 months ago for 2 blockages. I take 50mg of atenolol daily (as well as asprin, plavix, lipitor 80, zetia lorezepam and enalapril)and I have read that this beta blocker can weaken the LES. I have had 2 negative thallium stress tests in the past 8 weeks and I am relatively certain the pain is not cardiac related.
I realize that you cannot diagnose me in this forum. My gastroenterologist is booked solid for the next two weeks, and I would appreciate any insight you might have about my symptoms.
I am a 38 yo white male that suffers from GERD. 2 years ago I had an esophagal expansion do to scarring from reflux. I have been on 40mg of Protonix for 2 years now.
For the last month I have been having a pain right below my breastbone, where my stomach meets my chest, directly the center. It kind of like a squeezing sensation, and it usually is accompanied by a 'lump in the throat' sensation. Often this lasts all day long, sometimes it is worse at night. The pain leaves when I eat and for a while afterwards. The pain also is lessened by laying on my stomach (I have a beer gut) in bed, and usually only starts after I have been up for awhile. Sometimes the pain is rather pronounced, othertimes it is very mild. My appetite has been regular during this period.
I am wondering if this could possibly be a flare-up of my GERD, esophagitus or perhaps an esophigal spasm? I do not have any heartburn, however I am frequently 'gassy' and belch alot during these episodes. I might add that I was treated w/ angioplasty & stents 6 months ago for 2 blockages. I take 50mg of atenolol daily (as well as asprin, plavix, lipitor 80, zetia lorezepam and enalapril)and I have read that this beta blocker can weaken the LES. I have had 2 negative thallium stress tests in the past 8 weeks and I am relatively certain the pain is not cardiac related.
I realize that you cannot diagnose me in this forum. My gastroenterologist is booked solid for the next two weeks, and I would appreciate any insight you might have about my symptoms.
Doctor's Answer
by Kevin Pho, MD, Nov 24, 2004 12:00AM
, Nov 24, 2004 12:00AM
All of the possibilites you mentioned - GERD, esophagitis, or spasm - are possible and can cause the symptoms you described. Given your cardiac history, I would also consider heart disease. However, this is less likely given the negative stress tests you had recently.
I would consider a 24-hr pH study to definitively say whether this is GERD or not. If it is, and you continue to have symptoms despinte protonix, surgical options may be considered (i.e. a fundoplication).
You may want to discuss this option with your GI doc.
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.
Medical Weblog:
kevinmd_b
I would consider a 24-hr pH study to definitively say whether this is GERD or not. If it is, and you continue to have symptoms despinte protonix, surgical options may be considered (i.e. a fundoplication).
You may want to discuss this option with your GI doc.
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.
Medical Weblog:
kevinmd_b
Member Comments
by zb123, Aug 13, 2008 06:35AM
A related discussion, whats wrong with me was started.
