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Gastroenterology (Expert Forum)
Re:Chronic chest pain associated with esophageal spasms
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.
Re:Chronic chest pain associated with esophageal spasms
by Mike__0__0, Jan 01, 1995 12:00AM
Posted By Mike on June 23, 1998 at 02:43:40:
In Reply to: Re: Re:Chronic chest pain associated with esophageal spasms posted by HFHSM.D.-rf on June 19, 1998 at 21:51:46:
I am a 33 year old male who was diagnosed 2 years ago with esophageal spasms and GERD. I was put on pepcid and cardizem (120 mg 1X daily) and maalox as needed.
I recently developed an ulcer and was put on prilosec to clear it up. I stopped taking the pepcid as my doctor advised that I had developed a tolerance to it. The prilosec caused some really nasty side effects including loss of appetite, nausea and headaches. My cardizem also stopped working at this point and the spasms returned. These spasms lasted for hours and cycled for two weeks, sometimes occuring every hour. I went to the e.r. to get checked out and the ekg was normal. My doctor bumped up my cardizem to 240 mg 1X daily and this seems to help, but I'm feeling a little light headed. Is this light headedness likely to go away with time? I can exercise as normal, but jogging seems to make my stomach sore.
I am also wondering about a long-term solution to this problem. I don't want to continue taking medication forever. Are there any other therapies available?
I have all the classic signs of heart problems when my esophagus spasms (substernal pain, pain on both sides of my chest-sometimes radiating down both arms and my jaw), but I have had all the tests that could be run to track this down with negative results (ekg, echo's, stress test). I also had the 24 hour ph monitor of my esophagus, the manometery (sp) test, and have been scoped. The esophagus showed signs of old lesions that have healed, but my doctor feels that I have burned it rather well with my GERD. The doctor said that I may have a sliding hiatal hernia, but he's not sure. I am kind of at my wits end and need to hear what others have done to deal with this.
Thanks
___
: Dear mike,
It is necessary to determine if your problem is esophageal reflux, esophageal reflux plus a secondary motility disorder or a promary motility disorder (i.e. not due to reflux). The results of the manometry and 24 hr pH probe are crucial pieces of information. If your problem is reflux, there are other medical therapies to try instead of Prilosec. These include Prevacid ( a different proton pump inhibitor), Propulsid ( a prokinetic agent that promotes gastric emptying and strenghtens the lower esophageal sphincter) and antacids such as Gaviscon. It is not evident that you have received maximal medical therapy if your problem is reflux.
Laparoscopic surgery can be considered for refractory reflux and for primary motility disorders.
This information is presented for educational purposes only. Always consult your personal physician for specific medical questions.
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 disease by calling the Henry Ford Physician Referral Line at (800)653-6568.
HFHSM.D.-rf
*keywords; esophageal reflux, esophageal spasm, surgery
0.3
I forgot to mention that the 24 hour ph monitoring and motility study showed that I had chest pain and heartburn associated with a small amount of reflux. I had a problem eating during the 24 hour study (the probe made me gag), but I had what was called an, "essentially negative study," but the report added that I did have a small amount of reflux. The motility study showed that I had good motility.
Tonight after dinner, the chest pain returned and at one point radiated up and down my torso, even though I was sitting up at the time. In the past, I have noticed that after eating, if I bend over to tie my shoes, I feel like everything is coming up. The pain associated with this usually moves around from the front of my stomach to my back to my chest arms and jaws. I have done some research about this problem and have found that myotomy can be performed if the spasms don't stop. I was wondering what problems can crop up after this procedure (i.e. swallowing, diet restrictions, etc.)
Thanks for the help.
Mike
In Reply to: Re: Re:Chronic chest pain associated with esophageal spasms posted by HFHSM.D.-rf on June 19, 1998 at 21:51:46:
I am a 33 year old male who was diagnosed 2 years ago with esophageal spasms and GERD. I was put on pepcid and cardizem (120 mg 1X daily) and maalox as needed.
I recently developed an ulcer and was put on prilosec to clear it up. I stopped taking the pepcid as my doctor advised that I had developed a tolerance to it. The prilosec caused some really nasty side effects including loss of appetite, nausea and headaches. My cardizem also stopped working at this point and the spasms returned. These spasms lasted for hours and cycled for two weeks, sometimes occuring every hour. I went to the e.r. to get checked out and the ekg was normal. My doctor bumped up my cardizem to 240 mg 1X daily and this seems to help, but I'm feeling a little light headed. Is this light headedness likely to go away with time? I can exercise as normal, but jogging seems to make my stomach sore.
I am also wondering about a long-term solution to this problem. I don't want to continue taking medication forever. Are there any other therapies available?
I have all the classic signs of heart problems when my esophagus spasms (substernal pain, pain on both sides of my chest-sometimes radiating down both arms and my jaw), but I have had all the tests that could be run to track this down with negative results (ekg, echo's, stress test). I also had the 24 hour ph monitor of my esophagus, the manometery (sp) test, and have been scoped. The esophagus showed signs of old lesions that have healed, but my doctor feels that I have burned it rather well with my GERD. The doctor said that I may have a sliding hiatal hernia, but he's not sure. I am kind of at my wits end and need to hear what others have done to deal with this.
Thanks
___
: Dear mike,
It is necessary to determine if your problem is esophageal reflux, esophageal reflux plus a secondary motility disorder or a promary motility disorder (i.e. not due to reflux). The results of the manometry and 24 hr pH probe are crucial pieces of information. If your problem is reflux, there are other medical therapies to try instead of Prilosec. These include Prevacid ( a different proton pump inhibitor), Propulsid ( a prokinetic agent that promotes gastric emptying and strenghtens the lower esophageal sphincter) and antacids such as Gaviscon. It is not evident that you have received maximal medical therapy if your problem is reflux.
Laparoscopic surgery can be considered for refractory reflux and for primary motility disorders.
This information is presented for educational purposes only. Always consult your personal physician for specific medical questions.
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 disease by calling the Henry Ford Physician Referral Line at (800)653-6568.
HFHSM.D.-rf
*keywords; esophageal reflux, esophageal spasm, surgery
0.3
I forgot to mention that the 24 hour ph monitoring and motility study showed that I had chest pain and heartburn associated with a small amount of reflux. I had a problem eating during the 24 hour study (the probe made me gag), but I had what was called an, "essentially negative study," but the report added that I did have a small amount of reflux. The motility study showed that I had good motility.
Tonight after dinner, the chest pain returned and at one point radiated up and down my torso, even though I was sitting up at the time. In the past, I have noticed that after eating, if I bend over to tie my shoes, I feel like everything is coming up. The pain associated with this usually moves around from the front of my stomach to my back to my chest arms and jaws. I have done some research about this problem and have found that myotomy can be performed if the spasms don't stop. I was wondering what problems can crop up after this procedure (i.e. swallowing, diet restrictions, etc.)
Thanks for the help.
Mike
