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Gastroenterology (Expert Forum)
Sharp chest, neck and back pain after eating
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.
Sharp chest, neck and back pain after eating
by kazma, Apr 13, 2006 12:00AM
Hi,
I am a 39 year-old male. 4 years ago I had a laparoscopic nissen fundoplication. However, shortly after the surgery I developed paraesophageal hernia. I needed to have a second surgery to correct it. After the second surgery I developed acute pancreatitis for which UI was hospitalized for 8 days. After many uncomfortable weekes I learned I had gastroparesis. My stomach does not empty well. To treat it I have been taking Motilium (domperidon) and it works effectively. However, 12 days ago I started to have very severe chest, neck and back pains after about 10-15 minutes of eating. Once the pain start it does not go away and gets worse even I drink some water.
The pain is very unbearable, I can not work. The pain affects my arms if it gets very severe.
The doctors first thought it were esophageal spasm. However, I have no difficulty in swallowing. I just had and upper GI endoscopy and the inside of the esophagous was normal. I no longer have haerthburn. I also had a barium swallow test which showed the swallowing normal and the fundoplication was in place.
The gastroentologist who did the endoscopy thinks that my pains are due gastric emptying problem, because he saw some food in my stomach during the test. However, I have had the condition for more than 3 years and have not had chect pains, was able to eat regularly as long as I took my medication. My stomach emptying has also improved as confirmed by a test done in the summer.
If I don't eat all day, my pain is very minimal I hardly notice it. However, as soon as I eat even a small amount the pain becomes very sharp and unbearable. The pains becomes even sharper when I breath in and out deeply. However, my heart rate is normal. I can breathe fine if I don't eat. I have no feeling of nausea or abdominal pains. Therefore, I have almost stoped eating. I have lost 8 lbs in 13 days, and I have been feeling very week. If I eat very slowly in small quantities I don't have severe pain.
I would like to know if my pains could be due to the fact that when I eat the stomach expands and tightens the fundoplication which in turn causes pinching the vagus nerve. Could pinching the vagus nerve cause these kinds of sharp pains? Can pinching of this nerve explain my gastric emptying problem which developed after the second surgery?
Could the pain be due to some sort of tear of a tissue to which they attached my stomach during my second surgery to fix the hernia?
Is it also possible that these pains are due to some sort of tumors in the abdomen or chest.
I feel as if doctors are not making any progress in diagnosing my condition. I am not sure how long I can survive without getting enough food. I am going to have an esophageal manometry study. However, I don't believe it is esophageal spasm, becasue my pain is related to the volume of the food in my stomach.
I hope some one can provide some sort of information to diagnose my problem. Any help is appreciated. Thanks.
I am a 39 year-old male. 4 years ago I had a laparoscopic nissen fundoplication. However, shortly after the surgery I developed paraesophageal hernia. I needed to have a second surgery to correct it. After the second surgery I developed acute pancreatitis for which UI was hospitalized for 8 days. After many uncomfortable weekes I learned I had gastroparesis. My stomach does not empty well. To treat it I have been taking Motilium (domperidon) and it works effectively. However, 12 days ago I started to have very severe chest, neck and back pains after about 10-15 minutes of eating. Once the pain start it does not go away and gets worse even I drink some water.
The pain is very unbearable, I can not work. The pain affects my arms if it gets very severe.
The doctors first thought it were esophageal spasm. However, I have no difficulty in swallowing. I just had and upper GI endoscopy and the inside of the esophagous was normal. I no longer have haerthburn. I also had a barium swallow test which showed the swallowing normal and the fundoplication was in place.
The gastroentologist who did the endoscopy thinks that my pains are due gastric emptying problem, because he saw some food in my stomach during the test. However, I have had the condition for more than 3 years and have not had chect pains, was able to eat regularly as long as I took my medication. My stomach emptying has also improved as confirmed by a test done in the summer.
If I don't eat all day, my pain is very minimal I hardly notice it. However, as soon as I eat even a small amount the pain becomes very sharp and unbearable. The pains becomes even sharper when I breath in and out deeply. However, my heart rate is normal. I can breathe fine if I don't eat. I have no feeling of nausea or abdominal pains. Therefore, I have almost stoped eating. I have lost 8 lbs in 13 days, and I have been feeling very week. If I eat very slowly in small quantities I don't have severe pain.
I would like to know if my pains could be due to the fact that when I eat the stomach expands and tightens the fundoplication which in turn causes pinching the vagus nerve. Could pinching the vagus nerve cause these kinds of sharp pains? Can pinching of this nerve explain my gastric emptying problem which developed after the second surgery?
Could the pain be due to some sort of tear of a tissue to which they attached my stomach during my second surgery to fix the hernia?
Is it also possible that these pains are due to some sort of tumors in the abdomen or chest.
I feel as if doctors are not making any progress in diagnosing my condition. I am not sure how long I can survive without getting enough food. I am going to have an esophageal manometry study. However, I don't believe it is esophageal spasm, becasue my pain is related to the volume of the food in my stomach.
I hope some one can provide some sort of information to diagnose my problem. Any help is appreciated. Thanks.
Doctor's Answer
by Kevin Pho, MD, Apr 14, 2006 12:00AM
, Apr 14, 2006 12:00AM
It is difficult to say without examination.
Although possible, I am not aware of cases where irritation of the vagus nerve can lead to the symptoms you describe.
I would consider medications like erythromycin or Reglan which has been showed in small studies to help. Investigation studies has shown that injection of botulinum toxin into the pylorus can help.
End-stage disease can also consider gastric pacemaker placement - although this option is experimental.
I would also discuss with a surgical opinion whether your prior procedure may have played a role.
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
Although possible, I am not aware of cases where irritation of the vagus nerve can lead to the symptoms you describe.
I would consider medications like erythromycin or Reglan which has been showed in small studies to help. Investigation studies has shown that injection of botulinum toxin into the pylorus can help.
End-stage disease can also consider gastric pacemaker placement - although this option is experimental.
I would also discuss with a surgical opinion whether your prior procedure may have played a role.
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
Member Comments
by dshsue, Apr 18, 2008 05:34PM
A related discussion, chest pain was started.
