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GERD Diagnosis and Left Arm Pains

  I am a 45 year old male who has been complaining of digestive
  problems for the past 4 years. I have had all the normal testing
  done including an endoscope (yesterday) and esophogeal motility
  test and Bernstein Test to be done on Monday. I was on therapy
  for h-pylori and it had no effect at all. My gastroenterologist
  told me that the scope showed some signs of scare tissue in the
  food pipe.
  I have severe pain almost constantly in the breastbone area and
  often get pains down my left arm which always goes away when I
  get rid of my gas by belching. My left arm pain is really scary,
  it feels like my arm weighs about 50 pounds and it gets numb.
  My stomach is constantly full of gas from the time I wake up
  until the time I go to bed.
  My heart has been thoroughly checked and I am fine in that
  Why is he ordering the 2 tests for Monday (he said to rule out
  heart problems) and is there any other treatment that can be done
  so that I have to take medication forever. Can GERD cause these
  symptoms especially the arm pains.
  Thanks for any information,
Dear Blair Price,
There arer several questions in your lettter.  The Bernstein test is almost always done as part of the motility study.  The Bernstein test involves infusion into the esophagus of either acid or saline solutions.  If your pain is related to acid reflux, you will have symptoms during the acid infusion but no discomfort during the saline infusion.  
Regarding the cause of your chest pain, the first efforts must be directed towards exclusion of cardiac disease, done according to your note.  The other possibilities to consider are esophageal reflux, esophageal spasm, and irritable bowel disease.  None of these conditions would be expected to be associated with the arm symptoms that you describe.  Cervical nerve root compression, due to disc problems, for example, can cause arm pain but should not get better with belching.
The first task is to identify the cause of the pains.  If your problem is esophageal reflux, lifestyle modifications (e.g. no cigarettes, no alcohol, 3 meals, no snacks, avoid fatty foods, peppermints, chocolate, sleep with the head of bed elevated) would be the initial therapy.  Treatment with H2 receptor anyagonists or proton pump inhibitors e.g. Prevacid will improve symptoms.  the only way to control the reflux -related pains, without requiring medication, is surgery.
This information is presented for educational purposes only.  Always consult your personal physician for specific medical questions.
*keywords: esophageal reflux, chest pain

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