Brief Answer:
Follow the Advises..

Detailed Answer:
Hello XXXX, Welcome to HCM,
I've gone through your query and understand your concern,

Your symptoms are particularly indicating few possibilities, i.e. an allergic etiology (specially since you've recently recovered from that severe anaphylaxis episodes, and it's a rather common phenomenon due to muscular spasm/ over-stimulation due to certain stress mediators and hormones)..

Next is the on and off heartburn and acid-reflux which can also initiate those symptoms intermittently..apart from this, gastro-esophageal sphincteric anomaly/ any infrequent narrowing of the esophagus can also present as a similar symptom..

Good that the cardiac profile fine as per your description as that's another possible etiology in this regard..

No, even though you had those previous episodes of pneumonia, it's not likely to be related here, neither is diabetes(good to know it's already checked and your on regular medications for this)..

Legionnaires pneumonia is a very severe infectious condition and can have several long term impact on the neuro-muscular system as well as respiratory tract which can also present those occasional symptoms..

Yes, few relevant investigations needs to be done to narrow down the exact cause/ the cumulative factors responsible for this, i.e. Hemogram along with Peripheral blood smear, ESR, electrolytes, a Comprehensive allergic panel check-up to look out what all substances are you specifically allergic to, a repeat Chest X-ray (it must have done several times till now)- along with a detailed Clinical examination by an ENT specialist / Pulmonologist who'll thoroughly examine you, auscultate your lungs, examine for any deviated nasal septum, and indirect/direct laryngoscopy to examine the respiratory passage as well as upper esophageal structures, if found anything significant with the gastro-esophageal structures, then there may be a referral to a Gastro-enterologist for further evaluation..management will be entirely based on the findings as well as investigation reports..

Good that you live in the vicinity of such a huge medical complex..

Meanwhile, please continue the PPI/antacid on daily basis {eg. Cap PANTOPRAZOLE 40 mg once daily 15-20 min before breakfast for next 10 days} and observe how you stay..

Start taking steam inhalation thrice daily for next 4-5 days, it should provide symptomatic relief..

If all above investigations come normal and physical examination by the specialist doesn't indicate anything significant then only stress can be taken under consideration (as by virtue of medicine, we have to rule out any significant organic causes firstly)..


Please let me know how you stay in the due course..

Take Care
Kind Regards

---

Brief Answer:
follow-up consultation..

Detailed Answer:
Hello XXXX, Welcome back,
Thanks for following up with these details,

Yes, Pantoprazole is certainly over the counter, it's the generic name, which we are bound to suggest as brands vary from each and every place..in general, you can find it by the name Protonix (it's even available at the Walmart), yes to enlighten you further it's the newer generation of Prilosec(Omeprazole) only.. there are even newer generation available i.e. NEXIUM (Esomeprazole, but they are reserved for much more severe symptoms of Acid-reflux and acid-peptic diseases)..

But, If you've taken Zantac previously and experienced relief then no need to change it, you can simply continue it (150 mg Twice daily in empty stomach ~ 20 min before food)..

Yes, certainly Gastro-esophageal reflux is one of most probable as well as plausible diagnosis based on your symptoms, which I've already summarized briefly in my previous reply, and that's why I've suggested you to continue with the PPI like Pantoprazole (it's okay if Zantac provided relief, you can simply continue as advised)..

No alteration in heart rate, not feeling dizzy and occasional feeling the tightness can certainly be due to acid reflux, but a clinical evaluation by the ENT specialist and those investigations are needed in the due course, as it'll not only help in narrowing down the exact pathology, but will rule out any of those other respiratory and/ allergic pathology(if any) for long term benefits and well being..

No need to hurry, but do get yourself checked out by the relevant specialist (the ENT as the first priority), and the investigations as per your convenience..

Meanwhile just follow the advises as I've already advised.. yes keeping a tab on the discomfort - when it happens/ what relieves/worsens it/ how long dose it stay/ which particular part of the day/
if happens after any certain activities etc. can definitely help with the diagnostic process further..

Once again, it's a pleasure to guide you too, please let me know how you stay in the due course..

Take Care
Kind Regards

For future reference you can always get in touch with me, below is my Direct follow-up link through which you can contact me directly anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

---