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Question: I have been to see two doctors and had three EKGs (which were normal) in the last three weeks. I have had blood tests and my thyroid and pancreas are fine. Also, had stool samples done- no C.Dif infection, no parasites. My total white blood cell count is within normal range. My current symptoms are:
1. A feeling of burning or heat across my chest and down into my arms, on and off throughout the day.
2. After I eat the feeling of heat or burning moves lower in my belly and I feel some pressure under my right rib cage. Later still, there is a feeling of gnawing in my belly.
3. Waking in the middle of the night with my heart pounding and the feeling of heat or burning intensifying.
4. A feeling of weakness in my legs, intermittently. Feeling of weakness in my arms intermittently.
5. Also, a feeling of unsteadiness or light-headedness that occurs when I move my head from straight upright position.
6. I have lost about 10lbs since I asked my first question.
1. A feeling of burning or heat across my chest and down into my arms, on and off throughout the day.
2. After I eat the feeling of heat or burning moves lower in my belly and I feel some pressure under my right rib cage. Later still, there is a feeling of gnawing in my belly.
3. Waking in the middle of the night with my heart pounding and the feeling of heat or burning intensifying.
4. A feeling of weakness in my legs, intermittently. Feeling of weakness in my arms intermittently.
5. Also, a feeling of unsteadiness or light-headedness that occurs when I move my head from straight upright position.
6. I have lost about 10lbs since I asked my first question.
Brief Answer:
Gastritis with acid reflux causing Heart burn.
Detailed Answer:
Hello Dear,
Thanks for follow up query.
You are having severe Heartburn.Heartburn is actually a symptom of GERD (gastroesophageal reflux disease), and is caused by acid refluxing back into the esophagus.Due to overproduction of acid or due to the weakness of sphincter at gastro esophageal junction contents of stomach regurgitates back into esophagus causing severe irritation of mucosal layer of esophagus.This irritation can lead to further inflammationwhich can be felt as severe burnibg sensation in chest and retrosternal area.
As soon as you take food acid secretion starts from parietal cells in your stomach giving you a sensation of heaviness and pressure in chest again.
Excessive production and regurgitation of acid stimulates your autonomous nervous system which causes heart pounding.
All other symptoms like fatigue weekness etc are relate to GERD and dyspepsia only.Once this is controlled every thing with return to normal.
Suggestions
Please request your gastroenterologist to start you on PPI-antacids like Rabeprazole or Esomeprazole. Esomeprazole can be used in the dosage as high as 80 mg twice daily. Also, request him/her to add Domperidone 30mg or Levosulpiride(both are prokinetic)slow release once daily. This will slow down the reflux of acid back.Prokineic should be added in your regimen.
A combination of Rabeprazole with Levesulpiride would be the best.
An antacid containing local anesthetic (Mucaine gel or peptobismol) should be taken 2tsf thrice daily.(Oxethazaine +Aluminium hydroxide)) combination would be best for you take 2 tsf thrice daily with half cup of water.
Acotiamide is another wonderful new drug and is very effective in controlling symptoms of GERD and esophagitis. In trials- Acotiamide, a gastrointestinal motility modulator, at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults.Ask you Gastroenterologist to add it in thrice daily doses.It should be taken for minimum 3 months.
All these drugs can be considered by your gastroenterologist to provide you with symptomatic relief in your problem.All these medicine can be used at a time also by your primary.
General suggestion-
Drink plenty of fresh water daily.
Avoid juices they contain citric acid and will increase your acidity.
Drink two glasses of cold milk daily.Its alkaline and neutralise acid.
Take light easily digestible vegetarian food.
Avoid oily and spicy food.
No alcohol or smoking.
No aerated beverages or fast food like pizza etc.
Hope i answered your query well.
In case you need any other advice i would be glad to help you.
Thanks and Regards.
Gastritis with acid reflux causing Heart burn.
Detailed Answer:
Hello Dear,
Thanks for follow up query.
You are having severe Heartburn.Heartburn is actually a symptom of GERD (gastroesophageal reflux disease), and is caused by acid refluxing back into the esophagus.Due to overproduction of acid or due to the weakness of sphincter at gastro esophageal junction contents of stomach regurgitates back into esophagus causing severe irritation of mucosal layer of esophagus.This irritation can lead to further inflammationwhich can be felt as severe burnibg sensation in chest and retrosternal area.
As soon as you take food acid secretion starts from parietal cells in your stomach giving you a sensation of heaviness and pressure in chest again.
Excessive production and regurgitation of acid stimulates your autonomous nervous system which causes heart pounding.
All other symptoms like fatigue weekness etc are relate to GERD and dyspepsia only.Once this is controlled every thing with return to normal.
Suggestions
Please request your gastroenterologist to start you on PPI-antacids like Rabeprazole or Esomeprazole. Esomeprazole can be used in the dosage as high as 80 mg twice daily. Also, request him/her to add Domperidone 30mg or Levosulpiride(both are prokinetic)slow release once daily. This will slow down the reflux of acid back.Prokineic should be added in your regimen.
A combination of Rabeprazole with Levesulpiride would be the best.
An antacid containing local anesthetic (Mucaine gel or peptobismol) should be taken 2tsf thrice daily.(Oxethazaine +Aluminium hydroxide)) combination would be best for you take 2 tsf thrice daily with half cup of water.
Acotiamide is another wonderful new drug and is very effective in controlling symptoms of GERD and esophagitis. In trials- Acotiamide, a gastrointestinal motility modulator, at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults.Ask you Gastroenterologist to add it in thrice daily doses.It should be taken for minimum 3 months.
All these drugs can be considered by your gastroenterologist to provide you with symptomatic relief in your problem.All these medicine can be used at a time also by your primary.
General suggestion-
Drink plenty of fresh water daily.
Avoid juices they contain citric acid and will increase your acidity.
Drink two glasses of cold milk daily.Its alkaline and neutralise acid.
Take light easily digestible vegetarian food.
Avoid oily and spicy food.
No alcohol or smoking.
No aerated beverages or fast food like pizza etc.
Hope i answered your query well.
In case you need any other advice i would be glad to help you.
Thanks and Regards.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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