Hi, thanks for posting your concern in the HCM. You have a complex medical history. The present complaints of yours can be related to any of the following- 1. Ischaemic heart disease. Although your doctors have ruled out a myocardial infarction, by doing the tests you mentioned, an Ischaemic heart disease can be ruled out best by stress test or treadmill test. 2. GERD along with LPR. You are having a past history of GERD. Laryngopharyngeal reflux are very common in GERD and the concomitant presence of both may cause similar pain. This condition also seems more likely because this is more common after gastric bypass. 3. An unrelated but still common consideration is regional pain syndrome. This presentation is not very likely, but it s still a consideration. 4. Your other histories like PCOS, lupus, arrhythmia etc. -I don t think they have anything to do with your current complaints. 5. Iron therapy may cause GI irritation. But, such severe symptoms, especially after parenteral iron is very less likely. So, for the time being, my recommendations are- 1. Have a stress test done. 2. Avoid heavy meals, carbonated beverages, spices, alcohol, smoking. 3. Please consult your local physician for further clinical examination. 4. You may have some prokinetic tablets e.g. Tab Levosulpiride 25 mg thrice daily for 7 days. 5. Avoid stress. 6. Please maintain good oral hydration and high fiber diet. Regards