Hi, As you have ruled out cardiac causes, the most common etiology seems to be related to stomach for which you already have scheduled EGD. It will help in determining the etiology with gastroesophageal reflux disease being the most common that is a condition in which troublesome symptoms, or complications result from the reflux of stomach contents that are acidic in nature and hence cause burning sensation. Although these should have been improved by the treatment that you are already taking but improvement depends on the severity of the disease as well. So, it may take longer if the damage is severe. It will also help to know if peptic ulcer is the underlying etiology for it, where there are sores produced in the lining of the stomach, or of the duodenum (which is the first part of the small intestine). Also it is important that you take the medications prescribed to you properly. For that, take Prilosec. Also take Carafate. If the above regimen doesn’t work and the pain is troublesome, then you may try taking tricyclic antidepressants (imipramine and trazodone) that are felt to produce their favorable effect by reducing pain transmission from the esophagus to the brain. SSRI like Sertraline can also be tried. But I would suggest you that you discuss these treatment options with your primary health care physician. Apart from that, avoid drinking alcohol, smoking, spicy food or ingesting caffeine. The causes suggested by you (nerve or lymph problem) are rarely reported and have very less chances of occurrences. Also they generally have accompanying symptoms like shortness of breath, wheezing etc. Hence, it is better to rule out the common ones first. Also the symptoms as described by you of chest pain being worse in the evening(because esophageal reflux tends to occur after meals) and better with exercise are pointing towards GERD. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Maninder, General & Family Physician