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Feeling light headed, uneasy, severe burping, choking sensation. On pacemaker, pantop. Why persistent?

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Dear Sir, Over the past couple of years, periodically, I feel light headed and uneasy. I become OK with Pantop. I am now 65 yrs. Last 4-5 months, I have severe burping and then I feel uneasy and feel choking sensation in the chest. I am on Pacemaker last 10 yrs and its OK on recent check. My doc gave me PantopD 20 mg twice a day with ITOPRIDE for a month. I took for 17 days and also took ZiVit for a month. I felt much better. Now it has started again - suddenly I feel unsteady. I have no sugar problems.
Posted Mon, 7 May 2012 in Digestion and Bowels
Answered by Dr. Rakhi Tayal 1 hour later

Thanks for posting your query.

Your symptoms are very likely due to gastritis and esophageal reflux which is caused by excessive acid secretion and irritation of the lining of the stomach.

This causes a variety of symptoms including pain in the abdomen, nausea, lightheadedness, bloating and vomiting. Prolonged excess acidity and reflux can lead to ulcer formation in the long term as the mucosal lining of the stomach is destroyed by the acid.

Along with that stress can worsen the situation.

The best way to control these symptoms would be lifestyle changes with the following tips:
1.     Change and develop good dietary habits including eating several small meals daily.
2.     Diet should include fresh fruits, fiber XXXXXXX foods. Avoid spicy foods, fats and fried foods. Also avoid coffee, tea, alcohol, colas, and smoking. Avoid processed foods (Junk foods from refined carbohydrates). Eat freshly cooked food from whole grains.
3.     Adopt proper posture.
4.     Don't eat for at least three hours before you go to bed. If you have symptoms at night, try raising the head of your bed six to ten inches.
5.     Maintain adequate hydration.
6.     Adopting a sitting upright posture for 1 hr post meals will help in relieving the symptoms.
7.     Avoid foods to which you are intolerant.
8.     Start walking and reduce stress. You can also practice meditation techniques.

In addition to dietary and lifestyle changes, you can try the following medications to reduce your symptoms as follows.
1.     Antacids (Tums, mylanta) can be taken to relieve the acidity.
2.     Proton pump inhibitors such as pantop can be continued for few weeks.
3.     Activated charcoal will reduce the bloating sensation.
4.     Probiotics and digestive enzyme supplements will help to improve indigestion.
5.     Pepto bismol to relieve any abdominal discomfort.

As some of these drugs can be obtained by prescription, I encourage you to consider visiting your physician and use the following medications after discussing with him.

Hope this answers your query. I will be glad to answer the follow up queries that you have.
Please accept my answer in case you do not have further queries.

Wish you good health.

Above answer was peer-reviewed by
Follow-up: Feeling light headed, uneasy, severe burping, choking sensation. On pacemaker, pantop. Why persistent? 27 hours later
Dear Dr. XXXXXXX Tayal Madam,

Thank you for your very prompt reply. I have understood what you have said. Basic question is why there is excessive acid secretion? Any particular reason?

Till now I have not had stomach pain as such – maybe a dull pain once in a while. No bloating or vomiting. Main is light headedness and uneasiness (maybe because I then get nervous too). I have never fallen down. Last month I had severe burping and it used to come on – after exercise like climbing stairs. After I took 20 mg PAN D and Itopride BD for 17 days, it has reduced. I also now seriously do two prananyams (Kapal bathi and anulom vilom) for 30 mts or more daily. I am playing golf for 2 hrs 4-5 days a week.
My diet is simple – pure veg + eggs twice a wek and once in a while shallow fried stuff. No smoking or drinking (because of Aust Antigen +ve), tea, colas, processed/spicy etc.. Yes, being a south indian, I love my cup of filter coffee, which I have restricted to one medium size cup in the morning. It is difficult to stop that !!

An ayurved told me not to eat cabbage, cauliflower, potatoes, even dals, curd (have chaas/lassi instead) as they are gas producing. I love sweets and itch to have something after a meal. Maybe a chocolate or jaggery chiki. I enjoy icecream, or other sweets like XXXXXXX jamun/rasgullas.

Anything to worry on the Aust Antigen front? My Pace Maker may need replacement in due course. The usage has been minimal all these years as I am mostly on my own sinus rytham.

Pl give me some Indian commercial names for Tums, Mylanta, activated charcoal, peptobismol, probiotics/digestive enzyme supplements (is it unienzyme? If so what dosage and how long or sos only?). Can I continue ZiVit (Zinc and Multivitamin) ? Should I take Iron supplement? Also Vir B12? if so for how long?

My MD Physician calls me a hypochondriac – I am one probably. Do worry a lot (though most ly well settled on all fronts – except for my younger son of 34 yrs, in USA, was diagnosed and treated in Bangalore for a malignant tumour on his forearm soft tissues in 2009. He is OK now.)

Once again thanks so much for your inputs. With Regards. Cmde. M XXXXXXX XXXXXXX IN, Rtd.
Answered by Dr. Rakhi Tayal 26 minutes later

Thanks for writing again.

Excessive acid secretion might happen due to stress, anxiety, etc. Genetic predisposition might be a responsible factor.

Being australia antigen positive does not affect gastric acidity.

Indian names for antacids are Digene, Ulgel, Ranidom, etc.

Activated charcoal tablets are available over the counter.

Enzyme preparations that can be used are-- Unizyme, Aristozyme, etc.

You can take these on SOS basis or as prescribed by your physician.

Taking multivitamin and iron supplements do not help gastric acidity at all.

Hope my answer is helpful. Further queries are welcome.

Please accept my answer in case you do not have further queries.

Wishing you a trouble free speedy recovery.

Above answer was peer-reviewed by
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