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GERD,high BP,anxiety,nausea and vomiting,gastritis,spasms and shortness of breadth.

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ENT Specialist
Practicing since : 2001
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I am a 37 years old male, asian, only 5'2". history of high blood pressure(under control with diovan), history of Anxiety which was controlled and returned recently due to doctor change in blood pressure medicine to beta blocker, but stopped after a few days. In the pass couple of years, I had many ECGs, stress, echo, xray and even an angiogram done due to chest pain, discomfort, pressure, nausea and feeling of vomiting, even shaking. History of Annkylosing spondylitis(taking Celebrex 200mg 2x daily), also on nexium 40 mg, daily for GERD. Recently I had been having the problem of my life. I am on a trip and did not get a chance to do a thing. I had been having a very bad gastritis which cause me chest pain, nausea and vomit, but beside this issue, I also have other symptoms not related to the gastritis. I felt like my heart is beating irregularly, shaking at times, felt my breath is cut off, also with a lot of discomfort and chest pressure not from the gastritis. also palpitations. I am constantly afriad of my heart is having a problem and I am going to die. can i still be having a heart problem in any way with all those test results are normal? sometimes similar issues same up after I take my medicine just about 1 hours later. this happens sometimes, not all the time, I know it is non related to anxiety because it is only after my med. How harmful can these issues be and can it cause my heart problem? also I had been having problem trying to fall asleep, as soon as I am falling a sleep, it seem like something wakes me back up, felt like a short of breath, spasm, which keeps me awake most of the night and I am extremely exhausted. what can it be?
Posted Tue, 8 May 2012 in GERD
Answered by Dr. Naveen Kumar 3 hours later

Thanks for the query

With the history you have posted over here, you have described of having GERD and irregular beating of the heart. Gastro Esophageal reflux Disease (GERD) is a condition where in there is reflux or regurgitation of the acid from the stomach into the esophagus. Due to the constant reflux of acid there will be chest discomfort and also sense of irregular heart beat.

After going through your brief history, I have notice few important points:
1.     You seem to be very busy with your work schedule with lots of stress
2.     Along with stress you are also having lot of anxiety and fear of death
3.     Sleep apnoea

You will be surprised, if I mention that all these problems are inter related with the prime cause being the nature of your work and the undue stress you are experiencing. At this young age of yours, you are going through multiple problems because of the above mentioned reasons.

Stress will increase the blood pressure as well as increase the severity of acid reflux. As the GERD worsens there will be lot of chest discomfort which is experienced as tightening of the chest and difficulty in breathing. Even the night spells of neck tightening and sudden awakening from the sleep could be attributed to GERD.

Can I still be having a heart problem in any way with all those test results are normal?
According to you, after going through a battery of test you have mentioned that your doctors could not diagnose any cardiac problem. That means, you do not have any major problems related to your heart, but it is only your anxiety and GERD which is giving you the feeling of heart problems.
As soon as I am falling asleep, it seems like something wakes me back up, felt like a short of breath, spasm, which keeps me awake most of the night and I am extremely exhausted. What can it be?
This is called sleep apnoea, this is a condition where in there is sudden cessation of breathing which awakes you from the sleep. Sleep apnoea is due to obstruction in the upper respiratory tract because of short neck, large tongue, enlarged tonsils and sometimes reflux of acid into the upper part of the esophagus and the throat, etc.

I would suggest you to avoid stress, everyday have food at the same time, drink plenty of water. Consult a good ENT specialist for a thorough examination for sleep apnoea. Also, you need to take a prokinetic along with Esomeprazole to reduce GERD. Your doctor will know about these medicines.

Hope I have answered your query; I will be available to answer your follow up queries.

Dr. Naveen Kumar

Above answer was peer-reviewed by
Follow-up: GERD,high BP,anxiety,nausea and vomiting,gastritis,spasms and shortness of breadth. 4 hours later
Thank you Dr. XXXXXXX XXXXXXX for your long and detail explaination. Actually I am no longer working for a few years due to major Ankolosing spondylitis, I can no longer work the long hours and stay focus because of the pain and most of the medications which use to work is no long effective. But yes, when I was working a few years ago, it is a bet stressful and a combination of other things trigger my Anxiety. For the most part in the pass, it was controlled, but as I had mention, it had returned due to a new medication. However, some things are very noticable at times which leads me to think it is not Anxiety related. Sometimes after my I take my medication, just within the hour, I feel the reaction coming down suddenly. chest pressure, chiles throughout the body at times, and discomfort which felt in arm and neck. Is it just a coincidence or is it the medication that is causing the issue? If the medication can do that, am I in any danger from the medications I am taken? These are medication I had been taken for some times such as Celebrex and Tylenol 3. I keep having these thought that one day, I would probably die from taken medication because I require so many just to get through the day and it only adds on, not less. as a matter of facts, my doctor have 2 new meds waiting for me to try upon my return from the trip.

also, can you explain my illness issues after sex? I can not seem to find much post on this issue, mostly are women. After I have the orgasm, I start feeling pressure and discomfort in the chest area, at times, i wanted to vomit and it get nausea which lasted for hours, and even after I start feeling ok, my mood remains bidder because of the instance. So frustrated

Actually i have to stand corrected, even thought I am not working or build up and work related stress, but my stress level has not change, maybe even more because of the fact that I can not work, pain at 90% of the time, with very little or none outdoor/gathering activities. most of the time I am frustrated at myself because of the many medical issues I am having. i always ask myself the same question over and over, "why this happen to me?" And the one little thing everyone enjoys doing, such as Sex, I have to take a few pain killers before just to enjoy the short little moment, with a outcome that leads to more illness. I am on this trip not for entertainment, but trying to search for some herbo replacement.
Answered by Dr. Naveen Kumar 1 hour later

Welcome back

I am extremely sorry for the trouble you are undergoing. Ankylosing spondylosis is one medical condition which does not have cure but makes human life really miserable. If you feel you are having chest discomfort and chills running through your body, then it could be the side effect of the drug Celecoxib ( WWW.WWWW.WW . You need to discuss with your Doctor and request for the change of the drug.

Secondly, why have you been prescribed Paracetamol along with Celecoxib? Do you really need both the medicines to be taken together?

Pain, nausea and fatigue are part of Ankylosing Spondylosis. You are experiencing chest discomfort while performing sex is because of the spasm of the paraspinal muscles, which is again a part of this medical condition.

My sincere suggestion to you is to discuss with your doctor regarding these symptoms you are having and request him to change the medicines for you. There are lots of other drugs in the market which have similar benefits and lesser side effects. You also require physiotherapy; the movements will help in diminishing pain and stiffness. And remember! If the same is performed in an active inflammatory state it would just make the pain worse. Try to maintain proper posture and do stress relieving exercises.

Wish You Good Health
Above answer was peer-reviewed by
Follow-up: GERD,high BP,anxiety,nausea and vomiting,gastritis,spasms and shortness of breadth. 6 hours later
thank you again Doctor for your reply. as for the medicine, yes, I do need both, Celebrex is daily for inflamination, and Paracetamol (I'm not sure what this is), if you are talking about Tylenol 3, yes, this is only as needed because just the celebrex is not enough to do the job sometimes. As for Tylenol goes, I don't take a lot, sometimes 1 pill a day, sometimes at the most 2 pill a day and at times, none.
As far as I know from my doctor, Celebrex is so far has been the most safe medication in it's class of NSAID. I had been on it for 5 months already and it is mostly ok, except for sometimes I get some effect, which I do not understand why sometimes only and most of the time it is fine. I use to be on a infusion that work very well for a few years and suddenly it did not work any longer, than we change it to Celebrex. I will take your advice and speak with my doctor upon my return, maybe get a change is the dose to see it help or not.

You also said "There are lots of other drugs in the market which have similar benefits and lesser side effects", can you name a few for me? I know there are some worst side effects, but not less and I use to be on those many many years ago.

As for the Sex issue, according to you, it is just a spasm of paraspinal muscles, is this dangerous? all the discomfort is none related to my heart working extra hard?

I guess the most concern I have is not because of all the pain and GERD, but rather it's the heart related or not. it is extremely to have the felling of having a heart attack and going to die. I guess I can have a sense of releaf from your answers above that is only anxiety. I am no doctor, but also no one is feeling the issues I am feeling besides me, so, for the most part, I truely can set it aside and said it is anxiety, but at times, I do believe it is somewhat related to something which is unknown(medicine, heart, or other medical issues that is not yet defind in me yet), of course I will certainly have a talk with all of my doctors when I return, because I can not be this way all the time. it is just making my life difficult on top of the many problem I am having already.
Answered by Dr. Naveen Kumar 2 hours later

Welcome Back

Celebrex (Celecoxib – Cox2 inhibitor) is a new NSAID with least Gastro-intestinal side effects but not without the effects on the heart unlike other NSAIDs ( WWW.WWWW.WW WWW.WWWW.WW WWW.WWWW.WW .

Paraspinal muscles are those muscles which are supporting the vertebral column and in the conditions like spondylosis there is spasm of these muscles in order to protect the inflamed part of the spine hence more stress on the surrounding muscles of the rib cage, neck muscles and the groin muscles ( WWW.WWWW.WW .

During sex all the muscles of the body come in to action and more so during orgasm because of sudden contraction. The excessive forces unevenly exerted on the spine’s joints, ligaments and discs from overactive (hypertonic, semi-contracted) muscles and underactive (hypotonic, overly stretched) muscles can cause chest discomfort. In fact, cardiac function is also increased during this activity in the form of increased cardiac out-put and raise in blood pressure.

“I am no doctor, but also no one is feeling the issues I am feeling besides me”.

We do understand your problems, a doctor always tries to help his patients and always at the service of the needy. You are still very young, you should not lose hopes. Your problem requires a proper understanding of the current situation and meticulous planning. Any more doubts you are always welcome.

Wish You Good Health

Dr. Naveen Kumar
Above answer was peer-reviewed by
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