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Had GERD and anxiety problem. Having chest pain, nausea and bloating. All test normal. Concerned

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
acid refluxon 12/24/12 i was seen in the er for chest pain. the paun had been present for about a week before but got to the point i couldnt take it. whrn the dr camr in i told her i had been diagnoses with gerd and anxiety in the past and i was concerned it was my heart. she quickly said lets get to the bottom of this. she ran a ekg...ecg...chest xray...troponin blood test...and a ultrasound of my abdomin. she later came back in and said all test were gorgeous...heart..gallbladder and pancreas lookes great. told me it was gerd and anxiety and i shouldnt worry about heart. for a couple weeks it went away and for last week its back. i went to my pcp and he told me gerd as well and it can last for several weeks before the pressure can go away. my symptoms are...chest pressure...sorw throat....belching....stomach nausea...feel bloated...and stomach is making alot of noises. the most concerning thing is the chest pressure that comes and goes. with all the test that have been ran should i still be concerned about heart...or pancreas...or gallbladder even though they all came back negative? or should i just understand ita gerd and not worry? anxiety is getting to me!!
Posted Mon, 4 Mar 2013 in Digestion and Bowels
Answered by Dr. Mayank Bhargava 52 minutes later
Welcome to XXXXXXX forum.

With the available described symptoms, there appears to be possibility of dyspepsia; a group of symptoms suggesting upper gastrointestinal tract disease.

Dyspepsia includes acidic belching, abdominal discomfort, abdominal heaviness, excessive flatulence, sour fluid in throat, nausea or vomiting and you have defined most of these symptoms.
Dyspepsia may be organic (affecting upper gastrointestinal tract) or functional (feeling is present but all relevant investigations are normal).
Dyspepsia could be due to peptic ulcer disease, decreased gastrointestinal motility.
Peptic ulcer disease may be in form of chronic gastritis, fundal gastritis, nodular gastritis, follicular gastritis and gastric & duodenal ulcer, adenocarcinoma of stomach and GERD (all these disease are diagnosed by endoscopy).
Helicobacter pylori bacteria is responsible for peptic ulcer treatment and eradication is essential for complete relief.
Decreased gastrointestinal motility could be due to thyroid disorders, diabetes and age related.

Are you a smoker?
Smoking increases acid production in stomach with increased possibility of gastric problems.

You should consult with your treating doctor/ XXXXXXX medicine specialist/ gastroenterologist and should go for thorough check up.

Although your defined symptoms suggests the presence of GERD along with some component of anxiety, you should go for complete hemogram, thyroid profile and blood sugar, urea breath test for H. Pylori bacteria.
If urea breath test is found to be positive then you must have to take treatment against Helicobacter pylori bacteria.
You should also go for endoscopy for better clarification.
Meanwhile, you should take proton pump inhibitors along with prokinetics (which increase gastrointestinal motility) and tricyclic antidepressants & benzodiazepines (relieves anxiety) on written prescription.

Kindly follow these dietary restrictions:
1) Avoid tomatoes, citrus fruits, onion, garlic, oily and spicy food (particularly at night times), tea and coffee.
2) Avoid putting dough and boiled potatoes in refrigerator.
3) take less amount of legumes.
4) Only take 200 ml of milk; thats in the morning hours.
5) Keep difference of 3 hours between meals and sleep.
6) Take soft diet along with yogurt.
7) You should take frequent small amount meals.

Possibility of heart disease appears to be low as you have already undergone ECG but still you should go for stress test to rule out any heart related ailment.
Blockage of heart arteries can be detected by stress test.

Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
Follow-up: Had GERD and anxiety problem. Having chest pain, nausea and bloating. All test normal. Concerned 4 minutes later
they did a cbc and a thyroid panel already and all was clear. and i do not smoke and im 30 yrs old
and have had multiple ecgs
Answered by Dr. Mayank Bhargava 23 minutes later
You should go for endoscopy along with urea breath test for H. pylori.
There appears to be negligible chances of heart ailment.
Let me know the reports of above mentioned investigations.
Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
Follow-up: Had GERD and anxiety problem. Having chest pain, nausea and bloating. All test normal. Concerned 4 hours later
yes sir...they have done 3 ekgs......chest xray....ultrasound....troponin blood work....cbc....thyroid test...and have had multiple pcp check ups with blood pressure test....and all have said heart looks gorgeous and my risk factors are extremley low
Answered by Dr. Mayank Bhargava 7 hours later
Possibility of heart disease appears to be very low.
You should go for endoscopy.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
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