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Have occasional bouts of chest pain. Pain is moderate to severe. Do plenty of physical work during the day. What could it be?

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Internal Medicine Specialist
Practicing since : 1980
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I have occasional bouts of chest pain, sometimes I wake up from it at night. It never lasts longer than 20 minutes. There are no other symptoms. It is moderate to severe. I am a 54 yr old female, weigh 150 lbs. don't have high blood pressure, do plenty of physical work during the day.
Posted Fri, 8 Nov 2013 in Women's Health
Answered by Dr. Rakesh Karanwal 51 minutes later
Brief Answer:
Pain should get relieved by antacids

Detailed Answer:
Hi Ma'am,

Thanks for your query.

I wish that you had provided more details about the chest pain (which part of the chest), presence of acidity, nausea, associated breathlessness/sweating.

However, as you have mentioned that there are on other symptoms, I come to the conclusion- from the details provided- that you may be suffering from either :-

- Gastroesophageal reflux disease (GERD)- a condition in which the acid produced in the stomach regurgitates into the food pipe, causing burning severe pain.

- Hiatal hernia - a condition in which a part of the stomach goes into the food pipe and, thus renders the sphincter (unidirectional valve at the junction of food pipe and stomach) incompetent. Hence, during lying position, the stomach acid flows by gravity, into the esophagus (food pipe) and cause chest pain during sleep.

The exact diagnosis would be ascertained by endoscopy.

- Pain of heart origin- though unlikely- is the other possibility. A Treadmill Test (TMT), if at all required, will exclude the diagnosis of heart disease.

I will therefore suggest that you take antacid suspension 4 spoons four times a day; anti-acid pills such as omeprazole twice a day; sleep in a semi-reclined position by using extra pillows under the back; avoid alcohol, coffee/tea/beverages and spicy food; take small, frequent meals and a few snacks at bedtime. Observe the response over the next one week. If you improve, the diagnosis of either GERD or Hiatus hernia will be confirmed clinically. Then, endoscopy will distinguish between the two conditions.

You may discuss my opinion with your doctor/gastroenterologist, who will know what is best for you.

Hope I have answered your query. If you have further clarifications, I will be happy to answer them.

Fond regards,

Dr. Rakesh Karanwal
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