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Having chest pain, difficulty swallowing, sweating, feeling dizzy. CT and MRI normal. Any advice?

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Internal Medicine Specialist
Practicing since : 2001
Answered : 2272 Questions
A month ago I woke up with pain in the middle of my chest, problem with swallowing food, sweating all the time and dizzy. Breastbone pain and pain under my right arm, pressure near my ear radiated to the head, I was really weak. After three weeks I got bone pain in my arm and leg, also chest bone pain.

I did CT of my chest, abdominal, blood work neck CT brain MRI doctor didn't find any abnormalities, but I can not work, because of the pain of my bone I still can not eat a hard food only something soft or liquid, everything were on a right side but right now it's radiated to my left side. I don't know what to do I lost my hope already, please give an advice please.
Posted Mon, 23 Jul 2012 in Bones, Muscles and Joints
Answered by Dr. Ram Choudhary 1 hour later
Your problems seems to be resting not in your bone but it is in your gut most likely. They did all the investigations but found normal. The danger areas are cleared.
I suggest a trial dose of proton pump inhibitors like Prilosec OTC twice daily before food daily for 2 weeks. I believe it should help.
It is too early to lose hope. Medical science is far improved to assist you. Only thing you should gain confidence and help yourself. Avoid tight clothing and lying after food. Reduce consumption of coffee and suggest to get into walking shoes at least twice a day for 30 minutes.
Please consult a Gastroenterologist and get a Upper gastrointestinal endoscopy done because you are likely suffering from Oesophagitis- and a referred pain is being felt by you in chest bones.
Another possibility is a Reflux disease related to Gastro-oesophageal Reflux due to decreased tone of lower oesophageal sphincter.
Other investigation I would like to advise- CBC, Chest Xray and an ECG just to detect anything else if at all.
I hope that answers your query.
Above answer was peer-reviewed by
Follow-up: Having chest pain, difficulty swallowing, sweating, feeling dizzy. CT and MRI normal. Any advice? 25 hours later
Hello doctor XXXXXXX Choudhary,
Thank you for your response. I had ECG, endoscopy and CBC, all results came normal. But I have severe pain under my right breast, probably breastbone pain,
Bone pain in leg in arm, mostly on the right side, I lost 15 pound for 5 weeks, sometimes pain in my upper back in the middle of it and also pain under my shoulder I'm eating only soup and drink juices, because of my swallowing problem,
I feel like I have inflammation inside of my body all over. Doctor also check me for Lyme disease, it's negative. She also wants to do a bone scan, because of my pain in bone. Doctor is trying to help me , but she doesn't know what else she can do for me. And I also want to mention, I was on Prednisone, due to I had a shortness
Of breath also I had doxycycline just in case if it's Lyme, but it didn't help me.
That's why I'm exhausted from all of that.
Thank you in advance for you answer.

Answered by Dr. Ram Choudhary 10 hours later

Please do not be pessimistic surely you would be better.

If you have undergone endoscopy after the onset of pain then fine but if it was older then it is highly recommended to repeat one.

One thing I also have in my mind is a possibility of multiple myeloma. Serum electrophoresis and X-ray of skull and pelvis may provide a clue to it. If those also remain non-contributory then you should start Selective Serotonin Reuptake Inhibitor (SSRI) group of drug treatment for neuropathic / depression related fatigue and pain syndromes. Dose and duration of SSRI can be discussed with your physician.

In addition also start Prilosec OTC twice a day as soon as possible as already advised by me to treat gut related problems.

I hope that answers your query. Let me know if you have any other queries.

Above answer was peer-reviewed by
Follow-up: Having chest pain, difficulty swallowing, sweating, feeling dizzy. CT and MRI normal. Any advice? 2 days later
Thank you doctor XXXXXXX for your answer,
I will have a bone scan today. I have a question about gut, can it be found by endoscopy and how it can be recognize ? I had endoscopy couple days ago they didn't found anything ,but
I still have pain when I try to swallow even a medication. The pain radiate to my chest and back. I also have a low grade fever. When I don't eat I'm ok , but when I eat something I have pain everywhere. Thank you doctor in advance
Answered by Dr. Ram Choudhary 13 hours later
If you are absolutely pain free during interval periods and problem is related only to swallowing activity then probably you are having a functional disoder of the oesophagus called Cork Screw Oesophagus or cardiospasm, where oesophagus undergoes spasm induced by swallowing and more so for liquids.
The edoscopy reflects normal findings.
The problem can be detected by barium swallow test, where BaSO4 solution is given to swallow and X rays are taken which show the spasm.
If that is the case then it is worthwhile to get it done.
I hope this advise would be helpful.
Above answer was peer-reviewed by
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