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Having throat pain, acid reflux, tension. Took xanex and ambien. No relief. Any treatment?

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I am male, 37 years old, non smoker, 3 drinks a week drinker, no dip, play Basketball 3 times a week for 1 1/2 hours,pretty healthy diet but not the best, I own a construction company and all blood work is squeaky clean.

About 8 months ago I was 1/2 way in a large commercial project and getting a heavy dose of stress. I normally operate on stress, so much so that 5 years ago I went through bankruptcy and had plenty of stress, but never physically hurting from it.

I started feeling a pain/burn in my sternum to my throat. For a month or so I did nothing and lived with, but as is stayed strong I took .25 MG of Xanex from my friend, and it seamed to ease the tension. This pain doesn't seem to be associated with food, but more associated with thoughts. When I think of a stressful thought, I feel a burst of adrenaline in my stomach, which then goes to my sternum. Sometimes a random thought will come, and it's not a stress thought, but my mind treats it as such, and I feel the adrenaline in my stomach. I have been to my general doctor several times and they cant seem to tie stress to Acid Reflux, but they think that is what it is, Acid Reflux. I have been on Prilosec OTC for a few months now, and it has not appeared to help much. I have taken 20MG a day, and even bumped it up to 40MG per day. I take Ambien to sleep (as I have never been a good sleeper, my mind will not shut off), Xanex .50MG at night, and ibuprofen on occasion for general pains.

At night, aside from generally not sleeping well, my chest does not bother me at all. When I am playing basketball, or engrossed in something like mowing the yard, or pretty much any activity where I am not thinking, I am 100% fine. When I slow down, sit down, and start any activity involved in thought (Work) my chest starts hurting.

Please let me know ANY of your thoughts, sorry for the book, but it's important.
Posted Sun, 24 Feb 2013 in Anxiety and Stress
Answered by Dr. Ashish Mittal 52 minutes later
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

It is good that your blood work is normal. From your description and normal blood work, we should suspect presence of anxiety disorder. But, It will be better to rule out cardiac illness by examination and investigation specially EKG.

Severity of anxiety may vary time to time, in your case it is associated with stress in life. That is why your symptoms improved with Xanax which also have anti anxiety effect apart from sleep inducing action.

Other symptoms of anxiety which may or may not be present in your case: nervousness, restlessness, mild irritability, excessive worry regarding own health, tremor, muscle spasm, heaviness in body, easy fatigability, headache, sleep disturbance, palpitation and dry mouth.

Anxiety disorders can manifest with not only psychological symptoms but with a variety of physical symptoms also. Tingling, numbness, increase acid secretion, pain at different part of body, hot and cold sensations, etc. are common physical symptoms of anxiety. You already mention stress, anxiety, excessive worry associated with excessive pain and sleep difficulty in your query. These all symptoms will reduce after management of anxiety.

Anxiety occur due to neurotransmitters imbalance in brain most commonly involving serotonin neurotransmitter. You may need treatment with psychiatrist to treat your anxiety. It is not clear if you received any treatment in past, but believe me people life changes after treatment.

In drug treatment two types of medicine used. For immediate relief of anxiety benzodiazepines (like Xanax) group of medicines are used and for long term relief most commonly SSRI (selective serotonin reuptake inhibitors) are used. SSRI takes around 3-4 weeks to show its effect. Non drug treatment like cognitive behaviour therapy (form of psychotherapy) also takes weeks to show its effect.

All these process is complex. I have just simplified it to make you understand it. Xanax and Ambien are not used for long due to risk of addiction but SSRI can be used for years without risk of addiction.

Till you work on above advice following simple measures will help you:
-Decrease worrying by keeping yourself busy and distracted from worrisome thoughts by talking to family members or watching T.V. or counting back (100 to 0).
-Healthy diet: Milk and fruits in diet.
-Daily morning walk
-Breathing exercise, yoga and meditation (which you can learn from some expert in person)

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
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