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Suffer IgG deficient and have chest pain. Unexplained inflammations and high Uric acid. On nexium

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Answered by

General Surgeon
Practicing since : 1979
Answered : 2457 Questions
Hello Doc,

As you can see from my medical history I am IgG deficient and have had a multitude of ilness, I had chest pain for many years, they did a PH study and found that Acid was coming up into my chest at night while sleeping and staying for a long time - I since had a Fundiplication (did not go well - my heart stopped and took 3.5 hours).

My Rhuemo, thinks I could have a stomach problem still as I get a large amount of Rhuematlogical issues and unexplained inflammations and high Uric acid - My respiratory doc suggested a pill cam, but a Gastro doc advised against it because of the fundiplication - my chest hurts and it feels like I can breathe into my stomach, like a each breath sucks up fluid or something - my chest makes very strange and audible noises - large clunking sounds and a very strange sound indeed that sounds like water being poured slowly into a metal cup - I have blood in my poo but it is assumed that is from hemorrhoids as wiping my bottom aggravates it.

I am on Nexium 20mg daily - no doctor has worked out what causes the pain, I have had endoscopy and colonoscopy which were relatively normal and I had a Barium swallow, which showed the fundiplication was not perfect but stomach worked ok.

I cant do a PH study again as I cant get the sensor down past the sphincter at all - although the barium liquid was heavy and went through easily - when I drink water it seems to not pass the sphincter and stay trapped in my chest, if I drink and then breathe deep I can feel water moving up and down in my chest - I have a had a dialation of the fundus - but it did not help.

My docs are seriously wondering if there is bowel cancer or problem causing all my issues including the immune issues - Bowel Cancer is common in our family, I cant do a Pill cam even if a doc would approve it - because they are not funded without being eneamic (spelling).

I seem to be very bad after - seafood, coffee, chocolate or mint.

I have had Candida antibody tests which were negative

The pain is just level with the lowest left rib and is always there - i have a an MRI of the bowel (cant have anymore radiation) and it didnt show any thinning or thickening

Posted Thu, 7 Nov 2013 in Abdominal Pain
Answered by Dr. M Y Shareef 3 days later
Brief Answer:
Some suggestions on life style changes might help

Detailed Answer:
Hi XXXXXXX ! Good morning. I am Dr Shareef, a general surgeon answering your query.

Speaking first on the reflux of acid you have even after the fundoplication surgery, I would suggest you to raise the head end of your bed elevated with one or two blocks in the night when you sleep. This possibly will relieve your acid reflux symptoms. Also please try avoiding any food which aggravates your symptoms.

The strange and audible noises in your chest speaks of the possibility of a hiatal hernia , but as per your history, the endoscopic and MRI scan reports are normal, and so it is intriguing. Have you had a plain X XXXXXXX of chest both in upright and lying down position ? If yes, what was the report ? Was an intestinal biopsy performed during the endoscopy and what was the report ? Why are your doctos suspecting malignancy ? Is it just due to the family history ? I think your case has to be investigated from all these angles on discussion with your doctor.

Whether you have hemorrhoids or not can be decided only by a local and per rectal examination including proctoscopy.

You may continue taking Nexium, but I would like to add a prokinetic agent and a probiotic to it. Also an antacid gel containing a local anaesthetic may help you. As such there must be some amount of gastric irritation because of the drugs you are on including the steroids and those for the rheumatological issues. I would also suggest you to increase roughage in your diet gradually with enough liquids.

Many times it takes a long time to arrive at a particular diagnosis until some symptoms and signs show themselves up in due course. So your doctors have to keep a close observation of your problem, and you should also report to them in case of any new development. Please continue medications as advised your treating doctor for the very many other medical problems which you have referred to. .

I am sure these information might already be known to you and might not pinpoint to a particular diagnosis at present. But I am hopeful that these measures might relieve your symptoms to a great extent specially the night time acid reflux.

Thanks for choosing XXXXXXX forum for your health query. If you have any other question , please do not hesitate to ask. Good luck.
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