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Suggest Treatment For Chest Tightness And Feeling Of Food Stuck In Esophagus
Question: Dear Doctor,
I am a 34 year old, otherwise healthy male. I had acid reflux and acidity issues for over 10 years which i control using rabeprazole. I am an XXXXXXX settled in Sweden.
Recently two months ago, i started getting chest tightness and feeling of food struck in my chest and esophagus. I also had shortness of breath symptoms. I went to my family physician who did some X-ray, ECG and told me i dont have any problem with my heart or any respiratory issues like asthama, I felt relieved but still wanted to find out what the problem was. In the end i realised it was my acid reflux causing these symptoms.
I then asked my GP to refer to a Gastroentologist who did so, The gastro did a endoscopy two weeks back and said that everything looks fine, but the XXXXXXX is not closing properly causing me the symptoms as i suspected, she also said that i dont have H.Pylori bacteria which was great. She asked me to take Omeprazole 20 mg daily once in the morning which i am taking so
The last endoscopy before this i had was in XXXXXXX at Asian Institute of Gastroentology which almost pointed the same.
My question is i have this constant chest pain along with the feeling of a lump in my throat and chest (behind the breast bone), I have difficulty in belching and may be difficulty swallowing, this is getting worse day by day and waking me from my sleep during night. I have sudden esophagal spasms also when i go out (its -5C below zero in Sweden now).
I did some search on my sysmtoms and found a condition called Achalasia or Dysphagia which is similar to what i am experiencing, after reading through the sites, i got really scared, hence i am writing to you. What i want to know is, IS my condition really a critical one like Achalasia or Dysphagia? I just had endoscopy two weeks back and it didnt show any of this.
Secondly can i develop Achalasia or Dysphagia or my condition can get worse? If not what can i do now to reduce my symptoms? I am trying to get an appointment with the gastro specialist who did my endoscopy but this will take a while, so i am writing to you.
Also my doctor in XXXXXXX who diagnised GERD in 2010 gave me somaspas tabs twice a day, will that help?
I am a 34 year old, otherwise healthy male. I had acid reflux and acidity issues for over 10 years which i control using rabeprazole. I am an XXXXXXX settled in Sweden.
Recently two months ago, i started getting chest tightness and feeling of food struck in my chest and esophagus. I also had shortness of breath symptoms. I went to my family physician who did some X-ray, ECG and told me i dont have any problem with my heart or any respiratory issues like asthama, I felt relieved but still wanted to find out what the problem was. In the end i realised it was my acid reflux causing these symptoms.
I then asked my GP to refer to a Gastroentologist who did so, The gastro did a endoscopy two weeks back and said that everything looks fine, but the XXXXXXX is not closing properly causing me the symptoms as i suspected, she also said that i dont have H.Pylori bacteria which was great. She asked me to take Omeprazole 20 mg daily once in the morning which i am taking so
The last endoscopy before this i had was in XXXXXXX at Asian Institute of Gastroentology which almost pointed the same.
My question is i have this constant chest pain along with the feeling of a lump in my throat and chest (behind the breast bone), I have difficulty in belching and may be difficulty swallowing, this is getting worse day by day and waking me from my sleep during night. I have sudden esophagal spasms also when i go out (its -5C below zero in Sweden now).
I did some search on my sysmtoms and found a condition called Achalasia or Dysphagia which is similar to what i am experiencing, after reading through the sites, i got really scared, hence i am writing to you. What i want to know is, IS my condition really a critical one like Achalasia or Dysphagia? I just had endoscopy two weeks back and it didnt show any of this.
Secondly can i develop Achalasia or Dysphagia or my condition can get worse? If not what can i do now to reduce my symptoms? I am trying to get an appointment with the gastro specialist who did my endoscopy but this will take a while, so i am writing to you.
Also my doctor in XXXXXXX who diagnised GERD in 2010 gave me somaspas tabs twice a day, will that help?
Brief Answer:
Proper treatment will help you the most.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history. Nice to know that you are an XXXXXXX settled in Sweden.
I have read and re-read your history and understood the problem/s you have. I would like to be a be straightforward as you know your diagnosis and already visited the best Center in the world Asian Institute of Gastroenterology at XXXXXXX and also undergone Endoscopy just 2 weeks back, which says you have a weak XXXXXXX allowing the reflux of the stomach contents into the esophagus (GERD) causing the symptoms you have.
The heart and the lungs are normal.
Your question:
Your symptoms of constant chest pain, 'feeling of lump in throat and Chest', difficulty in belching and may be swallowing, getting worse and waking you up at night, esophageal spasms when you go out in cold- all are related to the known problem you have.
Achalasia or Dysphagia ::
Dysphagia is a symptom and not a disease.
Achalasia is a disorder where you get exactly reverse of the loose XXXXXXX it becomes tight not allowing the passage of foods.
So with your condition, which you are suffering for 10 years Achalasia can never develop in your case so just forget about it.
What can you do to reduce your symptoms:
Somaspas has no role to play in your case, so do not take it.
I would suggest you the treatment plan which helps all my patients, please discuss this with your Family Physician who must be your friend too and get a prescription and start following stringently, you may be benefited and will be improved a lot.
Ranitidine 12 hourly.
Antacid gel every 3 to 4 hours particularly when on empty stomach.
Domperidone exactly at 8 hourly interval.
Soft bland diet. Small frequent meals at least 4 times a day.
No aerated colas / soda/ drinks / smoking ( if you do)
Early dinner. No late nights.
Treatment for anxiety (as prescribed / needs a prescription by your Doctor)
Lying in a reclining position.
Walk around after dinner.
Think of the factors which increased the present problem, GERD, anxiety and try to avoid.
Please note: Anxiety and stress are the biggest causative factors in your symptom-complex. If you can control these you may be off the medicines as early as you want.
I have tried my best to keep the answer to the points and hope this helps you too.
Proper treatment will help you the most.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history. Nice to know that you are an XXXXXXX settled in Sweden.
I have read and re-read your history and understood the problem/s you have. I would like to be a be straightforward as you know your diagnosis and already visited the best Center in the world Asian Institute of Gastroenterology at XXXXXXX and also undergone Endoscopy just 2 weeks back, which says you have a weak XXXXXXX allowing the reflux of the stomach contents into the esophagus (GERD) causing the symptoms you have.
The heart and the lungs are normal.
Your question:
Your symptoms of constant chest pain, 'feeling of lump in throat and Chest', difficulty in belching and may be swallowing, getting worse and waking you up at night, esophageal spasms when you go out in cold- all are related to the known problem you have.
Achalasia or Dysphagia ::
Dysphagia is a symptom and not a disease.
Achalasia is a disorder where you get exactly reverse of the loose XXXXXXX it becomes tight not allowing the passage of foods.
So with your condition, which you are suffering for 10 years Achalasia can never develop in your case so just forget about it.
What can you do to reduce your symptoms:
Somaspas has no role to play in your case, so do not take it.
I would suggest you the treatment plan which helps all my patients, please discuss this with your Family Physician who must be your friend too and get a prescription and start following stringently, you may be benefited and will be improved a lot.
Ranitidine 12 hourly.
Antacid gel every 3 to 4 hours particularly when on empty stomach.
Domperidone exactly at 8 hourly interval.
Soft bland diet. Small frequent meals at least 4 times a day.
No aerated colas / soda/ drinks / smoking ( if you do)
Early dinner. No late nights.
Treatment for anxiety (as prescribed / needs a prescription by your Doctor)
Lying in a reclining position.
Walk around after dinner.
Think of the factors which increased the present problem, GERD, anxiety and try to avoid.
Please note: Anxiety and stress are the biggest causative factors in your symptom-complex. If you can control these you may be off the medicines as early as you want.
I have tried my best to keep the answer to the points and hope this helps you too.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dear Doctor,
Excellent, you have answered exactly what i was looking for, i read that Achalasia means tightening of XXXXXXX where as GERD means loosening of XXXXXXX but no where in any website its clearly mentioned that they are opposite of each other. You have explained it very well and in details, appreciate your answer.
You have already reduced half of my symptoms, i feel much better now. But these sudden esophageal spasms i get especially when i step out and also this chest tightness with feeling of food getting stuck all time etc, can these progress into worse to the point of not being able to eat anything?
I would also have a serious discussion about your recommendations with my GP and get the required medicines prescribed for me.
Also doctor you mentioned raising the bed when sleeping, can i use a pillow like this one ? http://www XXXXXXX com/Comfort-Position-Pillow-snoring-reflux/dp/B00P1RJQEI/ref=sr_1_8?s=hpc&ie=UTF8&qid=0000&sr=1-8&keywords=gerd+pillow
Reason for asking is since i share the bed with my wife, i don't want to disturb her by raising the bed, where as if i buy this GERD pillow, it would be only me using it without disturbing her.
Excellent, you have answered exactly what i was looking for, i read that Achalasia means tightening of XXXXXXX where as GERD means loosening of XXXXXXX but no where in any website its clearly mentioned that they are opposite of each other. You have explained it very well and in details, appreciate your answer.
You have already reduced half of my symptoms, i feel much better now. But these sudden esophageal spasms i get especially when i step out and also this chest tightness with feeling of food getting stuck all time etc, can these progress into worse to the point of not being able to eat anything?
I would also have a serious discussion about your recommendations with my GP and get the required medicines prescribed for me.
Also doctor you mentioned raising the bed when sleeping, can i use a pillow like this one ? http://www XXXXXXX com/Comfort-Position-Pillow-snoring-reflux/dp/B00P1RJQEI/ref=sr_1_8?s=hpc&ie=UTF8&qid=0000&sr=1-8&keywords=gerd+pillow
Reason for asking is since i share the bed with my wife, i don't want to disturb her by raising the bed, where as if i buy this GERD pillow, it would be only me using it without disturbing her.
Brief Answer:
Yes, the special pillow will help
Detailed Answer:
Thanks for your feedback and appreciation.
To elucidate on your points:
Sudden esophageal spasms on stepping out, chest tightness with feeling of food getting all time etc...
Not seen a single patient to progress this to the point of unable to eat. This will never happen in your case if you follow the basic principles of treatment as outlined; on the contrary you will be feeling far better very soon.
Please start the medicines and precautions at the earliest.
The link you have giver is perfectly alright for your needs. Just see that the support starts from the low back- buttock are for two reason; one to get a proper support to have a comfortable sleep and secondly for the upper abdominal are too get into reclining position, and obviously not disturb the better half (wife). Get this as soon as possible.
If you follow every single aspect, you shall be improved the best.
You may have a review Endoscopy after one to one and half month to see the changes and a happier Gastroenterologist.
In a good staid let us forget about the Achalasia, if you agree.
Yes, the special pillow will help
Detailed Answer:
Thanks for your feedback and appreciation.
To elucidate on your points:
Sudden esophageal spasms on stepping out, chest tightness with feeling of food getting all time etc...
Not seen a single patient to progress this to the point of unable to eat. This will never happen in your case if you follow the basic principles of treatment as outlined; on the contrary you will be feeling far better very soon.
Please start the medicines and precautions at the earliest.
The link you have giver is perfectly alright for your needs. Just see that the support starts from the low back- buttock are for two reason; one to get a proper support to have a comfortable sleep and secondly for the upper abdominal are too get into reclining position, and obviously not disturb the better half (wife). Get this as soon as possible.
If you follow every single aspect, you shall be improved the best.
You may have a review Endoscopy after one to one and half month to see the changes and a happier Gastroenterologist.
In a good staid let us forget about the Achalasia, if you agree.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Dear Doctor,
Many thanks, yes you have explained in simple ways to combat my problem.
I called my doctor today and have an appointment on Dec 9 where i will take your prescription and ask him to write as per your advise (My GP is a family physician and not experienced in Gastric problems).
Secondly yes, as you mentioned lets forget about Achalasia, Only reason i was worried and asked you was, I have the feeling of food struck and chest tightness all the times, especially after eating meals which are symptoms of achalasia as mentioned in the many websites (I know i read too much out of curiosity and end up being worried)
Its so worse that i have difficulty even in belching air from stomach or i cannot belch sometimes, but you explained it. I understand that in my case since it was a weak XXXXXXX not closing properly, may be the esophagus is swollen somehow and causing achalasia like symptoms, I now understand from you that this wont progress into Achalasia which is totally oppossite.
One thing i wanted to point out was, when gastroentologist was doing the endoscopy two weeks back, i remember the doctor told me to take deep breaths, relax and swallow when the tube was struck in my throat and not going down (i guess) after i did what the doctor told me then the endoscopy tube went in properly into my duodenum and stomach. Is this common (to have tube struck when going in) and when u swallow and relax, it can go smoothly?
Appreciate your time and response in this matter, for me to forgot all my worries and proceed with my life, waiting for your response, thank you
Many thanks, yes you have explained in simple ways to combat my problem.
I called my doctor today and have an appointment on Dec 9 where i will take your prescription and ask him to write as per your advise (My GP is a family physician and not experienced in Gastric problems).
Secondly yes, as you mentioned lets forget about Achalasia, Only reason i was worried and asked you was, I have the feeling of food struck and chest tightness all the times, especially after eating meals which are symptoms of achalasia as mentioned in the many websites (I know i read too much out of curiosity and end up being worried)
Its so worse that i have difficulty even in belching air from stomach or i cannot belch sometimes, but you explained it. I understand that in my case since it was a weak XXXXXXX not closing properly, may be the esophagus is swollen somehow and causing achalasia like symptoms, I now understand from you that this wont progress into Achalasia which is totally oppossite.
One thing i wanted to point out was, when gastroentologist was doing the endoscopy two weeks back, i remember the doctor told me to take deep breaths, relax and swallow when the tube was struck in my throat and not going down (i guess) after i did what the doctor told me then the endoscopy tube went in properly into my duodenum and stomach. Is this common (to have tube struck when going in) and when u swallow and relax, it can go smoothly?
Appreciate your time and response in this matter, for me to forgot all my worries and proceed with my life, waiting for your response, thank you
Brief Answer:
Yes, once you swallow the tube, Endoscopy becomes a natural process.
Detailed Answer:
Sincere thanks for your appreciation and confidence in me.
I hope the symptoms you discussed again would go way once you start the treatment.
You are absolutely right. The moment you relax, take deep breath and try to swallow the natural upper esophageal sphincter not only gets relaxed but practically the patient is swallowing the tube and hence the procedure becomes very easy.
So let us hope for the best response in life for you to be absolutely symptoms-free' have a great life.
Thanks for patient reading.
Yes, once you swallow the tube, Endoscopy becomes a natural process.
Detailed Answer:
Sincere thanks for your appreciation and confidence in me.
I hope the symptoms you discussed again would go way once you start the treatment.
You are absolutely right. The moment you relax, take deep breath and try to swallow the natural upper esophageal sphincter not only gets relaxed but practically the patient is swallowing the tube and hence the procedure becomes very easy.
So let us hope for the best response in life for you to be absolutely symptoms-free' have a great life.
Thanks for patient reading.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Dear Doctor,
Thanks once again for explaining me in details, so the tube getting struck is not related to closing of the XXXXXXX but a natural process and when you swallow, you open up the XXXXXXX and thats why the tube went in afterwards.
Regarding Randatine and domperidone, you havent mentioned the dosage, strength and number of days?
Can you specify the mg and number of days recommended for my issue? I noticed today that since i don't have much anxiety my chest tightness and difficulty swallowing is slowly getting better.
Also regarding the soft bland diet, can i eat white rice with some vegetable curry without much of spice and chillies? You know our XXXXXXX diet could be spicy, i am eating a banana or a apple at a 4 hour interval between lunch and dinner, hope this helps me a little.
Regarding exercise, you mentioned to walk after dinner, since it gets dark and already very cold outside, I started from yesterday night to walk in doors for 15 minutes, Do you think thats enough or shall i still think about any exercise?
Would appreciate your comments on this
Thanks once again for explaining me in details, so the tube getting struck is not related to closing of the XXXXXXX but a natural process and when you swallow, you open up the XXXXXXX and thats why the tube went in afterwards.
Regarding Randatine and domperidone, you havent mentioned the dosage, strength and number of days?
Can you specify the mg and number of days recommended for my issue? I noticed today that since i don't have much anxiety my chest tightness and difficulty swallowing is slowly getting better.
Also regarding the soft bland diet, can i eat white rice with some vegetable curry without much of spice and chillies? You know our XXXXXXX diet could be spicy, i am eating a banana or a apple at a 4 hour interval between lunch and dinner, hope this helps me a little.
Regarding exercise, you mentioned to walk after dinner, since it gets dark and already very cold outside, I started from yesterday night to walk in doors for 15 minutes, Do you think thats enough or shall i still think about any exercise?
Would appreciate your comments on this
Brief Answer:
absolutely fine.
Detailed Answer:
The tube gets stuck in the upper esophageal sphincter (UES) not the XXXXXXX When we swallow, the mechanism is such that the proximal (near the origin of a structure) gets contracted and at the same time the distal ( farther away from origin ) gets opened up to accommodate.
I am really sorry, as you still need a prescription and your Doctor would wright the exact dosage, I am sure. I have already mentioned a part of it in the first answer, please refer to. Ranitidine is available as 150 mg and Domperidone as 10 mg. Take this for minimum one and half months to be followed by the Endoscopy if it is possible.
I am sure, by this time you know which are the foods best suitable to you and which cause / increase your trouble.
The spices are the worst.
You can certainly take white rice and vegetable curries if it suits you.
No fried and oily things at all.
(I really do not know what would be available in Sweden) but anything cooked at home is always better than any of the hotels or restaurants, this is for sure. I hope you agree with me.
Banana is really good in many people, and the part will be covered by the antacid gels you are going to take at 3 hourly interval , whenever you are on empty stomach.
15 minutes walk indoors is exactly fine. No need of any strenuous exercises at the moment at all.
Take care, get well sooner.
absolutely fine.
Detailed Answer:
The tube gets stuck in the upper esophageal sphincter (UES) not the XXXXXXX When we swallow, the mechanism is such that the proximal (near the origin of a structure) gets contracted and at the same time the distal ( farther away from origin ) gets opened up to accommodate.
I am really sorry, as you still need a prescription and your Doctor would wright the exact dosage, I am sure. I have already mentioned a part of it in the first answer, please refer to. Ranitidine is available as 150 mg and Domperidone as 10 mg. Take this for minimum one and half months to be followed by the Endoscopy if it is possible.
I am sure, by this time you know which are the foods best suitable to you and which cause / increase your trouble.
The spices are the worst.
You can certainly take white rice and vegetable curries if it suits you.
No fried and oily things at all.
(I really do not know what would be available in Sweden) but anything cooked at home is always better than any of the hotels or restaurants, this is for sure. I hope you agree with me.
Banana is really good in many people, and the part will be covered by the antacid gels you are going to take at 3 hourly interval , whenever you are on empty stomach.
15 minutes walk indoors is exactly fine. No need of any strenuous exercises at the moment at all.
Take care, get well sooner.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Doctor,
Many thanks for patiently listening to all my queries and answering with the best knowledge you have. You have certainaly raised my spirits which was down otherwise due to this gastric discomfort.
I will wait for my appointment with my GP as per your recommendations on Dec 9. Until then i am trying to relax and eat a soft bland diet, also i am trying some relaxation exercises like Pranayama to calm down. I can feel better every day and will surely get better once i start my medicines.
I am able to control all the symptoms except for the esophageal spasms which i get when i walk to work, i noticed the trigger is cold air outside along with when i have my breakfast and walk, then it starts to contract involuntarily, this goes for few hours making my chest and throat tight.
Do you think these are normal spasms and nothing serious? I cant wait to start the medicines but until then i have to hold on.
Many thanks for patiently listening to all my queries and answering with the best knowledge you have. You have certainaly raised my spirits which was down otherwise due to this gastric discomfort.
I will wait for my appointment with my GP as per your recommendations on Dec 9. Until then i am trying to relax and eat a soft bland diet, also i am trying some relaxation exercises like Pranayama to calm down. I can feel better every day and will surely get better once i start my medicines.
I am able to control all the symptoms except for the esophageal spasms which i get when i walk to work, i noticed the trigger is cold air outside along with when i have my breakfast and walk, then it starts to contract involuntarily, this goes for few hours making my chest and throat tight.
Do you think these are normal spasms and nothing serious? I cant wait to start the medicines but until then i have to hold on.
Brief Answer:
Do you have any anxiety before you start for work?
Detailed Answer:
Thanks for your appreciation and You are most welcome!
Yes, Yoga certainly helps.
Is hardly few days to get your GP and get the medicines.
Esophageal Spams:
This may take more time and I know how much troublesome they are, in fact they increase the anxiety and stress also adding to the existing problem. Could understand the trigger factors > when you walk to work, exposed to cold air outside, when you have your breakfast and walk, starts contracting involuntarily, goes for few hours...
I have a thought, if you do not mind please:
I do not know the nature of your work - (self employed/ owner/ working for someone else)
The problem starts classically when you start going to work.
It is possible that, going for a work is something that increases your anxiety/ stress/ something you really do not like as a part of work or so on (just my guess).
This in turn can add to the cause of spasms or a sole cause of it, which is triggered by the factors you mentioned.
Just try this : take antacid liquid sip-by-sip before you leave the home.
I do not think this is something serious.
Do you have any anxiety before you start for work?
Detailed Answer:
Thanks for your appreciation and You are most welcome!
Yes, Yoga certainly helps.
Is hardly few days to get your GP and get the medicines.
Esophageal Spams:
This may take more time and I know how much troublesome they are, in fact they increase the anxiety and stress also adding to the existing problem. Could understand the trigger factors > when you walk to work, exposed to cold air outside, when you have your breakfast and walk, starts contracting involuntarily, goes for few hours...
I have a thought, if you do not mind please:
I do not know the nature of your work - (self employed/ owner/ working for someone else)
The problem starts classically when you start going to work.
It is possible that, going for a work is something that increases your anxiety/ stress/ something you really do not like as a part of work or so on (just my guess).
This in turn can add to the cause of spasms or a sole cause of it, which is triggered by the factors you mentioned.
Just try this : take antacid liquid sip-by-sip before you leave the home.
I do not think this is something serious.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Dear Doctor,
Ofcourse i dont mind at all and i have high regards to professionals like you, who are helping me in solving my difficulties
I am a Software Engineer and i always enjoyed my work, and i have been really good at what i do, my colleagues and manager respect me for the knowledge.
However you are right in guessing, I am by nature an anxious person from childhood, I keep thinking alot all the time some times over exaggerating my worries like this one, May be i should not think more about these.
These spasms also i developed just recently about a year back, even though i had reflux issues for almost 9 years. Since i moved from XXXXXXX to Sweden 4 years back and its cold here generally my body is not able to take it.
Do you think that if there was any other problem in my esophagus like a hernia or the achalasia (i know you answered this before, but just for my satisfcation) or any other serious issue, Would that had been discovered in the endoscopy i had two weeks back?
I only remember the doctor telling me that the XXXXXXX was not closing properly.
Many thanks for your time
Ofcourse i dont mind at all and i have high regards to professionals like you, who are helping me in solving my difficulties
I am a Software Engineer and i always enjoyed my work, and i have been really good at what i do, my colleagues and manager respect me for the knowledge.
However you are right in guessing, I am by nature an anxious person from childhood, I keep thinking alot all the time some times over exaggerating my worries like this one, May be i should not think more about these.
These spasms also i developed just recently about a year back, even though i had reflux issues for almost 9 years. Since i moved from XXXXXXX to Sweden 4 years back and its cold here generally my body is not able to take it.
Do you think that if there was any other problem in my esophagus like a hernia or the achalasia (i know you answered this before, but just for my satisfcation) or any other serious issue, Would that had been discovered in the endoscopy i had two weeks back?
I only remember the doctor telling me that the XXXXXXX was not closing properly.
Many thanks for your time
Brief Answer:
Relax !!!
Detailed Answer:
Nice to know that you are an Engineer in software.
But I have a feeling that there may be a loads of tons - the workload. the deadlines and so on...
The first thing I noticed on reading the first question was the nickname 'Anxiousherr' , and just wondered...
I hope by 4 years in Sweden, your body should have been really acclimatized, you are having this problem of spasms for the last 1 year only.
The other problem::
All the related problems are directly or indirectly seen on Endoscopy, like indentations, puckering and all, but have seen a few cases to miss out a few things not by chance but by unnoticeable nature of the problems. Since your history goes on for 10 years and you are young no one would really think of some dreaded disease (at the age of 34). I hope the endoscopy must have been definitely done properly.
Yet if you really want to be too much sure, I would suggest 2 more investigations in such patients: in XXXXXXX India:
1. Thick Barium study under direct fluoroscopy control, where the Radiologist can see the actual movement of the esophagus on the screen. We have only a few centers in XXXXXXX and the old-timers are best trained in such things as the newer breed is unfortunately not.
2. CT scan of the Chest for esophagus in particular. This gives a sedative dose to the Doctor and the patients if the report is norms . (I hope you understand what I mean by).
Relax !!!
Detailed Answer:
Nice to know that you are an Engineer in software.
But I have a feeling that there may be a loads of tons - the workload. the deadlines and so on...
The first thing I noticed on reading the first question was the nickname 'Anxiousherr' , and just wondered...
I hope by 4 years in Sweden, your body should have been really acclimatized, you are having this problem of spasms for the last 1 year only.
The other problem::
All the related problems are directly or indirectly seen on Endoscopy, like indentations, puckering and all, but have seen a few cases to miss out a few things not by chance but by unnoticeable nature of the problems. Since your history goes on for 10 years and you are young no one would really think of some dreaded disease (at the age of 34). I hope the endoscopy must have been definitely done properly.
Yet if you really want to be too much sure, I would suggest 2 more investigations in such patients: in XXXXXXX India:
1. Thick Barium study under direct fluoroscopy control, where the Radiologist can see the actual movement of the esophagus on the screen. We have only a few centers in XXXXXXX and the old-timers are best trained in such things as the newer breed is unfortunately not.
2. CT scan of the Chest for esophagus in particular. This gives a sedative dose to the Doctor and the patients if the report is norms . (I hope you understand what I mean by).
Above answer was peer-reviewed by :
Dr. Prasad
Dear Doctor,
Thanks for the suggestions, today i feel much better, no pains and i seem to be very relaxed, as you mentioned may be it was some stress and today being a weekend, i am home with my family which is good.
Regarding the tests, i will discuss with my doctor again to send me to a gastro, which could take few more weeks, unfortunately here everything works by appointment and they only prioritize severe cases.
The doctor who did my endoscopy was a very experienced doctor and she took 4 minutes to examine the who stomach, if i could recall, i dont know if she would be convinced for further tests else i can get it done when i am in XXXXXXX next year to see my relatives and extended family. What do you think? can i wait for few more months? The last two days i followed strict diet as per your recommendations and tried to relax which is helping me alot.
My only fear was after reading too much on the internet about achalasia and other deseases, i was terrified (I am not reading now), thats why i asked
Also my question in general, If a patient had any obstructive disease like achalasia, would that have been discovered in Endoscopy?
Thanks for the suggestions, today i feel much better, no pains and i seem to be very relaxed, as you mentioned may be it was some stress and today being a weekend, i am home with my family which is good.
Regarding the tests, i will discuss with my doctor again to send me to a gastro, which could take few more weeks, unfortunately here everything works by appointment and they only prioritize severe cases.
The doctor who did my endoscopy was a very experienced doctor and she took 4 minutes to examine the who stomach, if i could recall, i dont know if she would be convinced for further tests else i can get it done when i am in XXXXXXX next year to see my relatives and extended family. What do you think? can i wait for few more months? The last two days i followed strict diet as per your recommendations and tried to relax which is helping me alot.
My only fear was after reading too much on the internet about achalasia and other deseases, i was terrified (I am not reading now), thats why i asked
Also my question in general, If a patient had any obstructive disease like achalasia, would that have been discovered in Endoscopy?
Brief Answer:
Let us try the investigations in Sweden but you can wait too.
Detailed Answer:
Thanks for appreciation and great to know the improvement.
Surely you can wait till you come back to XXXXXXX I have mentioned very specifically that the tests I mentioned are only to make sure / to rule out any associated problems. There is no hurry and believe me they (further investigations) may not be needed by that time once you are relieved of your problems.
But who knows, she may agree if you discuss. . .
Oh, The Endoscope gets stuck at the XXXXXXX in Achalasia and has to be manipulated through it.
Somehow I have a a feeling you should get Barium studies and CT scan done to rule out such fears. Try out in Sweden and let us see....
All the best for your weekend !!!
Let us try the investigations in Sweden but you can wait too.
Detailed Answer:
Thanks for appreciation and great to know the improvement.
Surely you can wait till you come back to XXXXXXX I have mentioned very specifically that the tests I mentioned are only to make sure / to rule out any associated problems. There is no hurry and believe me they (further investigations) may not be needed by that time once you are relieved of your problems.
But who knows, she may agree if you discuss. . .
Oh, The Endoscope gets stuck at the XXXXXXX in Achalasia and has to be manipulated through it.
Somehow I have a a feeling you should get Barium studies and CT scan done to rule out such fears. Try out in Sweden and let us see....
All the best for your weekend !!!
Above answer was peer-reviewed by :
Dr. Raju A.T
Dear Doctor,
Many thanks and wish you the same, i will wait for my appointment in two days and will update you as well. Thanks for all the support
Many thanks and wish you the same, i will wait for my appointment in two days and will update you as well. Thanks for all the support
Brief Answer:
most welcome
Detailed Answer:
Most welcome dear friend.
Waiting for your update..
most welcome
Detailed Answer:
Most welcome dear friend.
Waiting for your update..
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Doctor,
Hope you are doing great! Today i met the gastro specialist who did the Endoscopy for me three weeks back. I went and explained her my new symptoms including those esophagal spasms, She listened to me carefully and suggested the following, based on my endoscopy results.
In my endoscopy report it says that i have a Hernia between my cardia, She says i have a widening at the opening of the diaphragm, which is causing my reflux and GERD symptoms, She said that i should not worry about achalasia as you also suggested :-)
She thinks that the spasms i descibed of having when i go out in the cold air and when i take hot showers have nothing to do with the esophagus, but may be something to check for asthama related symptoms. She also thinks i dont need further tests at the moment as the endoscopy clearly points to hernia, unless my condition worsens, then she will think of further tests.
So what you said and discussed is true, its a Weak XXXXXXX which is not closing properly due to hernia which is the oppossite of achalasia :-). I hope i will not get this dreadful achalasia with the above condition
she said if i take the new medications along with some diet, i will get better. She also said many people have the problem so i should not worry too much
I am pasting the text from the report translated from Swedish.
Report
--------------------------------------------------------------
gastroscopy
The scope slides down with xylocaine in the throat.
Mucosa of the proximal duedenum, bulb, the pylorus inspected and is normal
Antrum and corpus has slight reddening, I took a quick test for helicobacter that is negative.
Fundus inspected normal. In the inverted scope there is a gap at the cardia and XXXXXXX it has a widening of the opening of diaphragm and a hiatal hernia. However, no esophagitis is present
----------------------------------------------------------------
Hope you are doing great! Today i met the gastro specialist who did the Endoscopy for me three weeks back. I went and explained her my new symptoms including those esophagal spasms, She listened to me carefully and suggested the following, based on my endoscopy results.
In my endoscopy report it says that i have a Hernia between my cardia, She says i have a widening at the opening of the diaphragm, which is causing my reflux and GERD symptoms, She said that i should not worry about achalasia as you also suggested :-)
She thinks that the spasms i descibed of having when i go out in the cold air and when i take hot showers have nothing to do with the esophagus, but may be something to check for asthama related symptoms. She also thinks i dont need further tests at the moment as the endoscopy clearly points to hernia, unless my condition worsens, then she will think of further tests.
So what you said and discussed is true, its a Weak XXXXXXX which is not closing properly due to hernia which is the oppossite of achalasia :-). I hope i will not get this dreadful achalasia with the above condition
she said if i take the new medications along with some diet, i will get better. She also said many people have the problem so i should not worry too much
I am pasting the text from the report translated from Swedish.
Report
--------------------------------------------------------------
gastroscopy
The scope slides down with xylocaine in the throat.
Mucosa of the proximal duedenum, bulb, the pylorus inspected and is normal
Antrum and corpus has slight reddening, I took a quick test for helicobacter that is negative.
Fundus inspected normal. In the inverted scope there is a gap at the cardia and XXXXXXX it has a widening of the opening of diaphragm and a hiatal hernia. However, no esophagitis is present
----------------------------------------------------------------
Brief Answer:
Thanks for feedback.
Detailed Answer:
Thanks dear friend, doing great...
Nice to know that your Gastro had a keen ear. This is very important in any treatment.
Widening at the diaphragm can definitely enhance such symptoms.
Hiatus or hiatal hernia can be contributory factor in your case as your Doctor suggested.
What makes me happy in the report you posted is :No esophagitis is present along with other findings which you have translated for me.
Helicobacter is negative, duodenum and pylorus is normal. Fundus is normal,
Antrun and corpus slight reddening goes in favor of the stress related problem.
Gap at cardia and widening at the diaphragm.
Are you overweight or so ? This can cause it.
The treatment still is medical management as suggested.
Let us wait for the further tests.
Get the proper management and you will be fine.
Achalasia is a totally different disease entity and never develops in conditions that you have. You will never have it.
Yes, Hiatus hernia is also seen in many people / patients as a incidental finding on Endoscopy and never suffer from it.
So, relax more - why more- the most and get fully cured.
Thanks for feedback.
Detailed Answer:
Thanks dear friend, doing great...
Nice to know that your Gastro had a keen ear. This is very important in any treatment.
Widening at the diaphragm can definitely enhance such symptoms.
Hiatus or hiatal hernia can be contributory factor in your case as your Doctor suggested.
What makes me happy in the report you posted is :No esophagitis is present along with other findings which you have translated for me.
Helicobacter is negative, duodenum and pylorus is normal. Fundus is normal,
Antrun and corpus slight reddening goes in favor of the stress related problem.
Gap at cardia and widening at the diaphragm.
Are you overweight or so ? This can cause it.
The treatment still is medical management as suggested.
Let us wait for the further tests.
Get the proper management and you will be fine.
Achalasia is a totally different disease entity and never develops in conditions that you have. You will never have it.
Yes, Hiatus hernia is also seen in many people / patients as a incidental finding on Endoscopy and never suffer from it.
So, relax more - why more- the most and get fully cured.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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