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Suggest Treatment For Chest Tightness When Diagnosed With Costochondritis

Posted on Mon, 12 Jun 2017

Question: My 11 year old daughter was diagnosed with costochondritis 1 1/2 months ago. At that time she was having sharp pains. Anyway, the sharp pains aren't there anymore, it's chest tightness and feeling like she can't take a deep breath. She said when her chest feels tight it feels hard to breathe. Her O2 is at 100%, she looks and talks like she is breathing fine. This happens every day, twice a day and always at the same time of day. So could costo still be going on or did costo make her start thinking about her breathing and now it's become a habit. One other thing, she has had a lot of stress lately, could all of this be anxiety or stress?? Her doctor said it's still the costo, I'm not sure I am convinced??

Also, any suggestions on helping her through all of this? Whether it is costo or anxiety? Do kids have periods where they could be obsessing about something, like breathing?

Answered by Dr. Diptanshu Das (1 hour later)

Brief Answer:
Gastroesophageal reflux seems to be the cause of tightness of chest

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone very carefully through your query. Pain due to costochondritis is sharp and typical. Unless a sharp pain is present, I have doubts whether the tightness is due to costochondritis. Rather, her problems seems to be due to gastritis or gastroesophageal reflux i.e. due to the reflux of stomach acids. Anxiety contributes to increased stomach acid secretion and could worsen the process.

In order to provide relief, you need to ask for the following:
* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Give Lanzol Junior tablet (lansoprazole)/Nexium (esomeprazole) XXXXXXX once daily before breakfast.
* Give plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like isabgol/psyllium husk or senna. I would insist you to increase your dietary fiber intake.
* Regular playing or exercise for at 1 hour a day to keep the bowel movements proper.
* Give curd or yogurt on daily basis. It contains beneficial bacteria and should help.
* Proper relaxation is essential.

Hope that helps.

Let me know if I could help further.

Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Diptanshu Das (11 minutes later)

Ok but wouldn't acid reflux have more symptoms then just chest tightness and shortness of breath or not being able to catch that deep breath? She does burp a lot but she doesn't have any acid being burped up or typical acid reflux symptoms. These episodes last any where from 15 minutes to 4 hours, so I'm not sure about that either.

One more question....don't think this is related but...4 months ago I found a hard lump by the side of her spine. The doctor did a full work up, xray, MRI, and Ultrasound and the radiologist strongly suspects a hematoma. The lump has shrunk but it's not completely gone yet, maybe 1/2 cm, it was about an inch when found. They said probably 6 months for it to resolve because of the location. That couldn't have anything to do with her symptoms could it??

Sorry that was supposed to say the lump is now 1/4-1/2 inch...not 1/2 cm

Answered by Dr. Diptanshu Das (2 hours later)

Brief Answer:
Hematoma is unrelated. Problems could still be due to hyperacidity

Detailed Answer:
Thanks for writing back. I understand your apprehension but let me assure you that acid reflux could still give rise to the mentioned problems even if acid does not come up to the mouth. There can be wide variations in presentations especially in case of children.

The hematoma is unrelated and would eventually get resorbed. You need not worry about it.

Regards

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Above answer was peer-reviewed by : Dr. Remy Koshy