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What Causes Nocturnal Chest Pain, Swollen Lymph Node Behind Ear And Bulimia?

Posted on Mon, 6 Jul 2015

Question: I have had nocturnal pain in my chest and lower back and a swollen lymph node behind ear. These symptoms have come and gone periodically for around ten years. I am bulimic. I am worried about cancers but how likely is this given the longevity of the condition and the bulimia

Answered by Dr. Kathy Robinson (2 hours later)

Brief Answer:
esophageal cancer is possible

Detailed Answer:
Hello,
There are many possible causes for your symptoms but bulimia is a high risk condition for cancer of the esophagus due to the frequent reflux of stomach acids into the esophagus. This could explain your chest pains. But it could just be reflux and not cancer since reflux definitley gets worse when you lie down at night. It is important for you to see a gastroenterologist and get an upper endoscopy to see what is going on in your esophagus.
The lymph node is small and not that concerning but again it should be checked by your doctor.
Back pain is common and also can have many causes.
Please see your doctor as soon as possible.
Please also seek treatment for your bulimia so that you do not end up with permanent damage to your body
Regards,
Dr. Robinson

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kathy Robinson (3 hours later)

Is it possible that this condition could go undiagnosed for more than a decade though?

In addjrion, during this time I have had two babies. Would this cancer not have been detected in full blood works

Answered by Dr. Kathy Robinson (6 hours later)

Brief Answer:
more likely reflux

Detailed Answer:
Hello,
You are correct that if you had esophageal cancer it likely would have progressed over the course of 10 years. I only mentioned it because you said you were concerned about cancer. The problem is that if you have severe reflux it damages the lower esophagus and the only way to assess this damage is with an upper endoscopy, where they actually go in with a scope and look at and biopsy the esophagus. Blood work will not diagnose this condition.
Please see a gastroenterologist as soon as you are able to do so.
I really think you need the upper endoscopy to really know what is going on
Regards,
Dr. Robinson

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kathy Robinson (9 hours later)

Thank you. I visited the GP today who thinks an endoscopy isn't needed at this stage and it's likely to be reflux. Said that as I haven't lost weight, don't have problems swallowing and am not vomiting blood it is very unlikely to be cancer. Does that sound right?

Answered by Dr. Kathy Robinson (15 hours later)

Brief Answer:
yes that is okay

Detailed Answer:
Hello, I do agree that it is unlikely to be cancer. I still think that if you have had reflux for 10 years that an endoscopy would be a good idea at some point. If he/she can treat your reflux and the symptoms resolve then it may not be necessary. If symptoms persist then push harder for an endoscopy. I am glad that you saw your doctor about this. I wish you the best.
Dr. Robinson

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar