Question: Hi, My father who is about 58 years old, have following symptoms: He feels fullness in stomach, pressure and squeezing in chest, difficulty breathing and short breath, and anxiety. This happens any time (even while sitting in office or lying on bed), sometimes it is severe and lasts upto 30 minutes and sometimes it is for short time and mild. Most of the times, he sweats during this period (even in winters). Gets relief after having some burps which comes out on walking and situation worsen when sitting and lying. These burps, during severe symptoms cycle, have a strange sound like air is coming out of some loose and soft tissues. This usually occurs when he eats something heavy or difficult to digest like milk products, spicy etc. My question is if this is a heart related problem or gastric related problem? What tests should he undergo for the diagnosis? Last time we noticed that BP was very low after the attack: 90/60 and he felt very very weak. Always goes to bed after 1 hour after dinner and his bed is elevated as advised. During nights, he feel too anxious and often no good sleep. Often wakes up in night and difficulty in getting sleep again.


What you have already tried:
Pantoprazole 40mg for 8 weeks course taken in april-may and again started this week after getting severe symptoms again which lasted around 45 minutes, after consulting GP. Before taking Pantoprazole course of 8 weeks, in Apr May 2014, almost daily chest felt like squeezed or with pressure up to about midday since waking in the morning and the course provided relief that time. ECG shows no abnormility. Endoscopy has not been done yet. Cholestrol, sugar, are normal. HDL(28mg/dl) is low, Sodium(128 mmol/l), Potassium(2.5mmol/l) is low. During the symptom attack, BP becomes very low.


Medical History:
Having prostate (grade II prostatomegaly[43.3 gm] with about 120 ml PVR). Found two small 6mm and 8mm simple lever cysts in left lobe of lever. Chest xray is normal. No other abnormalities found in ultrasound.


Known Allergies:
Hard antibiotics and medications and dry fruits starts loose motion. In deep anxiety and stress bowel movement occurs.

Thank you doctor for your advice.
Within couple of days we will have endoscopy. If a capsule endoscopy will be sufficient in this case?
Yes Domperidone 30mg along with the antacid is started as our GP also prescribed the same.
Please give some more detail about use and type of probiotic.
All the precautions as you have suggested will be followed strictly.

And some points I missed out last time:
During last ECG, the lab technician asked to hold the breath and he observed some vibration. However the ECG result was normal.
For excessive stomach gas and flatulence used Zantac for 12 years whenever gas occurred. Now the chest problem also started along with.
Has inguinal hernia since last 10 years and uses hernia belt and no corrective surgery is done yet.

Thank you.