Brief Answer: Accumulation of gas,increased acid formation. Detailed Answer: Hello XXXXXXX Thanks for your query. Regarding the symptoms as mentioned in your post, kindly let us know about the following: 1. Any recent illness? 2. Injury/trauma to the chest region? 3. Is there a significant past history or family history of systemic disease like Diabetes, Hypertension, Heart disease, Thyroid disorder, etc. ? 4. History of prolonged intake of certain medications? 5. Any other associated features like breathlessness, nausea, loss of weight or apetite, etc.? 6. Any history of irregular periods, tenderness in breast or discharge from nipples? If your answer to the above mentioned questions is NO, then the symptoms can be attributed to production & accumulation of gas in the stomach, which can be secondary to increased acid formation. The reason for increased acid production can be Stress, inappropriate diet & lifestyle methods or infection associated with a type of bacteria called Helicobacter pylori (H pylori). Other than the basic investigations like complete blood count, estimation of serum electrolytes & blood glucose, specific investigations such as Endoscopy & Ultrasound scan of abdomen are helpful in detecting any pathology in the Gastrointestinal tract. However, an ECG and X ray of chest can be done to rule out any Cardiovascular or Respiratory etiology. Symptomatic relief can be obtained with intake of: 1. Proton pump inhibitors (which prevent acid formation in stomach) like Omeprazole, Pantoprazole,etc. to be taken twice a day, half an hour before meals. Nexpro (pharmacologically Esomeprazole) as advised by your treating Doctor also acts by the same mechanism. 2. Antispasmodics like Dicyclomine preparations (to be taken twice a day after meals). 3. Antacid gel can also be taken after meals for the same. It is also needed that you take certain precautions regarding your diet & lifestyle, such as: 1. Take soft, plain, non-spicy foods 2. Drink lots of water to maintain adequate hydration 3. Avoid consuming irritating substances such as acidic & rich foods, caffeine, nicotine, and alcohol. 4. Have your meals regularly and at appropriate time of the day. Do not skip breakfast & never stay hungry. 5. Keep away stress, think positive. 6. Exercise regularly & practice meditation. 7. Avoid medicines like Ibuprofen, Diclofenac, etc for pain relief. They may further aggravate the condition. 8. Avoid staying awake late at nights. Get sufficient sleep. There is no need to worry, you will be fine. Please let me know if I can clarify further. Wishing a good health. Take care.

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