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Chest Tightness, Vomiting Phobia And Breathing Difficulty. Diagnosed With Musculoskeletal. Worrisome

Posted on Fri, 25 Jan 2013

Question: I arrived in australia 10 days ago for a holiday and same day had chest tightness, was sweating, difficulty getting air in but not breathless. I went to a&e twice being concerned but all bloods, ecg, cxr and general obs were normal. Duagnosis:musculoskeletal. I had the tightness on/off over coming days. I didnt feel great but put some of it down to jet lag too. Three days ago i had had a bit of the tightness that day, then whilst eating i suddenly felt very hot, sweaty as if about to vomit. I didn't vomit however. However ever since i have had same sensation when trying ti eat anything solid. Doesn't happen with fluids (thankfully). To complicate matters i have a vomiting phobia so i would rather not eat than risk those sensations. I am of course now feeling the effects of not having food, headache, bit dizzy this evening. I am concerned what Im going to do I cannot continue like this. I do feel there is something in my chest, like a sensation, not particularly painful, maybe something in the oesophagus. Losing weight of course.

Answered by Dr. Ketan Vagholkar (9 minutes later)

Hi,
Thanks for writing in.
From your description of symptoms it appears to be a esophageal problem since you have already ruled out a cardiac cause.
The possibilities are
1. hiatus hernia
2. achalasia
3. malignancy.
The advisable investigation would be an upper GI endoscopy which will enable one to find the exact cause. Once this has been done ,then depending upon the findings either further investigations or treatment can be commenced.
I would therefore suggest that you consult a gastroenterologist at the earliest and get an endoscopy done.
I hope this answers your querry.
With regards

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

Follow up: Dr. Ketan Vagholkar (4 minutes later)

Thanks for your reply. The problem is Im on holiday in Australia until end of january and healthcare here is not free. I am from the UK. Should I try and pursue this here in Australia or wait. I did see a GP yesterday who prescribed omeprazole but I am worried that the symptoms will continue and I won't be able to eat.

Answered by Dr. Ketan Vagholkar (11 minutes later)

Hi,
Thanks for the feedback.
Did you get relief from symptoms?
If yes then you can hang on with that treatment. Otherwise since you can tolerate liquids I would suggest that you continue with a liquid diet till your trip is over.
Avoid eating food articles which are known to cause you problems for the time being.
Just ensure that you consume at least 2 liters of electrolyte containing fluid daily to avoid systemic complications of fluid and electrolyte disturbances.
I hope this answers your doubt.
With regards

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

Follow up: Dr. Ketan Vagholkar (9 minutes later)

Hi,
Only had 2 omeprazole. No change yet. The chest tightness is quite mild now, though not sure it ever felt like classic heartburn, its the feeling i could vomit after swallowing anything solid that is more troubling.
Fluids seem to be ok, am trying to get in 2-3 litres of fluid a day and have taken 2 build up drinks a day. I am avoiding all food. I should buy gastrolyte or equivilent which replaces electrolytes as if lost through stomach bug?
Many thanks

Answered by Dr. Ketan Vagholkar (8 minutes later)

Hi,
Yes you can buy any electrolyte containing preparation.
In addition to capsules you can also take a liquid by name of sucralfate 1 tablespoon after every meal three times a day. This is antacid which will give you better relief.
With regards

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