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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Having pain in rib cage, acid reflux and anxiety attacks. EKG normal. On prilosec 20 mg. What to do?

Answered by
Dr. Akhilesh Dubey

Internal Medicine Specialist

Practicing since :1986

Answered : 2094 Questions

Posted on Sat, 22 Dec 2012 in IBS(Irritable Bowel Syndrome)
Question: i had pain in october under my left rib cage that lasted all day. i finally went to the er..they did an ekg . normal, they took my protime little elevated. (i take alot of ibuprofen) so they did a chest xray with contrast and without..turned out normal..and then when i was discharged from the hospital. My pain pretty much subsided. since then I have had bouts of panicand anxiety attacks.. I have terrible gerd acid reflux ...i had a upper gi in march of this year and was normal. I also do not have a thyroid. i get checked every four months. what is going on with me. I have chest tightness, no pain breathe fine. and when i feel like i wann burp. liquid comes up a little and sometimes it burns and chokes me and sometimes it doesnt. i only take prilosec 20mg a day..should I up the dose. ? I am getting anxiety more from all this nonsense. I went to a cardiologist this year in april and my ekg was fine and he suspected it was p/s hypo or hyper. been to the endo since and he didnt say a thing with my recent blood is now time for me to go again to see him this week with new labs and im also making my self go to another cardiologist for an echo this friday just for peace of mind. Since ive had my thyroid out in 08 i get heart palps flutters,,not all the time ..i just want answers,,Ive even beginning to think i should go to a rhuematologist and be tested for fibro. etc.. am I crazy.?
Answered by Dr. Akhilesh Dubey 2 hours later

Thanks for sharing your concerns here,

After going through all information you have given, basically you have
1) Atypical Chest pain which seems to be non cardiac.
2) Hyper acidity with some dyspepsia and Reflux of acid in food pipe.
3) Some anxiety and Panic.

Please continue to take acid suppressing drugs as prescribed to you which will help to keep acidity level low. Take small meals and less oily and spicy food, If possible raise head end of bed by 10 to 12 centimeters. Please avoid use of too much Ibuprofen instead you can use Paracetamol for pain which causes less acid problem.

You can go for check up where Complete blood count, Thyroid function test, kidney function test along with a Echocardiography , Tread mill Test and upper G I endoscopy ,if required, may be planned in consultation with your treating Physician.

As far as your anxiety and panic are concerned, you should relax and take up some yoga and meditation. It will help, but if problem is severe enough, then a short course of anti anxiety drugs after consultation may be the answer.

I do not see any role of rheumatologist right now, but if it is necessary it may be taken up later on. This information should help you. If you have any further query, I will be available to answer that.


Above answer was peer-reviewed by : Dr. Mohammed Kappan
Follow up: Dr. Akhilesh Dubey 9 hours later
Whats the reason for rib cage pain sometimes..then after that i get anxiety and panick can that stuff run hand in hand? I also get XXXXXXX Bone pains in my upper kegs sometimes and my shoulders get really right the trapezoid muscles...just sometimes a general malaise feeling for no reason...then it goes away..that's why i suggested a rhuematologist. At this point i think my anxiety is to far for yoga . I do XXXXXXX breathing.but does not seem to help. Every little pain i feel i start to freak out..its so frustrating ..i feel like i should run to the e.r. And then i talk my self out of it. I don't like taking o.25 of xanax i calms me down i feel but then im sluggish and i dont like that either. My gp wants to put me on an anti depressant but i dont want it normal to get adrenaline rush feelings once in a while almost like a whooshing feeling and my great feels like its pounding in my neck and even get a little pain in my throat for a minute?
Answered by Dr. Akhilesh Dubey 16 hours later

Thanks for the follow up.

Your pain could be a somatization of your anxiety and hence investigation like X-ray is normal.
If your symptoms are better with anti anxiety drug, there are many other options are there. Your doctor can choose what is best for you. Even use of anti depressant can help to improve such symptoms.
Adrenaline rush feeling may occur once a while when you feel anger.

You can see Rheumatologist and get RA factor, Uric acid level to rule out ant pathology.
Have faith, you will improve with anti anxiety and anti depressant medicines. It may take some time before you notice improvement.

Please avoid over use of analgesic to prevent any toxicity from analgesic to kidneys.

Please keep me informed about progress.

Good luck

Above answer was peer-reviewed by : Dr. Mohammed Kappan

The User accepted the expert's answer

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