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Heartburn, nausea, stomach upset, nausea after eating, back pain, increased heart rate, stomach spasm. Any idea?

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My husband is complaining of heartburn, nausea, upset stomach, feels like he wants to throw up after he eats or sometimes even if he hasn't eaten anything at all, has an occasional rapid heart rate, back pain and an occasional spasm in the stomach area....any idea what may be going on with him? He has had an ultrasound of the stomach which came back with nothing, x-ray of the back which came back with nothing, his labwork comes back 'remarkable' and he heart checked out just fine.
Posted Wed, 23 May 2012 in Digestion and Bowels
Answered by Dr. Poorna Chandra K.S 5 hours later
Hi and thanks for the query
Nausea and 'heartburn' XXXXXXX occur because of a variety of causes - both GI specific and some systemic causes where the abdominal pain and heartburn are the secondary phenomenon. The duration of the illness and presence of associated features could help point towards the cause.
The local GI causes may be secondary to a bad reflux disease, gastritis, pancreatitis, gallstone diseases, hepatitis or enteritis. Of these gallstone disease is unlikely if an ultrasound is normal. Others need to be looked at by doing certain blood and stool examinations like serum lipase, LFT, stool routine examinations and if persistent an endoscopy to rule out reflux and gastritis.
The systemic causes may be secondary to a raised intracranial pressure, migraine, labrynthitis, myocardial infarction, urinary tract infection and axotemia. A proper history taking and a physical examination with some directed testing should be able to rule these out.
The raised heart rate is probably only a sympathetic response to the pain and the vomiting.
Hope this answers the query
Above answer was peer-reviewed by
Follow-up: Heartburn, nausea, stomach upset, nausea after eating, back pain, increased heart rate, stomach spasm. Any idea? 8 hours later
It all started in November with what seemed to be chest pains and back pain. Since then things have progressed to the list I mentioned before. The newest thing being the spasms in his abdominal area. The ultra sound ruled out abdominal aortic aneurysm. We have been through the following tests since November. What do you recommend?

Echocardiogram: The ventricle has a normal chamber size and wall thickness. The ejection fraction is estimated to be between 60 to 65%. The right ventricle visually has a normal chamber size and systolic function. No significant valvular abnormality noted.
Stess Test: Good exercise tolerance. No complaints of angina. No evidence of ischemia or significant arrhythmia per EKG criteria. Patient achieved 10.6 METs at maximum exercise.
EKG: I don’t know how to read these, but I am told they are fine. I have attached them for you.
Brain CT: Normal CT brain.
Chest X-Ray: Full pulmonary expansion. No demonstrated acute disease. No change.
Labs: 2 from when he was in the hospital in November when he was told his bloodwork was remarkable and one from January where we told his bloodwork was good. The one in January included a urinalysis, which was all good.
Physical: His most recent physical was completed in February of this year and includes labs, urinalysis, hearing, pulmonary, vision, EKG and a chest x-ray. All are good.
Still trying to figure all of this out, we went back to his liver cleanse. The symptoms have grown and the pain seems to be getting worse. She also suggested that he start taking some supplements.
Abdominal Sonogram: No significant abnormality is detected on this study. Liver measures 14.6 in maximum diameter. Liver pattern is homogeneous. No focai lesions noted. Common duct measures 4mm in diameter. No evidence of gallbladder wall thickening, gallbladder distention or cholelithiasis. Pancreatic appears unremarkable. Spleen is not enlarged and appears unremarkable. Right kidney measures 11.2 x 4.0 x 4.7 cm in size. Left kidney measures 106. X 5.7 x 4.9 cm in size. There was no evidence of dilatation of the right or left renal collecting system. No evidence of renal cortical atrophy. There is no evidence of an abdominal aortic aneurysm. Inferior vena cava is patent.
Lumbar Spine: Mild multilevel spondylosis.
Thoracic Spine: No thoracic fracture or malalignment is seen.
Since he last saw his primary care physician at the beginning of February and his medical history:
He attempted to do a colon cleanse; taking the stuff you can get at the pharmacy before someone has a colonoscopy. He did not have any bowel movement from it. I found that strange!!
He did not attempt the liver cleanse because the pharmacist would not recommend anything to do such.
He now takes Glucosamine, which he initially said helped the back and joint pains, but now he is not sure if it is helping.
He now takes a daily vitamin.
He now takes a Psyllium Husk with Acidophilus for colon care. Initially he said he was feeling better.
He now takes Milk Thistle Extract 300mg for a healthy liver. Initially he said he was feeling better.
He now takes Zantac 150 daily. Initially he said it was helping, but now it isn’t helping so much. Two weeks ago he started taking Pepto fairly regularly. He says it helps sometimes, but not that much. It is making stools black.
He has quit eating processed foods and is trying to eat a much healthier diet. Initially eliminating the processed foods helped quite a bit.
He drinks about a pot of coffee a day.
He smokes a pack of cigarettes a day.
He is a social drinker.
Family medical history:
His father has a cardiac history and I think others on his fathers side of the family have cardiac issues.
His mom is a colon cancer survivor. His maternal grandmother has some GI issues and I believe maternal Uncle has GI issues as well. His grandmother takes Protonix.
He has no known allergies.
He has no other health issues or diseases. Although from time to time I don’t like his blood pressure readings. They often are in pre-hypertension numbers when he checks his blood pressure at the pharmacy regularly.
I asked him last night to list off all of his symptoms for me one more time and I wrote them down:
Heartburn – all the time
Nausea – all the time
Upset stomach – all the time
Feels like he wants to throw up – all the time (after he has eaten or even when he hasn’t eaten)
Occasional rapid heart rate
Occasional spasm in the stomach area – this is a new thing
Back pain – mostly lower but also around his ribs

What do you recommend? What do you think this may be?
Answered by Dr. Poorna Chandra K.S 5 hours later
Hi and thanks for the follow up
I would suggest him to get a stool routine examination on three consequtive days, Serum CPR quantitative, a fasting vit D3 levels and an upper GI endoscopy.
Ask him to quit smoking and alcohol as the impair healing. I would also like to look at his liver function tests and the hemogram. You also need to reattatch the ECG as I couldnot find it
Above answer was peer-reviewed by
Follow-up: Heartburn, nausea, stomach upset, nausea after eating, back pain, increased heart rate, stomach spasm. Any idea? 2 hours later
I apologize. I didn't attach the test results because it has his personal information; I didn't want it floating around on the internet. And, I don't see how to upload the reports. I can always white out specific personal information like his name, date of birth and social security number.
Answered by Dr. Poorna Chandra K.S 15 hours later
Hi and thanks for the reports
All the attached reports are normal
Please get the above suggested tests done after consulting your GP
Above answer was peer-reviewed by
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