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Stomach ache, bloating, shortness of breath and chest pain. Anxiety related symptoms?

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Dr. Das Arindam

General & Family Physician

Practicing since :2008

Answered : 1416 Questions

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Posted on Sat, 2 Feb 2013 in General Health
Question: I have been experiencing some weird symptoms for the last month or so. I have stomach pain and bloating. Pain behind my breastbone with a congested feeling. I sometimes cough but it is not excessive. I feel short of breath almost, but I am still able to exercise, clean the house, etc without seeing it worsen. I had a normal chest x-ray and oximetry at the beginning of december 2012. I have undergone an echo and holter which I have not gotten results for yet. I am a 29 year old female, non-smoker. 2 months ago I was running 5km 3xweekly but have since stopped since I am feeling afraid I won't be able to breathe. I am highly anxious and am on meds for this. Could this be anxiety related? Don't know what I should be worried about anymore. It's really affecting my quality of life lately.
doctor
Answered by Dr. Das Arindam 52 minutes later
Hello,

Thank you for posting a query.

Look, these shortness of breath, pain behind chest wall, congested feeling, sometimes cough all are common symptoms of many diseases like cardiac abnormality / gastroesophageal reflux disease / pulmonary disease. It is difficult to differentiate these conditions.

As, you had a normal chest X-ray and Oximetry tests exclude the possibility of any pulmonary disease.

You are taking anti depression agents for anxiety disorders, they can enhance the acid secretion and thus may lead to these type of symptoms. So, just continue the rabeprazole for 2 to 3 weeks. I think, that will reduce the problem.

But, the Holter and ECHO reports are also very important. They will detect any intermittent abnormality in cardiovascular system.

Sometimes, a patient suffering from anxiety disorder, may experience these type of symptoms as a part of disease progression. If other possibilities are excluded, anxiety should be considered as causative agent. It indicates need of more meticulous treatment.

If all the tests are within normal limit, there is no reason to be worried. If there is a chronic underlying disease, it will be detected in these tests. So, wait for the reports. And try not to worry too much. It will deteriorate your health more. Keep faith in yourself.


Hope this information suffices. Let me know, if you have any more question.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Das Arindam 38 minutes later
The thing that I struggle with is being happy with negative test results. For example, I have a normal chest x-ray, but couldn't there be something that is being missed, like that would not show up on there? Could my pulse oximetry fall from 98% to abnormal in just 1 month?

I know these thoughts are part of my anxiety, and that if I were to have repeat tests today they would be normal again, but they are things that bother me just the same.

And this is an aside comment, will my anti-depressents eventually be better tolerated by my body? Or will I always have digestive upset, etc.?
doctor
Answered by Dr. Das Arindam 23 minutes later
Hello,

Thank you for posting a query.

Suppose, you have the disease of any of the system I have mentioned earlier. When the doctor examined you clinically, he / she must have found some abnormalities right? But, in your case, there was nothing.

A disease, when involves a particular system, it presents with some signs like irregularity in pulse, abnormality in heart sounds, abnormality in breath sounds, etc. From these signs, we try to think about the disease. Even today, after having such advancement in investigative procedures, clinical examination and findings are considered as gold standard for diagnosing a disease.

Another point is – you are still able to exercise, you can clean home. This is not possible, if you are suffering from a chronic disease.

No, it is not possible to fall your pulse oximetry from a normal level to an abnormal one within one month without having any devastating symptoms.

After reading your description again and again, I have found one thing. You told that you are suffering from shortness of breath. If echo and holter rports are within normal limit, you can consult with your treating doctor about spirometry. It detects abnormality in breathing mechanism. If there is something, which has been missed, in other tests, can be detected in this test.

Regarding your antidepressants, I think you need some more time to tolerate these. Look, any drug can lead to these type of hyperacidity and indigestion. It is common side effect. But, for this, rabeprazole is enough. Just continue it.

Hope this information suffices. Let me know, if you have any more question.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Das Arindam 2 hours later
you are right....the doctor said that my heart and lungs sound fine (no murmurs or abnormal lung sounds). Sending me to a cardiologist is precautionary as I get heart palpitations (which I had all the test for in 2010 and all were fine).

It is just scary for me when I experience weird physical symptoms like this. It is hard to believe that sometimes anxiety can be the culprit. I have had 4 other instances where I have had strange physical symptoms and thought it was something bad, but ended up being nothing. Just a product of over-worrying and fixating on my body. Once I got normal results back, I would feel better.

I am seeking help to try and brake this cycle, but in the meantime I still have to live with not feeling well which is stressful.

Thank you for your answers. I helps to re-assure me that tests would pick up on underlying problems.
doctor
Answered by Dr. Das Arindam 5 hours later
Hello,
Thank you for writing back.

I can understand your concern.

Yes, sometimes anxiety is the culprit. Look, as I have told you , these type of symptoms indicates poor control of anxiety. So, my recommendation is to consult with your treating doctor about readjustment of the drugs you are taking.

That is all you need right now.

Hope you have your answers.

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