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Suggest remedy for acute pain and heaviness in the chest region

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Posted on Thu, 28 May 2015
Question: Hello Dr. XXXXXXX
I had been in touch with you once when my husband reacted with blackouts to a Cetrizine preparation. I would like your advice for a problem I am facing. I have been suffering from acidity for a long time. I have consulted doctors some time and been advised to take Gelusil before food. But this is only a temporary remedy. I sometimes have acute burning which turns into a heaviness and pain in my chest. Then after sometime it settles down and goes away. I don't know what aggravates it and what soothes it. I just want to know whether this pain that I sometimes experience is something serious. Or that since it subsides on its own eventually, it is alright.
doctor
Answered by Dr. Rakesh Sharma (6 hours later)
Brief Answer:
Tablet Pantoprazole and domperidone empty stomach.

Detailed Answer:
Hello again.
Thanks for the trust .I am honoured.It gives me pleasure to help you out again, and you are welcome any time.
I remember the cetirizine episode.
The present problem seems to be due to acid peptic disorder with reflux disease.
I will advice you to take Tablet Pantoprazole with domperidone combination empty stomach twice daily.
Take small frequent meals preferably bland diet, and fruits.
I , in my patients prescribe gelusil after food, that gives better result.
Avoid tea, coffee, areted drinks and spicy food for time being.
Drink lots of water.Make sure you do not drink plenty of water at a time immediately after meals.Take little break before drinking in bulk.
Do not lie down immediately after meals.
If constipated take mild laxative.
In my opinion you will start feeling better in 2-3 days after applying these measures.
Please also feel free to write back to me for any further clarifications, I am always here to help.
Hope this suggestion helps.
Good luck.

Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Rakesh Sharma (9 hours later)
Hello doctor,
Thank you very much for your advice. I have started the medication today. There are, however, a few questions that I would like to ask.
1. Is this a long term remedy? Or is it symptomatic? I mean, am I likely to have the problem again and do I have to take it every time it happens?
2. For how much time can I safely take this medicine in one course? I have bought 10 tablets to be taken as per your advice of twice a day, for 5 days. Is that alright?
3. I like and often drink green tea with honey and lemon juice. Is that also to be stopped?
4. Do I have to take Gelusil also? Or did you only mention it because of my question?
Finally, is what I have the same as what is called GERD?
Looking forward eagerly to your reply,
With regards,
XXXX
doctor
Answered by Dr. Rakesh Sharma (34 minutes later)
Brief Answer:
GERD occurs due to acid peptic disease

Detailed Answer:
Hello again.
Thanks for prompt reply.
1.This is a long term remedy. You must take it even after you are symptom free.you can repeat it as and when required for at least 4 weeks.
2.You should take for at least 4 weeks at a time.
3.In my opinion lemon juice should be avoided.
4.You should take gelusil after food.Syrup sucral gives better results in most cases, so you can change to that.
Hope you have answer to your query, any thing else, you are welcome.
Good luck.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Rakesh Sharma (2 days later)
Hello doctor,
I have been taking the medication from Sunday onwards. I am as of now, nearly completely relieved of the heartburn. Occasionally I feel a very mild heaviness in the chest instead of the pain which was there when I first wrote to you. I have now got medicines enough to be taken twice a day for 4 weeks, as advised by you. I am taking the syrup after meals, also twice a day. Is that the frequency I should be following for the syrup?
I would like to know:
1. Whether I should take the tablets twice a day for the whole of the 4 weeks or should I reduce the dosage after some days?
2. I am now following totally bland diet. For how much time should I continue that?
3. Am I allowed to eat all the fruits available, or are there any specific fruits for me?
4. When I mentioned about green tea with honey and lemon juice, you told me to avoid lemon juice. Does that mean it is ok for me to have green tea with honey? Can I have one cup of that everyday?
You have been very patient in answering my queries, doctor. If it is possible to briefly tell me how this tablet acts, I will be very grateful.
With regards,
XXXX
doctor
Answered by Dr. Rakesh Sharma (1 hour later)
Brief Answer:
Twice a week for at least 2 weeks

Detailed Answer:
Hello again,
It is nice to know that your condition has improved.
I will answer your question in order you have asked,
1.Take tablets twice daily for atleast 2 weeks , you should do it once a day only after you are totally symptom free for about a week.Syrup has to be taken twice for one month , after that you can stop it or take SOS.
2.once you are symptom free you can gradually start normal diet.
3.You can eat every fruit, but in small helpings.Avoid citrus druits empty stomach.
4.Yes you can have green tea every day , but take biscuits with it.
Hope you have answers to your query.If any thing else you are welcome or you can rate the answer and close the question.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rakesh Sharma (22 hours later)
Thank you for all the help, doctor. I will follow your instructions implicitly.
Please tell me whether I should check with you before I stop the tablets or I can simply stop it after 4 weeks.
Also, would I need a follow up course of the medication as a matter of procedure? Or will this one course suffice?
Is there any test I have to undergo to confirm completeness of cure?
Thank you once again, doctor.
Regards,
XXXX
doctor
Answered by Dr. Rakesh Sharma (1 hour later)
Brief Answer:
If happens recurrent then gastroscopy is advocated.

Detailed Answer:
Hello again,
You can stop it on your own after 4 weeks.
You can take it for at one recuuarnce again or check with me.
If you have same symptoms again and again, then I advice you to go for an endoscopy of upper gastrointestinal tract.
Keep following small frequent diet regime.
Hope you have answer to your query, if any thing else you are welcome.
or you can close the question by rating it.
Good luck
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rakesh Sharma (6 days later)
Hello Dr. XXXXXXX
First off, I hope all is well with you and your family after the recent earthquake.
I have now been following your instructions for the past 10 days and am onto the 11th day of medication twice a day. I have been completely free of the heartburn. The pain and heaviness in the chest had almost gone. But today I am feeling a dull heaviness accompanied by a very mild pain, especially well I apply pressure on the sternum. Will this go completely in due course of time? I am still on bland diet.
Regards,
Rama XXXXXXX
doctor
Answered by Dr. Rakesh Sharma (6 hours later)
Brief Answer:
Carry on with medication.

Detailed Answer:
Hello XXXXXXX
Thanks for your concern. we all are fine.
It is nice to know that you are better.
Pain on applying pressure on sternum may be muscular or may be of costrochondrial joint.
Apply some analgesic gel and see if it improves.
You should avoid Pain killers for time being due to your gastric condition.
Now you can gradually start food of your choice in small frequent diet,but avoid chillies.
Keep taking medication for another 2 to 3 weeks.It may take time but will go.
Any doubts about chest pain ,you must always get an EKG done.
Hope this answers your query. If any thing else you are welcome.
Good luck.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Rakesh Sharma (41 hours later)
Dear Dr. XXXXXXX
Thank you for patiently answering all my queries.
1. When you say avoid chillies, is it that I must not eat raw green chillies? Or any chilly at all? Our staple diet consists of sambar and rasam which contains masala containing dried red chillies along with a lot of other things like Dhania spowder, cinnamaon, methi, mustard, etc., added to the sambar/ rasam along with tamarind juice. So can I start having this gradually?
2. I don't generally eat a lot of fried stuff, but do so occasionally. Now I have been avoiding this completely. Can I have this also gradually?
3. The pain in my chest is not consistent. But when it is there, it is a feeling of some kind of pressure inside. Does not feel like a muscular pain, and it is not like I can apply a gel to get rid of it.
I used to have migraine attacks and I was advised to take Grenil tablets when it is intolerable. So I continue to take it now SOS. It contains paracetamol and domperidone. Can I take it if I have severe headache?
With regards,
XXXX
doctor
Answered by Dr. Rakesh Sharma (10 hours later)
Brief Answer:
Small quantity of sambar.Advised EKG.

Detailed Answer:
Hello XXXXXXX
Firstly I am sorry for delay due to some unforseen circumstances.
You can have sambar but in small quantities.
Eating raw chillies is not advisable.
Even tamrind juice is cause of dyspeptic symptom, so when you make sambar put these things in lesser quantity.
You can have fried food , in small quantity once in a while.
Keep taking syrup sucral all this while.
If you still feel pressure in side your chest then you must get your EKG done, because we must rule out any cardic ailment.
Grenil is very safe and good medicine for migraine.You can take that.
Please also feel free to write back to me for any further clarifications, I am always here to help.
Good luck.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rakesh Sharma (2 days later)
Dear doctor,
I am strictly following your advise and I am stable right now.
I plan to start taking the tablets once a day from tomorrow.. I have 19 tablets with me and plan to finish it. So I would have taken it twice a day for 15 days and once a day for 19 days. I hope that should be sufficient.
My diet is very slightly towards normal. But I hope I will eventually be able to eat normal food.
Right now I do not have the pain in the chest. It seems to be very sporadic. I feel extremely puzzled by it. Sometimes I feel alarmed by it and at other times I feel I am unnecessarily worrying. I wish I could be sure of my symptoms.
But having you guide me has been very comforting indeed.
I shall keep you informed and take periodic advice from you,
With regards,
XXXX
doctor
Answered by Dr. Rakesh Sharma (5 hours later)
Brief Answer:
Can take tablet once a day.

Detailed Answer:
Hello XXXXXXX
Good to know you are stable.
Yes you can start taking your tablets one time a day.
But I will advice you to take syrup two times after meals for another 2 weeks.
Hope you are not suffering from constipation, if yes you can take mild laxatives like lactulose syrup once a while, as chest symptom can be related to gas as well.
You must observe if your chest discomfort is related to food, constipation or exertion.
If exertion is the cause , you must get your heart checked.Sometimes clinically it is difficult to differentiate between these two.
Please also feel free to write back to me for any further clarifications, I am always here to help.
Hope and wish every thing is going to be fine.
Good luck


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rakesh Sharma (2 days later)
Good evening, doctor
I will do exactly as I am told. As a rule, I do not have constipation, but I do often have gas build up. Today I felt some chest pain after I had to drive around quite a bit in the city. But I have undergone TMT once in the past and been told there is no problem. If the pain persists, I will go for it again.
Regarding the laxative you have prescribed, can it be taken by anybody, without a prescription? Sometimes my mother in law of 79 years complains of constipation. Can I give it to her?
I do hope I will be fine soon, thanks to your timely and professional help.
With regards,
XXXX
doctor
Answered by Dr. Rakesh Sharma (17 hours later)
Brief Answer:
yes lactulose is safe laxative.

Detailed Answer:
Hello again
Sorry fo delay in replying.
Yes you must go through TMT again to make sure there is no heart ailment involved.As soon as possible.
Lactulose is safe laxative. It is availalble without prescription at many places. Please check with yoru local chemist.
It ca be taken as and when required even by elderly.
If anything else you are most welcome.
Good luck
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Rakesh Sharma

General & Family Physician

Practicing since :1982

Answered : 728 Questions

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Suggest remedy for acute pain and heaviness in the chest region

Brief Answer: Tablet Pantoprazole and domperidone empty stomach. Detailed Answer: Hello again. Thanks for the trust .I am honoured.It gives me pleasure to help you out again, and you are welcome any time. I remember the cetirizine episode. The present problem seems to be due to acid peptic disorder with reflux disease. I will advice you to take Tablet Pantoprazole with domperidone combination empty stomach twice daily. Take small frequent meals preferably bland diet, and fruits. I , in my patients prescribe gelusil after food, that gives better result. Avoid tea, coffee, areted drinks and spicy food for time being. Drink lots of water.Make sure you do not drink plenty of water at a time immediately after meals.Take little break before drinking in bulk. Do not lie down immediately after meals. If constipated take mild laxative. In my opinion you will start feeling better in 2-3 days after applying these measures. Please also feel free to write back to me for any further clarifications, I am always here to help. Hope this suggestion helps. Good luck.