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Suggest Treatment For Acid Reflux, Anxiety And Stress
Question: Hello,
A short background story. I have had GI issues since high school. I had acid reflux in high school, gallblader removal about 7 years ago, and I think either a gluten intolerance or some type of dairy issuse. My husband was diagnosed with cancer 5 moths ago. He has received treatment and is currently in remission. A few days ago I was hit with this overhwelming feeling that I had cancer of some type colon, stomach, ovarian because there are times when my stools are less than hard. I notice it when I have more fatty foods or a lot of dairy. I also sometimes have a bit of nausea as well. I went to the dr and she told me that she believes it is all stress related. I left feeling better but yesterday the fear set in and is still not going away. I can eat and have eaten today. I have had two normal BM's but I have this feeling of pain in my upper abdomen and tightness in my chest. I am still so convinvced that the dr was wrong and I have cancer. Should I go back? Can a anxiety/panic attack last all day?
A short background story. I have had GI issues since high school. I had acid reflux in high school, gallblader removal about 7 years ago, and I think either a gluten intolerance or some type of dairy issuse. My husband was diagnosed with cancer 5 moths ago. He has received treatment and is currently in remission. A few days ago I was hit with this overhwelming feeling that I had cancer of some type colon, stomach, ovarian because there are times when my stools are less than hard. I notice it when I have more fatty foods or a lot of dairy. I also sometimes have a bit of nausea as well. I went to the dr and she told me that she believes it is all stress related. I left feeling better but yesterday the fear set in and is still not going away. I can eat and have eaten today. I have had two normal BM's but I have this feeling of pain in my upper abdomen and tightness in my chest. I am still so convinvced that the dr was wrong and I have cancer. Should I go back? Can a anxiety/panic attack last all day?
Brief Answer:
Your primary problem is psychological and it is called obsessive compulsive disorder.
Detailed Answer:
Hello Dear,
Have gone through your details and i appreciate your concerns.
You are most likely having Obsessive-Compulsive Disorder (OCD).It is a chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions=i have cancer) and behaviors (compulsions=getting worried) that he or she feels the urge to repeat over and over.In your case obsession is your fear to have cancer and compulsion is your mind thinking again and again ,despite of clearance from your family doctor.
1) I get afraid and very scared that I may get cancer-obsession
2) But my doctor said I will not get but not able to tell that to my mind - compulsion, despite of clearance given by doctor without any significant symptom your mind is not satisfied that you are normal.
Tell tail features of ocd are-
Ptient can't control her thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive.
Spends at least 1 hour a day on these thoughts or behaviors
Experiences significant problems in their daily life due to these thoughts or behaviors.
So my strong suggestion is-
Start paroxetine at low doses to be increased every 14 days to maximum doses.(to be prescribed by a psychiatrist)
Ask him/her to add tab clonazepam or Lorazepam ( benzodiazepenes), to lessen your anxiety levels.
Consult a psychiatrist for the same.
Try to take 8 hours sleep,try strenuous exercises 45 minutes a day, yoga can be done to relieve your mind.
Follow medications for atleast 3 months,and you will be fine .
Its panic attacked caused by obbsession.Treat obbsession panic attack will settle down by itself.
Start the medications which I have advised in consultation with a psychiatrist .As per your quey no you should consult a pyschiarist and yes panic attacks can be there for days also even multiple panic attacks can overlap each other.
Don't worry you will be fine soon.
In case you have any other query ,feel free to ask i would be happy to help you.
Warm regards.
Your primary problem is psychological and it is called obsessive compulsive disorder.
Detailed Answer:
Hello Dear,
Have gone through your details and i appreciate your concerns.
You are most likely having Obsessive-Compulsive Disorder (OCD).It is a chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions=i have cancer) and behaviors (compulsions=getting worried) that he or she feels the urge to repeat over and over.In your case obsession is your fear to have cancer and compulsion is your mind thinking again and again ,despite of clearance from your family doctor.
1) I get afraid and very scared that I may get cancer-obsession
2) But my doctor said I will not get but not able to tell that to my mind - compulsion, despite of clearance given by doctor without any significant symptom your mind is not satisfied that you are normal.
Tell tail features of ocd are-
Ptient can't control her thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive.
Spends at least 1 hour a day on these thoughts or behaviors
Experiences significant problems in their daily life due to these thoughts or behaviors.
So my strong suggestion is-
Start paroxetine at low doses to be increased every 14 days to maximum doses.(to be prescribed by a psychiatrist)
Ask him/her to add tab clonazepam or Lorazepam ( benzodiazepenes), to lessen your anxiety levels.
Consult a psychiatrist for the same.
Try to take 8 hours sleep,try strenuous exercises 45 minutes a day, yoga can be done to relieve your mind.
Follow medications for atleast 3 months,and you will be fine .
Its panic attacked caused by obbsession.Treat obbsession panic attack will settle down by itself.
Start the medications which I have advised in consultation with a psychiatrist .As per your quey no you should consult a pyschiarist and yes panic attacks can be there for days also even multiple panic attacks can overlap each other.
Don't worry you will be fine soon.
In case you have any other query ,feel free to ask i would be happy to help you.
Warm regards.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you so much Dr. you answer just allowed me
To breathe a little easier. It's funny that you mentioned lozapram because that is what my dr. Wants me
To take. So I will be filling that prescription this evening. I think I've had this issue for longer than I think because I've had a fear of dying from cancer for a long time. Way before I met my husband and way before he was diagnosed. It's like by biggest fear was realized but it wasn't happening to me. I will begin excercise and yoga. I know that will help tremendously. Thank you for your time and answers. I have one more question. Can I be making the symptoms worse by stressing that I'm stressing about my obsessive fear? I feel like that's happening. When I'm distracted I feel better but as soon as I think about the fear it comes back. Now I feel pain in my side and back so I'm afraid of that too. My dr also told me that inflammation can be caused by stress and anxiety and that's why I have pain. She said it's not pain to even test because it hasn't been chronic and just happened when this irrational fear set in. She said I can do labs to make my self feel better but nothing would show up because I don't have cancer. I just don't like feeling this way.
To breathe a little easier. It's funny that you mentioned lozapram because that is what my dr. Wants me
To take. So I will be filling that prescription this evening. I think I've had this issue for longer than I think because I've had a fear of dying from cancer for a long time. Way before I met my husband and way before he was diagnosed. It's like by biggest fear was realized but it wasn't happening to me. I will begin excercise and yoga. I know that will help tremendously. Thank you for your time and answers. I have one more question. Can I be making the symptoms worse by stressing that I'm stressing about my obsessive fear? I feel like that's happening. When I'm distracted I feel better but as soon as I think about the fear it comes back. Now I feel pain in my side and back so I'm afraid of that too. My dr also told me that inflammation can be caused by stress and anxiety and that's why I have pain. She said it's not pain to even test because it hasn't been chronic and just happened when this irrational fear set in. She said I can do labs to make my self feel better but nothing would show up because I don't have cancer. I just don't like feeling this way.
Brief Answer:
Follow up suggestions.
Detailed Answer:
Hi again,
OCD is stress responsive,as symptoms increase during periods of stress but also because stressful events may precede the onset of OCD.
So definitely yes stress is increasing your symptoms.
You are having OCD and only proper treatment will help you.Please don't worry too much.You would feel much better after starting treatment.
All your symptoms are because of stress anxiety and obsession.
Don't go for any investigations right now.
Start taking SSRI's(the main stay of treatment) with lorazepam initially for few days and after that sos.
Treatment would take appox 3 months time so don't panic,Don't get depressed just follow proper medications and you would be normal again very soon.
P.S-Don't google too much its going to make things worse.Don't read the mechanism of action side effects and all.Have faith on your doctor and you will soon
Follow up suggestions.
Detailed Answer:
Hi again,
OCD is stress responsive,as symptoms increase during periods of stress but also because stressful events may precede the onset of OCD.
So definitely yes stress is increasing your symptoms.
You are having OCD and only proper treatment will help you.Please don't worry too much.You would feel much better after starting treatment.
All your symptoms are because of stress anxiety and obsession.
Don't go for any investigations right now.
Start taking SSRI's(the main stay of treatment) with lorazepam initially for few days and after that sos.
Treatment would take appox 3 months time so don't panic,Don't get depressed just follow proper medications and you would be normal again very soon.
P.S-Don't google too much its going to make things worse.Don't read the mechanism of action side effects and all.Have faith on your doctor and you will soon
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you, Doctor. I am feeling a bit better today. I have tried some techniques that my dr. told me about and it is kind of working. I am also filling my prescription of Lorazapem and will take it tomorrow. You have been very helpful.
Brief Answer:
Folow up.
Detailed Answer:
Hi again,
Thank you so much dear and wish you a fast recovery.
Along with medicines you could try natural herbs like Brahmi,Ashwagandha and Sarpgandha. They are natural stress busters and are very effective.
Lactium is a unique milk extract that contains a natural bioactive protein with relaxing properties. Research suggests Lactium may help relive stress naturally without side effects.
I am just penning down the names as i don't know if you have faith in herbal and natural pathies. However in case you want details just write to me a follow up.
Thank you
Regards.
Folow up.
Detailed Answer:
Hi again,
Thank you so much dear and wish you a fast recovery.
Along with medicines you could try natural herbs like Brahmi,Ashwagandha and Sarpgandha. They are natural stress busters and are very effective.
Lactium is a unique milk extract that contains a natural bioactive protein with relaxing properties. Research suggests Lactium may help relive stress naturally without side effects.
I am just penning down the names as i don't know if you have faith in herbal and natural pathies. However in case you want details just write to me a follow up.
Thank you
Regards.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you Dr. I am willing to try herbal medicines. So I will look into them. I started my first dose of meds and I'm feeling a bit better. The first dose I felt really good for several hours but the pain in my chest and back came back after a few hours and my mind starting racing. Is that common? I saw another dr yesterday and she concurred with my family dr. She actually examined men because my fear now is esophageal cancer. I am not sure why I have pinpointed that specific cancer, probably because my chest is tight and my back hurts. But she she said my lungs sounded good and my bowel sounds were perfect as did the other dr. She also said that I showed no symptoms and she did not pick up on any red flags when I was talking to her. She said dr know what to listen for when patients describe what they're feeling and she didn't hear anything "red flag " from my symptoms.
I also know that the chest pain went away earlier today when I felt good. So cancer symptoms don't just go away. They are constant and get worse. Am I correct?
I know you have said this before but as an GI dr should I be worried about esophageal cancer? I am eating just fine, no vomiting, no black tarry stools, just the chest pain when I get panicky. No coughing. The dr told me that the main symptom that she sees in esophageal cancer is coughing and vomiting after eating. I don't have that at all. She thinks I have GERD brought on by stress.
Do you concur with this?
I'm still scared.
I also know that the chest pain went away earlier today when I felt good. So cancer symptoms don't just go away. They are constant and get worse. Am I correct?
I know you have said this before but as an GI dr should I be worried about esophageal cancer? I am eating just fine, no vomiting, no black tarry stools, just the chest pain when I get panicky. No coughing. The dr told me that the main symptom that she sees in esophageal cancer is coughing and vomiting after eating. I don't have that at all. She thinks I have GERD brought on by stress.
Do you concur with this?
I'm still scared.
Brief Answer:
Follow up advice.
Detailed Answer:
Hi again Dear,
-The first dose I felt really good for several hours but the pain in my chest and back came back after a few hours and my mind starting racing. Is that common? = Please specify the name of medication doses and frequency of medicine.
- I also know that the chest pain went away earlier today when I felt good. So cancer symptoms don't just go away. They are constant and get worse. Am I correct? =100% Correct any chronic disease like cancer of esophagus have persistent symptoms.Fluctuating symptoms are again suggestive of anxiety issues.
- I know you have said this before but as an GI dr should I be worried about esophageal cancer? I am eating just fine, no vomiting, no black tarry stools, just the chest pain when I get panicky. No coughing.-Obsession causing panic attacks is the main cause of all your symptoms.
GERD is characterised by severe heart burn(retrosternal chest pain with burning sdensation in chest.As acid from stomach is reflux back into esophagus it damages esophageal mucosa layer causing severe spasm and inflammation leading to nausea vomiting.As mucosa is irritated body releases large amount of mucous causing irritant coughing.You have not mentioned any of these symptoms.
Chest pain can be caused by a number of issues like Cardiac ,gastric,anxiety ,muscular,pyschological(A very non specific symptom).
Getting scared is a part of obsession dear patient.
Have you started SSRI's?(Main stay therapy for you.Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain cells. SSRIs block the reabsorption (reuptake) of serotonin in the brain, making more serotonin available.Initial response to this medicine takes minimum 14 days and therapy has to be continued for 3 months minimum.)
Anxiolytics are given along with it(Lorazepam) to calm down nerves.
Please mention the medicines you are on and doses and frequency dear patient.
Waiting
Warm regards
Follow up advice.
Detailed Answer:
Hi again Dear,
-The first dose I felt really good for several hours but the pain in my chest and back came back after a few hours and my mind starting racing. Is that common? = Please specify the name of medication doses and frequency of medicine.
- I also know that the chest pain went away earlier today when I felt good. So cancer symptoms don't just go away. They are constant and get worse. Am I correct? =100% Correct any chronic disease like cancer of esophagus have persistent symptoms.Fluctuating symptoms are again suggestive of anxiety issues.
- I know you have said this before but as an GI dr should I be worried about esophageal cancer? I am eating just fine, no vomiting, no black tarry stools, just the chest pain when I get panicky. No coughing.-Obsession causing panic attacks is the main cause of all your symptoms.
GERD is characterised by severe heart burn(retrosternal chest pain with burning sdensation in chest.As acid from stomach is reflux back into esophagus it damages esophageal mucosa layer causing severe spasm and inflammation leading to nausea vomiting.As mucosa is irritated body releases large amount of mucous causing irritant coughing.You have not mentioned any of these symptoms.
Chest pain can be caused by a number of issues like Cardiac ,gastric,anxiety ,muscular,pyschological(A very non specific symptom).
Getting scared is a part of obsession dear patient.
Have you started SSRI's?(Main stay therapy for you.Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain cells. SSRIs block the reabsorption (reuptake) of serotonin in the brain, making more serotonin available.Initial response to this medicine takes minimum 14 days and therapy has to be continued for 3 months minimum.)
Anxiolytics are given along with it(Lorazepam) to calm down nerves.
Please mention the medicines you are on and doses and frequency dear patient.
Waiting
Warm regards
Above answer was peer-reviewed by :
Dr. Yogesh D
I am on lexapro 10mg and xanax when needed. 5mg. I have not taken xanax. Just the lexapro. The reason why the last dr mentioned gerd is because I had it in the past and I told her the top of my abdomen was tight and sometimes gurgled in the evening. I am not experiencing a feeling of dry throat and like there is phlegm or something stuck. I don't think it's good because it doesn't happen right away. That started yesterday after I talked to the last dr and she mentioned the coughing as a major symptom of esophageal cancer. It's like I'm taking the new info I receive and then somehow manifesting the symptoms to my body. The dr also told me to try Prilosec for 14 days. Should I be concerned about my throat? I do have allergies and asthma this just seems different. I just want the meds to help me. I do feel like I'm making this worse everyday.
Brief Answer:
Follow up suggestions.
Detailed Answer:
Hi Dear,
Good to hear that you are on lexapro 10 mg. After 14 days depending on your response lexapro would be increased to 20 mg per day(optimal dose to control symptoms of ocd and panic disorders). Most people won't start experiencing the full positive effects of the medication until 6 to 8 weeks after beginning it.So remain calm and patient don't worry you will be fine very soon.
Initially i would suggest you to take xanax also minimum for 2 weeks after 2 weeks it could be taken sos.
Prilosec 40mg can be taken once daily to see if your symptoms respond to it. It's a very safe medicine. In fact when on SSRI's Prilosec should be taken daily to prevent gastritis(some times caused by SSRI's).
I do feel like I'm making this worse everyday-you are loved by your family friends,you deserve to feel better, and will feel better with appropriate treatment so don't blame yourself. Up's and downs are a part of life my friend.The strongest people are not those who show strength in front of us but those who win battles we know nothing about. You are very strong and important my friend.Don't underestimate your self just because of few bad days.
Some beautifully crafted lines for you from Bhagwad gita-
Why do you worry without cause?
Whom do you fear without reason?
Who can kill you?
The soul is neither born, nor does it die.
Whatever happened, happened for the good; whatever is happening, is happening for the good; whatever will happen, will also happen for the good only. You need not have any regrets for the past. You need not worry for the future. The present is happening and future is all yours.
What did you lose that you cry about?
What did you bring with you, which you think you have lost?
What did you produce, which you think got destroyed?
You did not bring anything - whatever you have, you received from here. Whatever you have given, you have given only here. Whatever you took, you took from God. Whatever you gave, you gave to him. You came empty handed, you will leave empty handed. What is yours today, belonged to someone else yesterday, and will belong to someone else the day after tomorrow. You are mistakenly enjoying the thought that this is yours. It is this false happiness that is the cause of your sorrows.
Wish you great luck you would be fine soon.
Follow up suggestions.
Detailed Answer:
Hi Dear,
Good to hear that you are on lexapro 10 mg. After 14 days depending on your response lexapro would be increased to 20 mg per day(optimal dose to control symptoms of ocd and panic disorders). Most people won't start experiencing the full positive effects of the medication until 6 to 8 weeks after beginning it.So remain calm and patient don't worry you will be fine very soon.
Initially i would suggest you to take xanax also minimum for 2 weeks after 2 weeks it could be taken sos.
Prilosec 40mg can be taken once daily to see if your symptoms respond to it. It's a very safe medicine. In fact when on SSRI's Prilosec should be taken daily to prevent gastritis(some times caused by SSRI's).
I do feel like I'm making this worse everyday-you are loved by your family friends,you deserve to feel better, and will feel better with appropriate treatment so don't blame yourself. Up's and downs are a part of life my friend.The strongest people are not those who show strength in front of us but those who win battles we know nothing about. You are very strong and important my friend.Don't underestimate your self just because of few bad days.
Some beautifully crafted lines for you from Bhagwad gita-
Why do you worry without cause?
Whom do you fear without reason?
Who can kill you?
The soul is neither born, nor does it die.
Whatever happened, happened for the good; whatever is happening, is happening for the good; whatever will happen, will also happen for the good only. You need not have any regrets for the past. You need not worry for the future. The present is happening and future is all yours.
What did you lose that you cry about?
What did you bring with you, which you think you have lost?
What did you produce, which you think got destroyed?
You did not bring anything - whatever you have, you received from here. Whatever you have given, you have given only here. Whatever you took, you took from God. Whatever you gave, you gave to him. You came empty handed, you will leave empty handed. What is yours today, belonged to someone else yesterday, and will belong to someone else the day after tomorrow. You are mistakenly enjoying the thought that this is yours. It is this false happiness that is the cause of your sorrows.
Wish you great luck you would be fine soon.
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you so much, Dr. I absolute appreciate the lines that you sent at the end. I've re-read them several times already. I've had two panic attacks already this morning. Once before church and one after. The chest pain is, I know, brought on by the anxiety. I didn't have chest pain last week. Last week I felt "normal ". Why does my chest hurt even after I'm done with the panic attack? I feel like it's almost all of the time now. Is it because I'm thinking of why it hurts and that makes it worse? Like you mentioned before it's overlapping or physically the anxiety and obsession is making it hurt continually? Sometimes it spreads to other parts of my chest but usually it's right in the middle. It will ease up when I'm distracted but it's more and more so? Also, since taking the lexapro I've experienced some diarrhea. Is that typical as well? You have been very helpful and I thank you again.
Brief Answer:
Follow up.
Detailed Answer:
Hello again,
Loose stools are common side effect of escitalopam.It would go away in few days.Till that time take a good probiotic daily.
As the pain you are experiencing is typically in middle of your chest(behind breastbone) then it could be due to acid reflux also.
Acid reflux causes heartburn which presents with retrosternal chest pain.
A therapy with omeprazole 40mg should be taken for 5 days along with antacids and tell me if the pain responds to it or not.
Thanks.
Follow up.
Detailed Answer:
Hello again,
Loose stools are common side effect of escitalopam.It would go away in few days.Till that time take a good probiotic daily.
As the pain you are experiencing is typically in middle of your chest(behind breastbone) then it could be due to acid reflux also.
Acid reflux causes heartburn which presents with retrosternal chest pain.
A therapy with omeprazole 40mg should be taken for 5 days along with antacids and tell me if the pain responds to it or not.
Thanks.
Above answer was peer-reviewed by :
Dr. Prasad
I feel like the pain really gets going when I feel the most panicky I.E. "I know I have cancer. I know the labs will come back with something." Then when I calm down it eases up. I guess what I'm asking is can the pain still stick around because even though I'mmost likely having psychosomatic symptoms can my chest still feel pain that lingers? I also have pain in my lower back that sometimes accompanies it. That's lessened over the past few days but it still comes and goes. The dr.'s I've seen all say that's where people hole their stress. I know I'm repeating myself. And I know that you and the other dr told me that I'm most likely OK. You've been very patient. Also, the pain I told you about in the first post, at the top of my abdomen is all but gone. So I know the omneprozole is working. Basically this is all psychosomatic, isn't it? Thank you.
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
A panic attack can last from a few minutes to hours and could repeat itself many times in a day.
So yes pain can even persists for hours or days following a attack.
Most likely its pyschosomatic however response to therapy with Lexapro will help make things clear.
As omeprazole is helping you then GERD can also be a cause of pain in chest.
Wait and watch for response of medicines would be the best policy right now.
Regards.
Follow up.
Detailed Answer:
Hi again,
A panic attack can last from a few minutes to hours and could repeat itself many times in a day.
So yes pain can even persists for hours or days following a attack.
Most likely its pyschosomatic however response to therapy with Lexapro will help make things clear.
As omeprazole is helping you then GERD can also be a cause of pain in chest.
Wait and watch for response of medicines would be the best policy right now.
Regards.
Above answer was peer-reviewed by :
Dr. Kampana
Thank you very much. I went and had my follow up with lab results. All was good on the labs. Now it's up to me to work on my mental health and well being. How much stress can I hold in my back? It's been really sore all over and moves from place to place. Will this too ease up as my other symptoms ease up? Yesterday it hardly hurt at all. It was my chest. Today it's my back. Will this ever end?
Brief Answer:
Follow up answer.
Detailed Answer:
Hi again,
See we can't quantify stress. Handling stress depends on attitude which varies from person to person.
Yes relief from symptoms should relief all the problems.
Yes it should be much better in 2-3 weeks.
You just need to be patient.
Thanks.
Follow up answer.
Detailed Answer:
Hi again,
See we can't quantify stress. Handling stress depends on attitude which varies from person to person.
Yes relief from symptoms should relief all the problems.
Yes it should be much better in 2-3 weeks.
You just need to be patient.
Thanks.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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