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Suggest treatment for mild GERD and high cholesterol

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Posted on Mon, 25 Jul 2016
Question: very quick spasm/congraction/squeeze in upper chest and throat upon climbing 3rd flight of stairs. I have high cholesterol, on statins. some mild GERD, taking ranitidine. This symptom has become chronic past couple of days. had this once before months ago, went away on its own. Has also occurred while eating and at rest a couple of times.
doctor
Answered by Dr. Neel Kudchadkar (3 hours later)
Brief Answer:
Bronchospasm: You need terbutabline and salbutamol medication.

Detailed Answer:
Hi!

1. These are the classic features of bronchospasm. Meaning the sudden contraction of the main airways of the lungs. This is caused to due heavy exertion, anxiety among other organic factors such as asthmatic illnesses (in other persons) and more specifically allergic reactions.

2. I suggest that you take medication either in syrup or in tablet form containing Salbutamol or Terbutaline (They come in combination as well). These are bronchodialators.

3. There is no need of nebulizer treatment at this time, though you might want to see a doctor for pulmonary function tests and a chest examination.

4. This isn't a heart issue. However, an ECG exam, that is quick, cheap and easy; would reveal and rule out cardiac involvement, due to your feelings about being on statin therapy for cholesterol.

Thanks,
Dr. Neel Kudchadkar
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Neel Kudchadkar (5 hours later)
Thank you- the ENT SPECIALIST felt it was GERD due to redness on my vocal cords- but what you are saying makes sense due to the sensation- is this something serious which can manifest into something more serious- I was a smoker 15 yrs ago- or has the GERD caused this over time- I hiccup after any meal but I don't realky feel burn from the GERD- I dont have allergies' or anxiety- what else can cause this ' seems so random! Thank you!!

Why have I not received reply to follow up questions
doctor
Answered by Dr. Neel Kudchadkar (3 days later)
Brief Answer:
Sorry for the delay

Detailed Answer:
Sorry for the delay, I was busy due to a hectic schedule. Hiccuping sometimes after a meal is normal. Broncospasm is not related to GERD.. It can be due to any chronic use of drugs, asthma or in your case most probably any obstructive lung disorder. You need to visit a pulmonolgist. Complications can include apnea and even cessation of breathing. Thus, you need to start on medications at the earliest. Thank you.

Above answer was peer-reviewed by : Dr. Sonia Raina
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Follow up: Dr. Neel Kudchadkar (2 days later)
Thank you- I had a spirometry done' although my dr still believes it is GERD- symptoms have accrued again when I have been anxious! No history of drugs- asthma - going for stress rest soon as well! Do you suggest another lung test, it was a battle getting the Spielberg@ if that is clear' means lungs are ok? Thanks again! Our medical may be cheaper in Canada' but we have very poor preventative care and diagnostics! !

By the way- I do not have any coughing! My doctor says thst bronchispasm would have coughing involved!
doctor
Answered by Dr. Neel Kudchadkar (2 days later)
Brief Answer:
get a PFT and x-ray chest

Detailed Answer:
Thanks for follow up.

It looks like you are having typical GERD. If you are really concerned, you can get a pulmonary function test and an X-ray chest which will give you clear idea.
Avoid Tea, coffee, spicy food,juices with citrus content, alcohol, smoking. Drink plenty of water. Regular Physical activity is mandatory.

Kindly get back to me if any query
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Neel Kudchadkar (8 days later)
I have had a spirometry, a heart stress test, which i was asked to stop at 6 minutes, due to the heart rate up to 162..blood pressure was good. no symptoms, no skipped heart beats, all was good, other than out of shape (I have a desk job), I am over weight about 20 pounds.(working on this).. Also had a barium swallow test, all my tests were good, nothing unusual. I am very concerned and don't know what other tests to ask for. I am still getting the spasm/contraction in the center of my throat, sometimes radiates to upper chest, just below the neck. I have even tried ativan...I do not have panic attacks! I have been taking 20mg of Proton pump inhibitor for the acid reflux. My symptoms come on when going up over 2 flights of stairs, althought, no symptoms on treadmill, although I am far more breathless going up stairs than I was on treadmill for the stress test. Also getting symptoms at rest on occasion. I have been treating the GERD for a month now, should this symptom not be gone if it were from GERD. I am rambling but I am concerned, any other tests I should do other than the chest XRAy, which I will ask for today. Thank you!
doctor
Answered by Dr. Neel Kudchadkar (36 hours later)
Brief Answer:
follow below instructions

Detailed Answer:
hi,
Thanks for follow up query

Treatment for people who have symptoms of GERD begins with making lifestyle modifications.
1 Sleeping with an elevated head in patients with documented nighttime reflux
episodes, smoking cessation, weight reduction and low-fat diet (< 45g/d) have
all been found to be useful measures.
2 Avoidance of food and beverages with a pH of < 5 and/or capability of relaxing
the lower esophageal sphincter — such as alcohol, chocolate, mint, onions, tea,
cola, citrus fruits — is also highly recommended; and patients should avoid food
and beverages 2 to 3 hours before going to the bed.
3. Medications for GERD include proton pump inhibitors (PPIs) and H2 blockers. 4 4. you may require different medications or combinations of medications
before finding the one that best relieves their symptoms.
5. Long-term medication therapy is usually necessary to treat severe, persistent
symptoms or complications of GERD. If GERD symptoms are present, begin a 3-
month empiric twice-daily trial of PPI, while monitoring baseline respiratory
symptoms, pulmonary symptoms and peak expiratory flow rate.
5. If at the end of empiric trial, pulmonary symptoms do not improve, then 24-
hour esophageal pH–testing should be performed while the patient is on GERD
regimen, to see if acid is adequately suppressed.
6. If the patient's respiratory symptoms are found to improve after a 3-month
empiric trial, then maintenance GERD therapy is required.
7. Do not stress yourself, it increases your problems

Kindly get back to me if any query
Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Neel Kudchadkar

General & Family Physician

Practicing since :2004

Answered : 532 Questions

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Suggest treatment for mild GERD and high cholesterol

Brief Answer: Bronchospasm: You need terbutabline and salbutamol medication. Detailed Answer: Hi! 1. These are the classic features of bronchospasm. Meaning the sudden contraction of the main airways of the lungs. This is caused to due heavy exertion, anxiety among other organic factors such as asthmatic illnesses (in other persons) and more specifically allergic reactions. 2. I suggest that you take medication either in syrup or in tablet form containing Salbutamol or Terbutaline (They come in combination as well). These are bronchodialators. 3. There is no need of nebulizer treatment at this time, though you might want to see a doctor for pulmonary function tests and a chest examination. 4. This isn't a heart issue. However, an ECG exam, that is quick, cheap and easy; would reveal and rule out cardiac involvement, due to your feelings about being on statin therapy for cholesterol. Thanks, Dr. Neel Kudchadkar