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    What causes chest pain along with nausea and back pain while on Gaviscon?

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Posted on Wed, 2 Aug 2017 in Digestion and Bowels
Question: Hey doctor, I have been having gerd problems for about 2 years now I am a 19 year old Male that weighs only 59kg and is 175cm tall. The severity of gerd comes and goes. I was first on Nexium 40mg 2 years ago for a month which cleared my symptoms and I was fine for a year after that needing only Zantac or Gaviscon to control occasional gerd symptoms. Recently though about a month ago I had a really bad flare up after a night out of drinking alchool with gerd symptoms of chest pain, feeling of food coming up my throat, a lot of burping, back pain and nausea so I my doc put me back on the Nexium 40mg once daily at night since that's when it's at its worst for me for 7 days, but was off it after a week because of even worse nausea from it. I then switched to Somac 40mg once daily at night for 2 weeks a week later and it barely did anything at all for me it felt like it made my chest pains and nausea even worse so the doctor referred me for an endoscopy but he also switched me back to Nexium 40mg as the doctor recommended trying it again and it's working worlds better than the Somac was without the nausea either. I am wondering if I should still get the endoscopy since I already booked it about for 2 weeks away? I am not symptom free that's for sure I'm still burping a bit and have a bit of and back pain mainly plus some regurgitation depending on what I eat but it's gotten better with the Nexium even being on it for only 4 days after the switch from Somac. I'm a bit of an anxious person when it comes to health which definitely makes my symptoms worse off and I'm not really keen on an endoscopy since I've never been sedated before or anything and dont like the idea of a camera down my throat. Could I maybe cancel it and see how I go with the Nexium again? Between the two ppis i've only been on them for 24 days in total 7 days on the Nexium with a week break and then onto the Somac for 14 days and then I switched back to Nexium and it has been 4 days on it again. How long should I give the Nexium since I started it again before going for the endoscopy and is their any harm in waiting since I am quite young would the treatment really change after an endoscopy?
doctor
Answered by Dr. T Chandrakant 54 minutes later
Brief Answer:
As detailed

Detailed Answer:
Hi.
Thanks for your query, albeit an elucidate one.
Noted the history well and understood your concerns.
GERD is Gatroesophageal reflux disease wherein the contents of stomach come up in the esophagus and cause the symptoms.
PPIs either Pantoprazole/Somac or Nexium/Esomeprazole work by reducing the acid secretions hence reduce the symptoms. They have no role as anti-reflux activity. Same is true for Zantac/Ranitidine.
Anxiety and/or stress can be the instigating or enhancing factors, hence needs good control over to help relieve the symptoms.
Alcohol, late nights, junk, oily, spicy foods enhance the problems hence be avoided strictly.
Antacid should be taken when you are on empty stomach means there is no food in the stomach.
To have better control you can discuss with your treating Doctors and get a valid prescription of Domperidone as it has anti-reflux activity. Needs to be taken at 8 hourly interval.
Out of the Nexium, Somac or Ranitidine, everything is equally effective and depends upon which suits you the best should be continued and you can continue for about one and half months and repeat whenever the instigation or enhancing factors recur your problems.
Endoscopy is an ultimate investigation which shows exact pathology and gives a chance to add on the treatment as per the findings, hence can add on the management of GERD.

I hope this answers your queries as well as helps you for further relief.
If you follow the advise stringently, you will definitely get better.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 35 minutes later
Is an endoscopy something I have to rush to do though or can it be done when it's more convienant for me? In terms of my current treatment of Nexium 40mg is it also possible to have Gaviscon or Zantac on top extra if symptons were to flare up quite a bit or should the Nexium really being doing the trick? They dont seem to be too bad at the moment I just have this pain in my upper back. Do late nights in general worsen reflux or is it more so eating late at night? I have limited eating at least 4-5 hours before bed but I don't usually go to bed until around 12am-1am but still always get 8-9hours sleep. To add to that Gaviscon dual action is the one I am referring to if you can take it with Nexium or other PPIs for bad flare ups? I have attached pictures of it and the ingredients.
doctor
Answered by Dr. T Chandrakant 4 hours later
Brief Answer:
As detailed below.

Detailed Answer:
Either way. You can get the Endoscopy at your convenience, earlier the better as it gives exact information as to what is going on as explained above.
You can take Gaviscon when you are on empty stomach as it helps to neutralize the acid as well as gives protective covering for the mucosa of esophagus and stomach.
Nexium acts to reduce the acid output and Gaviscon helps to neutralize acid. Hence can be taken on the same dates.
Late nights and eating late enhances the problems.
It is good that you have complete sleep but try to avoid late nights if possible as it is part of the management of GERD.
You may please take Gaviscon before going to sleep as you have early dinner.

I hope this information helps you further.
Getting cured is the most important agenda.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 4 hours later
Will do thanks for the detailed info doc its very apperciated! In terms of diet though what are the best meats to eat and the best type of bread for gerd management? I've been trying to stick to low fat meat but its hard to know what is and what isn't low fat? I have also made a diary of foods that trigger my symptons as well and avoided those I ate one of those trigger foods yesterday without knowing it was one that I have now added to it which has made my symptons flare up again how long does that usually last? With the endoscopy procedure how exactly does it work in terms of what happens throughout it? I have heard that they sedate you but don't put you to sleep completely? I have never had those type of drugs so I have no idea how I would react to them either.
doctor
Answered by Dr. T Chandrakant 3 hours later
Brief Answer:
As detailed below.

Detailed Answer:
You have done the right thing; make a list of the foods and beverages that instigate or enhance the problems and stop them altogether. There is no sure-shot answer about what is to be eaten and what not. This is very subjective and differs from person to person.
In spite of going into the details of the types of foods, fat or low fat the best thing is to list up and stop. And if you still want to know please ask the Dietician.
Flare up can last for a few days to a few weeks depending upon many factors that we discussed above and hence unpredictable.
If you ''swallow the scope, this is practically a painless procedure.
If you have no anxiety about the procedure, it is smooth and an expert takes a few minutes only.
It depends upon centers/Doctor's choice whether to sedate everyone or the selected ones with apprehension.
You do not need to sleep fully if there is no apprehension.
Stop the apprehension and you will be half cured, see all these questions, anxiety too add to the symptoms that you already have.
Take care.
All thebest.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 2 days later
One last thing as well doctor before the procedure they told me that I only had to stop taking my Nexium the day before is this normal since it's my first time doing one? I've heard a lot of other people that had to stop it a week before doing the endoscopy?
doctor
Answered by Dr. T Chandrakant 4 hours later
Brief Answer:
Yes

Detailed Answer:
Opinions differ but that does not alter the picture much as you are already taking, so follow the instruction of stopping Nexium a day before the procedure.
Relax for the procedures, it is really painless if you swallow and cooperate.
Take care.
All the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 18097 Questions

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