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Heartburn, severe chest pain, reflux. On ganatone tablets, pan-d capsules. Treatment?

Sir I am suffering from heartburn with severe pain in left side chest . Doctor diagonized it as reflux and prescribed me Ganatone tab and pan D capsule to be taken before meals in the morning and ganatone tab before lunch and dinner. After two weeks of medication still Iam feeling in the same area. Please advise me for further treatment
Asked On : Sat, 1 Sep 2012
Answers:  3 Views:  578
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Internal Medicine Specialist 's  Response
Dear friend, welcome to HCM !

How old are you?
Do you have sweating, palpitations (thumping heart beats), nausea, giddiness?

if acid blockers and prokinetics are not helping, i think you should rule out a heart problem -coronary ischaemia- pre attack stage.... commonly mistreated as acidity and may become serious if not treated in time.
please get an ECG and an Xray chest doene early.
The other possibility is inadequate duration of treatment of acidity.
Is an Endoscopy (OGD scopy )done?
If there is an ulcer or uncommon causes of dyspepsia, it may not show relief.
please see a gastro enterologist if above ECG, Xray are normal.

Take care and please keep me informed of your progress.
Good Luck !
I hope to have answered your query satisfactorily.
May I request for your rating and review of this answer before you accept the answer and close the query (if there are no more follow up questions)?
Thank you !
Answered: Sat, 1 Sep 2012
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General Surgeon Dr. Grzegorz Stanko's  Response

Thank you for the query.

It would be easier to answer your question, knowing what tests has been performed. It is impossible to recognize gastric reflux disease without endoscopy.
Such pain may be caused by heart problems, gastric problems and lungs problem. And this diseases may be concomitant.

So you should have: ECG and blood work for troponine and CK-MB (necrosis heart enzymes) and heart ultrasound may be necessary.
Endoscopy should be performed as acid reflux may be not a disease itself, but a symptom of peptic ulcer, hiatus hernia and other gastric diseases. During the endoscopy there should be performed test for Helicobacter Pylori. If it will be positive, antibiotics and proton pump inhibitors therapy is necessary. Reflux disease may be diagnosed with esophageal ph monitoring. Abdomen ultrasound should be performed as well and fool blood work with liver and pancreas enzymes to rule any other upper digestive tract diseases.

Such pain may be also caused by either asthma or COPD (chronic obstructive pulmonary disease - this one is associated with smoking). Moreover, acid reflux is very often related with asthma. Chest X-ray and spirometry should be performed.

Your acid reflux (when recognized) may not response for your current treatment, and some other acid blocking medicines might be necessary.

Hope this will help.
Answered: Sat, 1 Sep 2012
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General & Family Physician Dr. Michelle Gibson James's  Response
Hi, welcome to healthcare magic

Ganatone tab is in the family of medication (proton pump inhibitors) that is commonly used for reflux.There are other medications in this family of drugs and sometimes persons respond differently to medication and you may have a different response to another drug.
If you remain unresponsive or worsen , your doctor may consider a test to check for the presence of a bacteria that, if present can aggravate or start symptoms of reflux. It is called H pylori and if present, requires antibiotics.

Imaging may be necessary to make sure that no ulcerations are present.
Lifestyle measures for reflux include: weight loss if there is excess weight, reducing high fat, spicy or acidic foods, eating small meals, not lying down within 2 hours of eating, avoiding carbonated drinks

I hope this information helps
Answered: Sat, 1 Sep 2012
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