Monday, September 22, 2014

Friday, April 16, 2010 M.Norman, Community Member, asks

Q: Chronic Esophageal Pain

 

 

For the last 18 months I have had the following symptoms near constantly day and night:

 

- Severe to moderate pressure-type pain in the middle of my chest from my throat to my upper stomach

- Pain and sensitivity to pressure (like when I press on it, lean forward, or when I eat) in my upper stomach

- Nausea

 

In September 2008 I tested positive via Hida Scan (34.9%) for low gallbladder function. Later that month, my gallbladder was removed, but my symptoms have remained.

 

In February 2009 I underwent an Endoscopic Ultrasound, which revealed that I was born with a Pancreatic Divisem. Doctors ruled out that this was the cause of the symptoms due to the fact that my amylase and lipase levels are normal.

 

To date doctors have been able to rule out the following as possible causes:

 

  • GERD/Bile Reflux

  • Esophageal Spasms

  • Gallbladder Stones/ Dysfunction

  • Pancreatic Dysfunction

  • Cardiac Related Problems (Angina, Coronary Spasms, Pereicarditis, etc).

  • Hiatal Hernia

  • Achalasia

  • Celiac Disease

  • Sphincter of Oddi Dysfunction

  • Thyroid Condition

  • Cancer

     

 

Since my symptoms started in May of 2008 I have been to the ER almost 10 times and have had multiple blood draws for (among others) amylase/lipase, sprue panel, thyroid levels as well as CBC rate and hepatitis and a H. Pylori stool sample. I have also had the following tests all which turned up negative:

 

07-08-08 Gallbladder Ultrasound

07-23-08 Endoscopy

07-28-08 EKG Stress Test/Pulmonary SVC

09-12-08 Barium Swallow

09-17-08 Hida Scan

09-26-08 Gallbladder Surgery

01-09-09 Chest MRI

01-19-09 EGD with MRCP

02-02-09 EGD with Ultrasound

02-06-09 Barium Meal

02-12-09 Small Bowel Follow-Through

02-17-09 EGD with Bravo Placement

06-15-09 Colonoscopy

03-16-10 EGD with Sprue Biopsy

 

On May 19th 2008 my wife and I took a day trip to Tijuana, Mexico while on vacation in San Diego, CA. Before crossing back over to the US, I stopped ate at taco stand close to the boarder eating two chicken tacos and two pork tacos along with two bottled Cokes. There were no immediate negative effects, but 24 hours later I was having signs of food poisoning in the form of severe cramps, dehydration, nausea and diherria. After a visit to the doctor's office I was given some anti-biotics and felt better generally except for a persistent gnawing at the top of my stomach. Another trip back to the doctor and I was diagnosed with gastritis, tested for H. Pylori and parasites and given a prescription for general Protonix and anti-parasitic medicine. After a few weeks I began to feel better generally and went for a run. This proved to be a mistake because after the run the gnawing sensation returned. I went to the doctor again and this time was checked for gallstones through an ultrasound which came up negative. I was told to continue taking the Protonix and limit my diet to things containing low fat and low acid. That same day I began having severe chest pain, but being only 28 and in good condition assumed that it was nothing serious and after calling the doctor was told that it was most likely acid reflux or esophageal spasms. After a few more weeks of pain and no results from the Protonix I decided to switch to another general practitioner and was able to get in to see a GI specialist. After a barrage of tests ordered by both physicians in late September I had gallbladder surgery. When my symptoms didn't clear up after a few months I was subjected to more testing and tried various drugs to combat smooth and then skeletal muscle tension including nitro glycerin. My GI doctor has ruled out the need for an ERCP, claiming that because my amylase and lipase levels are steady and the risks for the test are too high. The doctor also claimed that I most likely had 'Heightened Viscera Noceception' (which from what I can tell, means absolutely nothing) and that I should get onto an SSRI to correct the problem. This idea was fast-tracked following an emotional breakdown after the death of my brother. I was put on Paxil and Ativan for anxiety and told by my newly prescribed psychiatrist that my pain could be a constant series of anxiety attacks. I was on these medications for eight months and even at maximum dosage both saw no significant improvement. In January 2010 I received the results of a blood draw from a third-party 200 Food Panel testing for IgG. The test indicated that I had an alarmingly high intolerance for wheat, gluten and yeast. To confirm the results I saw a local allergist who performed 50 panel skin prick test. This test came up negative along with subsequent blood-work and a biopsy taken from another EGD. I am currently looking into the viability of IgG food allergy testing and have been on a gluten-free diet for 4-weeks (with no results), with plans to remain on the diet for a least 8 weeks.

 

What is wrong with me?

 

 

 

 

 

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Answers (1)
jdog, Community Member
7/31/10 8:56pm

M.Norman,

 

I am not a medical professional. However, I have been through all the tests as well for the same symptoms. I happened upon your question while searching for a definate answer myself. I have found that when I eat some types of chicken, I experience this pain. I also experience the pressure which feels like the food is moving up and I get an increase in saliva. The pain is really bad. The only way to calm the pain is to drink a cool beverage and wait about a half hour. Anti-Acids don't work, Pepcid etc. I've had this for over 10 years. My only solution is to avoid chicken (I like chicken Frown) and see if that helps. I wish I knew more.

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By M.Norman, Community Member— Last Modified: 04/08/14, First Published: 04/16/10