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Old 09-27-2008, 12:37 AM   #1
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EKG Normal, Endoscopy Normal, symptoms remain with no diagnosis?

This is one of the most frustrating situations I think I have ever dealt with. 9 months ago I went to the hospital for what I thought was a heart attack. After blood work and EKG came back normal, the ER doc said it was probably G.I. related and that I was free to go. As the months progressed following the ER visit I found myself more frequently needing to take a pepcid A/C to relieve the pain. I wasn't able to sleep at night, had chest pain, was constantly burping, felt like food was coming up into the back of my throat, would get shortness of breath, etc. Finally, I started taking Prilosec OTC daily and I felt normal again. After several weeks of the Prilosec I decided I would stop using the pills and see if I could manage without (At this point I had assumed it was GERD and had stopped drinking alcohol, coffee, using chewing tobacco, eating spicy foods, started exercising, etc). After a week with no Prilosec the symptoms came back twice as bad as before and my attempts to silence them by using Prilosec OTC again didn't work so off to the primary care physician I went. I explaied to him my problems so he put me on Nexium and told me to come back for a physical. I'm 23, a male, 235 lbs, everything on my physical came back normal, bloodwork for H Pylori was negative so he recommended I go see a specialist and we switched my prescription to Prilosec 40mg b/c the Nexium made me feel terrible. What I do know is that I haven't had any strong episodes while I have been on the 40mg Prilosec, however, most symptoms persist but just in a dulled down format. After seeing the specialist he put me on Zegrid, which again as helped, but hasn't alleviated the problem. I went in for an endoscopy recently and he said everything looked normal. The problem that I am having is that in the beginning when I went to the hospital, it seemed like my episodes were spread apart, now, over the past 2-3 months I haven't had one good day. The most recent troubling symptoms are that I have a very hard time sleeping. Everytime I try to go to sleep, it feels like I stop breathing and wake right back up. I've tried drinking chamomile tea (sleepy time) before I go to bed, sometimes it works, but for example tonight, I went to sleep at midnight, and finally got out of bed at 1:15am b/c I just couldn't fall asleep. These problems are persisting even though I've changed my diet, lost weight, don't drink, have never smoked, and don't drink caffeine. The doctors say everything is normal, but I know it's not. This came out of nowhere and is not going away. I've done lots of internet research and it seems like the chest pain I usually have during the day isn't associated with cardiac problems, but my dad (pharmacist) thinks it might be due to constriction in my veins. Does anybody know what is causing me to feel like I stop breathing when I try to sleep? Has anybody else had similar issues and gone through the gauntlet of medical tests just to be told everything is normal? This is starting to affect my relationship with my g/f, my job, etc. I'm a pretty outgoing guy but this has completely sidelined me. How can something like this come up out of nowhere, not go away, but yet doctors can't diagnose it. Any helps or related scenarious are greatly appreciated...

 
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Old 09-27-2008, 09:50 AM   #2
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Re: EKG Normal, Endoscopy Normal, symptoms remain with no diagnosis?

Hi Ryan, I can only speak to the pain you have, not the why you can't sleep. It is quite possible that you are having esophageal spasms. They can make you think you are having a heart attack. Having a test come back normal is not unusual, you just don't have the problem at the time of the test. I recently had foot surgery and while waiting to go into the surgery room, I had esophageal spasms. None of the nurses had ever heard of them, but they called around and found out what to do. They put something in my IV to relax me, and bingo, the spasms went away. I have had these spasms since 1981, and believe me, I have never found anything to relieve them until now. I have to say, I have always sat up and either drank water slowly and eat soda crackers to relieve the spasms, and it does work after a time, but the med they gave me acted like, right now! So I am going to find out from my pain management doctor if I can get that kind of med or something like it because it was liquid, so probably have to find something like it,
Anyway, sorry to make this so long, hope some of what I have said makes sense and helps.

Sunny

 
Old 09-27-2008, 06:49 PM   #3
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Re: EKG Normal, Endoscopy Normal, symptoms remain with no diagnosis?

Thanks for the reply Sunny. I mentioned to the G.I. specialist that many have mentioned it being an esophageal spasm, but he said he didn't think that was the problem. The frustrating part is that it bothers me everyday and has for the past 9 months when it came up out of nowhere but the docs are saying everything looks normal...clearly something is wrong...

 
Old 09-28-2008, 09:40 AM   #4
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Re: EKG Normal, Endoscopy Normal, symptoms remain with no diagnosis?

Hey Ryan, I think I would go to another GI doctor. Sometimes it can take a lot of diferent doctors to get some kind of diagnosis. I went 2 years before I got a diagnosis of achalasia, meaning I couldn't swallow, not even water. A specialist even gave me a prescription of something with novacaine in it to numb my throat. Another doctor said I was constipated, and these doctors were specialist. Well as I said, it took 2 years to get to the right doctor, he did an endoscopy and saw that I have no motility in my esophagus. So, it still is an ongoing problem, I just watch what I eat. Anyway Ryan, bottom line is, you have to get out there and pitch your problem to any doctor that will listen, and of course you know you have a problem, you just have to find the right doctor. In the mean time, as silly as it sounds, try eating some soda crackers while having these attacks and see if it helps.

The med they gave me was to relax my whole body, they just gave me a little dose, I could feel it come on, and not more than 5 minutes later, I felt that it was gone and so was the pain, so I am believing it comes from stress. Let us know how you are doing...

Sunny

 
Old 09-28-2008, 09:52 AM   #5
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Re: EKG Normal, Endoscopy Normal, symptoms remain with no diagnosis?

Achalasia is a subtype of esophageal motility disorder. It's rare - but you've been tested for almost everything . . .

[url]http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/000267.htm[/url]


Achalasia is dx by esophageal manometry and barium X-ray. (can't be seen with endoscope - endoscope does rule out cancer, thankfully)

Edit to Add: Sunny beat me to it!

Last edited by AuntieLeela; 09-28-2008 at 09:55 AM.

 
Old 09-28-2008, 10:37 AM   #6
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Re: EKG Normal, Endoscopy Normal, symptoms remain with no diagnosis?

Actually AuntieLeela, my endoscopy did show the motility disorder. While they were putting the tubes down my nose thru the throat, I had to swallow when they asked me too, which showed no motility. To repair the (can't even swallow water), they did a dilitation of the esophagus, which did not fix the disorder, it ruptured my esophagus.

Sunny

 
Old 09-28-2008, 12:15 PM   #7
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Re: EKG Normal, Endoscopy Normal, symptoms remain with no diagnosis?

A pH test would be able to verify if you are having reflux problems. Just because your EGD didn't show any damage, doesn't mean that you don't have reflux.

Also, have you inquired about having a sleep study done?

 
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