Paging Polly, Tex, Gabe, others - Deep pain centered in ches

hoosier1 · Post by **hoosier1** » Fri Jul 24, 2015 3:52 pm

Need some ideas for pain in my chest not related to heart (had full workup) and no ulcer (had endoscopy).

It is a deep pain that feels warm to hot, and extends deep into my chest right below my sternum. Feels like internal pressure too. Lots of loud gurgling noises (and vibration feeling) when happening and occurs about an hour after I eat for several hours. I had a hida scan and ultrasound of my gall bladder and they said OK (I wonder though). Gastric emptying study was OK as well.

I do get bloated a lot (pretty much some level of bloat at all times now) and no one knows why. I tested negative for H Pylori and even swallowed a pill camera (doctor was looking for Chrons). The pill cam took a photo of a spot in my small bowel that looked constricted. But he mentioned that that location could have been spasming at the time so it may be a red herring. The pill cam did not get stuck either. Neither did the trial camera pill I swallowed the week prior.

Appetite is way down and nausea way up.

They want me to see a surgeon to discuss exploratory. Help. At wits end.

Post by **Rosie** » Fri Jul 24, 2015 5:12 pm

I don't post much anymore, but come here on a regular basis because I keep learning new things. When I saw your post, I felt compelled to respond because the symptoms sound quite similar to what a friend's husband had. Like you, he had a full workup, nothing was found by the doctors. He was in pain, lots of stomach problems, and feeling very miserable. My friend is a veterinarian, and in desperation she put him under her office X-ray machine to see what she could see and discovered that he had such a bad hiatal hernia that his stomach was in his chest cavity and pressing on his heart! How something that major wasn't ever picked up by all the testing blew her mind. Of course we are all different, but I guess the take-home message is that sometimes obvious things get missed. I hope that you can get this sorted out soon.

Gabes-Apg · Post by **Gabes-Apg** » Fri Jul 24, 2015 6:22 pm

I agree with Rose
Hiatal Hernia (i had it bad 4 years ago) even saw the pics of it post endoscopy...

I used a magnesium/potassium powder to relieve symptoms. and followed alot of the Gerd principles
- elevated bed head
- sleep on left side
- dont lay down for at least 2 hours post eating
- dont eat too close to coffee
- big doses of Vit D3

It has become non-existant since fixing Magnesium deficiencies.. and vastly reducing inflammation etc.

Post by **tex** » Fri Jul 24, 2015 10:07 pm

Hi Rich,

I'm sorry to hear that another problem has turned up. Considering your description of your symptoms (especially the vibration sensation), I have to agree with Rosie and Gabes that a major hiatal hernia certainly seems to be a possibility, especially since your hida scan and ultrasound were negative for gallbladder problems. And the "deep pain that feels warm to hot" also fits, since food generates heat as it is being digested in acid. Normally we don't even notice that symptom, but if the stomach is pushed into a location where it shouldn't be, then that area of the body would presumably notice a source of heat that wasn't there previously.

A chronic bloating problem (for 4 years?) could certainly provide a mechanism whereby the stomach could be eventually pushed up so that a significant part of it might be lodged in the chest cavity (above the diaphragm). Doctors relying on standard tests can easily miss something like this, because it's a zebra, not a horse.

We may be all wet, but IMO this is worth checking out. Maybe Polly might have a better idea.

Tex

hoosier1 · Post by **hoosier1** » Sat Jul 25, 2015 9:04 am

Thanks for the replies. How do they diagnose a hiatal hernia? I thought the endoscopy would see something like that? Thx

Post by **tex** » Sat Jul 25, 2015 12:45 pm

An endoscopy checks out everything inside the esophagus/stomach/upper part of the duodenum. A hiatal hernia occurs in the diaphragm, outside of the esophagus/stomach. They're usually diagnosed by means of x-rays and the use of a swallowed barium solution.

The more I think about it, the more that "deep pain that feels warm to hot" fits this particular scenario. If the hernia were large enough, then at least a major portion of the stomach could be pressing against the heart, or close enough for all practical purposes, and the heart would surely be sensitive to temperature increases caused by the heat of digestion.

I haven't been able to think of any other scenarios that would fit the boundary conditions imposed by your symptoms.

Tex

hoosier1 · Post by **hoosier1** » Sun Jul 26, 2015 7:40 pm

Thanks Tex,

Looks like I will need to request a barium swallow test. Zebra and not a horse. So true. My GI doc calls it the "algorithm". If one doesn't fit the algorithm, they don't know what else to do.

Rich

Clemmie · Post by **Clemmie** » Mon Jul 27, 2015 1:36 pm

My hiatus hernia was diagnosed via a gastroscopy. I used to often feel it had slid up into my chest where it was most uncomfortable. But it rarely slides up now although still causes nausea when I haven't taken Esomeprazole for a while. Clemmie

Gabes-Apg · Post by **Gabes-Apg** » Sat Aug 01, 2015 9:08 pm

Rich
some info and an exercise that may assist the issue

http://drlwilson.com/Articles/GERD.HTM