Nerve Disorder/Hypersensitivity Causing GERD and Esophagus Problems

[smarty666]

Hi all! Since the beginning of August, have had severe acute episodes of chest pains, breathing difficulties, nausea after eating, sore/scratchy throat, hoarseness, clearing throat, etc. Had endoscopy that showed gastritis and chronic esophagitis with edema. Biopsy came back positive for non-dysplasia barrett's esophagus.

The situation is this, was on both prescription PPI's, which had problems tolerating, and thus have been on OTC PPI's and Carafate. They helped a little but I continue to have chest pains and several other symptoms after weeks of being on the medications. So GI's believe that I might have another issue going on besides the GERD. Got more opinions after my initial GI left me hung out to dry as to why I continued to have a lot of GI symptoms while on the medications. Other doctors basically second guessing that I have Barrett's and that my initial GI might have taken piece of upper stomach rather than esophagus. But that is another story which I will need to get rebiopsied at another time.

In regards to my continue GI issues, am currently going through a 48-HR pH test. So far the monitor is showing pH's of between 6-8 so no acid is coming up into the esophagus into the stomach, thus ruling out that my continued symptoms are from acid reflux. The GI I'm seeing now originally said he would have to do other tests to rule out other issues but after having terrible pain in my chest from the capsule/clip they used for the pH test, he hows believes I have a hypersensitive vagus nerve that is causing all my problems since most people don't get this excruciating chest pain from the pH capsule. Doesn't plan on doing any other testings and blaming everything on oversensitive nerve.

I am thinking that this is BS, not that it can't be related to nerves somehow but now he has changed his tune and won't do manometry to rule out a motility problem, which I think I have since I'm really starting to feel muscle spasms with the pH capsule in place or endoscopic ultrasound, or capsule endoscopy.

Have any of you ever heard of over sensitive nerves as being the sole causes of GI related chest pains? Everything with my heart and lungs have checked out and we know its GI related since a lot of the pain, burning, nausea, etc comes with exercising and during/after eating. Don't you think he should do those remaining tests for motility or another problem to make sure its not something else before giving up on me and sending me to a pain management doctor?

[ssick]

just seen this post, I have been under so many Drs to find a dx, the only thing they came up with was nerve hypersensitive esophagus, non of the medication has help, just wondering if you got a final Dx for your problem>

[svetoslav80]

Hi,
I'm a similar case. 2 x-rays and 2 gastroendoscopies came back normal. I experience chest pain, but also very bad fatigue and brain fog. The pain gets very worse, and continues for a week, if I just do one of the following:
1) eat the wrong food (acidic, milk, too salty, hard food etc ...)
2) jump or run
3) cough, sneeze or hiccup too hard

I'm almost completely disabled.

[Lola_99]

Hi -
I also have GERD and Barret's Esophogus. My GERD and Barrets is caused by slow gastric emptying.  So the food from lunch is still sitting there are dinner time making me feel ill   I've found a cocktail that makes life bearable:  
20 mg omeprazole am and pm
10 mg reglan with meals (usually lunch and dinner) and at bedtime
I also take OTC fiber with physllum(sp) to help with other intestinal issues and vitamin E for liver health.

I'd suggest having a gastric emptying study done if you haven't already.  

Good luck!

[selmaS]

Below r some meds I found..they do refer usage for children...but, I know many of these r used for adults as well.


Motillium (Domperidone) is another effective medication that is only available outside of
the United States. It is not FDA approved in the United States and there is some evidence
of issues with heart problems.

Bethanachol is an older medication that increases contractions in the GI tract. It has
fewer side effects than Reglan but is not as effective in many children.

Low dose Erythromycin employs a side effect of a common antibiotic to increase
gastrointestinal motility. This medication is well-tolerated by many children.

Propulsid (Cisapride) is a very effective medication that increases motility within the GI
tract. It has been withdrawn from the US market due to serious heart complications, but
is available to certain children with very complex or serious motility disorders after
extensive testing. A similar restricted program is available for distribution of this
medication in Canada.

[smarty666]

Thanks for the input. I can answer a lot of what you mentioned. My internist did a whole set of blood work back in the middle of Sept and he checked my thyroid hormones and all was normal so no issue there.

When this originally started back in August, the ER doctor and my allergist thought I had costochondritis but my SED rate has never been elevated in my blood works and the doctors say that if I had that me SED rate should be very elevated. Also, they told me that costochondritis does not cause pain during and after eating or the other GI symptoms I have gotten (like the sore/scratchy throat, nausea after excercising/eating, horseness, heartburn sensations, etc

Though another doctor said that I could have atypical costochondritis. But no pain meds has taken this pain away, except for Predisone, but the GI docs don't want we on that indefinitely b/c it does a number on your GI system.

My GI told me that if my pH test comes back normal, which I think the numbers I saw will indicate that it is normal, and my chest CT was normal, he is going to refer me to a pain management doctor for the irritable esophagus (visceral hypersensitivity).

But to me, shouldn't they do a manometry and maybe an endoscopic ultrasound to make sure they are not missing anything or that I have a motility problem? Also, I have incredible amount of shooting middle/upper back pain in conjunction with the chest pain which is a big sign of esophageal spasms so I do not understand why they would not do a manometry to rule out motility problems? What kind of meds can be used for motility and spasm issues?

[selmaS]

Hi...I am not a dr, but feel u should ask ur drs to look at ur thyroid levels....it is possible that u have a auto immune thyroid issue....they should check freeT3 and freeT4 and TPO antibodies as well as TSH...if they just do TSH ur thyroid could appear normal.

The vagus nerve can affect u in so many ways...and cause pains like u mention.

There is also another issue u could have ur drs look at.

Costochondritis (kos-toe-KHON-dri-tis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes sharp pain in the costosternal joint — where your ribs and breastbone are joined by rubbery cartilage. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.

Your doctor might refer to costochondritis by other names, including chest wall pain, costosternal syndrome and costosternal chondrodynia. When the pain of costochondritis is accompanied by swelling, it's referred to as Tietze syndrome.

Most cases of costochondritis have no apparent cause. In these cases, treatment focuses on easing your pain while you wait for costochondritis to improve on its own.

Do let us know how u r doing

"selma"