GERD, Palpitations, Esophageal Spasms

[GV40]

I have been suffering from episodes of pain and discomfort in the epi-gastric and chest area. It feels like I am going to have a heart attack, it is a pressure/discomfort in upper abdomen and back between shoulder blades with palpitations, difficulty getting a deep breath and feeling lightheaded. It seems to come on as an "attack". I find that it happens most during my walks for exercise, when bending over, before or after meals, and also before bowel movements.
I have had several tests run: blood tests all normal, abdominal ultrasound normal, several EKG's normal, Echocardiogram showing MItral Valve Prolapse, Endoscopy showing gastritis, eosinophilic esophagitis, incompetent LES. I have been taking Achipex in the AM and Zantac in the PM plus really watching what I am eating.  It seems to be OK for awhile and then it seems like out of the blue I will get one of these attacks. I'm not sure what else to try, the Dr's haven't been very helpful. The last few episode I went in feeling terrible and left feeling the same way, their only suggestion is to double up the medicines for GERD.
I am starting to think that the episodes are being caused by esophageal spasms, is there any way to treat those other than doubling up the Gerd medications?  Could it have to do with delayed food allergies? I have also noticed that I have low blood pressure usually about 100/60 could that be contributing to these problems? I feel like the GERD medicines are not really helping and I have switched between several brands I don’t like the idea of just taking medicines if I am missing the real problem.
Thank you!

[Kevin Pho, MD]

There has been a pretty comprehensive evaluation done already.  More specialized tests like a 24-hr pH study and esophageal motility study can be considered.

If GERD continues to be present despite maximal medical therapy, surgery can be considered.

If an esophageal motility disorder is found, medications like calcium channel blocks can help.  

These options can be discussed with a GI physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[tsco]

Have you had a hida scan for your gallbladder?  I have battled all of this stuff for years including the palpitations.  Mine are triggered often on full stomach bending over etc.  My gall bladder I found is not functioning and I am starting to think it is somewhat tied to all of the symptoms.

[sissy1950]

I just had nissen fundoplication 12 days ago.  I'm feeling good, able to eat, burp a little but still have heartburn almost all the time.  I am thinking my surgeon didn't get the wrap tight enough. I go back to him at 6 weeks. i am on nexium. Should I have this redone or tightened if he suggest it or would it be dangerous.  could it be something else.  Is it too early to say its a failure. It feels like it

[sissy1950]

i've posted but get no answer, why?