Heartburn Pain In Chest

Q.My wife has had MS long ago with gradually increasing episodes and symptom problems. The latest and most annoying problems are esophageal and swallowing. She is having big problems with indigession, burning, burping, and general swallowing problems accompanied with chest pains. Family doctor says MS caused esophageal dysmotility and dysfunction after upper GI and esophagus tests. He is sender her to a gastro-interologist. He also put her on acid reflux type meds and suggested TUMS. What can we expect for prognosis? Any hints on what to do to make it more tolerable comfortable for her? Has anyone else dealt with these types of MS problems in the chest?

A.I have a lot of esophageal problems also. Some of the things you can do for it are quite simple in fact. Medically wise, PLEASE have your doctor refer her to a speech therapist -- these are the people who work with swallowing problems. "She is having big problems with indigestion, burning, burping," These definitely sound like reflux, as your doctor said. There are some things you can do, life style wise, that can help. First, ALWAYS make sure that she keeps her shoulders higher than her stomach. Also, I have found that I can NEVER sleep flat -- I have the head of the bed raised. When I first started having problems I put a wedge between the mattress and the box springs, now I have an electric bed which makes it easier. Oh, Gaviscon works better for reflux pain than Tums -- it is designed to work in the upper stomach/esophagus area. For bad times the liquid, for "normal" the chewable tablets with LOTS of water. "general swallowing problems accompanied with chest pains." This sounds like esophageal spasming. I don't know how bad she gets, but this pain can actually imitate a heart attack in its severity and "spreading" effect. Interestingly enough, the med that is used for heart conditions also works here -- both the heart and the esophagus are "smooth" muscles. I always carry nitrogylcerin with me, so that when a spasm hits I can take one under my tongue to calm it down. Warning, it can cause what they call a "nitro headache" -- and always does for me so I hate taking it. But it is the only thing that has ever worked quickly -- prior to nitro it wasn't uncommon for me to spend weeks in the hospital under IV only waiting for the esophagus to calm back down after a bad episode. Talk to the gastroenterologist about this. Also, make sure that all food is moist. Dry food, large chunks of improperly chewed foods, etc. are more apt to trigger spasms. Also very cold foods or fluids, especially when she is warm, are a big trigger. I also found certain additives such as MSG are a major trigger. Whenever she gets an episode, make a note of things like what the food was, temperature of both the food and your wife, etc. With a log like this you can start isolating what her triggers are. It IS controllable in most cases -- I've had problems with it for almost 30 years, and it took years to find the combination of things that worked. With the help of friends and doctors, hopefully your wife can get it under control quickly.

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