I have severe acidity and panic attacks. How to manage them?

Question

Hello doctor,

I am a 26-year-old female, and my height is five feet four inches, and my weight is 94.7 lbs. I have been suffering from severe acidity for the past five to six years. I have consulted many doctors and undergone several tests, but everything always comes back normal.

Most doctors say it is due to acidity or anxiety, but my condition has not improved.

Sometimes I experience symptoms similar to a panic attack or mild seizure; my heartbeat becomes very fast, I feel dizzy, and I almost lose consciousness, but I remain aware and cannot speak during that time.

I also visited a neurologist and had an EEG done, which was normal. Currently, I have been taking Pantoprazole (once daily) for the past month, but I still do not feel any improvement.

Please advise what could be the actual cause of my symptoms and what further treatment or tests I should consider.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for sharing your symptoms. I understand how challenging and frustrating it must be to deal with this for so many years without clear improvement.

Based on your history, it appears you may be dealing with a combination of functional gastrointestinal issues, such as non-erosive reflux disease (NERD) or functional dyspepsia.

It might be worsened by low body weight, nutritional deficiencies, and panic episodes or autonomic dysfunction, which can cause symptoms like rapid heartbeat, dizziness, and near-fainting without loss of awareness.

Since your EEG (electroencephalogram) was normal and Pantoprazole has not helped much, a deeper evaluation is needed. I recommend the following tests:

Upper GI (gastrointestinal) endoscopy (if not already done).
Esophageal 24-hour pH monitoring.
Esophageal manometry.
Gastric emptying study.
Blood tests include CBC (complete blood count), iron profile, vitamin B12, vitamin D, magnesium, calcium, TSH (thyroid-stimulating hormone), and fasting blood sugar.
If episodes of fast heartbeat persist, a Holter monitor or ECG (electrocardiogram) should also be considered.

Based on the findings, treatment may include adjusting your acid-reducing medication, adding prokinetics, addressing any nutritional deficiencies, and possibly using low-dose neuromodulators or non-habit-forming anxiolytics if panic or gut-brain interaction is involved.

Please follow up with me on these test reports, and we can move forward with appropriate treatment.

I hope this helps.

Thank you.