How do I manage chest and throat burn despite meds?

Question

Hi doctor,

The burning in my chest and throat has become unbearable. It feels like acid crawling up my neck every night, and I wake up choking and terrified. My general practitioner said it is reflux and prescribed Omeprazole, but it has been three weeks, and the pain is still there. I have stopped drinking coffee and eating spicy food and chocolate, but nothing seems to help.

Sometimes the pain radiates to my back, and I panic, thinking it could be my heart or even cancer. I can no longer sleep properly or focus at work. Should I ask for an endoscopy?

Please tell me what is happening to me.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Your symptoms are very distressing, and it is understandable that you are frightened. Severe burning in the chest and throat, especially at night, with choking sensations, is most commonly due to gastroesophageal reflux disease (GERD). When acid repeatedly flows back into the esophagus and throat, it can cause intense burning, sleep disturbance, and even panic-like symptoms.

Pain radiating to the back and throat irritation can still be related to reflux and does not automatically indicate heart disease or cancer, especially when the symptoms occur at night or while lying down. Omeprazole is an appropriate first-line treatment, but not all cases of reflux respond quickly. Some patients require higher doses, twice-daily dosing, a longer duration of therapy, or a different acid-suppressing medication.

In addition, nighttime reflux often improves with lifestyle measures such as elevating the head of the bed, avoiding meals at least three hours before sleep, and avoiding late-night fluid intake.

At 50 years of age, with persistent symptoms despite three weeks of treatment and significant anxiety, an upper gastrointestinal endoscopy is reasonable and advisable. This procedure helps rule out complications such as erosive esophagitis, Barrett’s esophagus, ulcers, or, rarely, malignancy, and it often provides reassurance when findings are mild or treatable.

Importantly, reflux itself can mimic cardiac pain and trigger panic, creating a vicious cycle of fear and worsening symptoms. If you develop chest pain with exertion, breathlessness, or sweating, cardiac causes should be excluded, but your description is most consistent with reflux.

Please do not suffer in silence. A gastroenterology consultation, optimization of medications, and endoscopy can provide both a clear diagnosis and meaningful relief.

I hope this has helped you.

Please feel free to reach out to me again for further queries.

Thank you.