Dr. Ghulam Fareed
Medical Gastroenterology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am worried that I have esophagus cancer. I am suffering from symptoms such as pain in the chest, gas in the chest, belching and burping, and feeling like something is stuck in my throat and chest. I am also feeling that things are moving down the esophagus slowly, had difficulty breathing, and feel bloated all the time. I had an endoscopy a few years ago that was normal and the symptoms were not present back then. I had also done a chest CT scan with contrast, but the reports were normal, and a negative H. pylori test. Do I need to do another endoscopy? I am very scared.
Please help.
Hello,
Welcome to icliniq.com.
I went through your query and understood your concern.
I have reviewed your case history in detail. Your symptoms are of the typical upper gastrointestinal tract, but not every patient has cancer with the above symptoms, especially in the presence of a normal CT (computed tomography) scan as per your history. I suggest you take proper medicines for the above symptoms, including acid suppression medicine like Pantoprazole 40 milligrams (proton pump inhibitor) daily half an hour before breakfast, syrup Gaviscon (antacid) 10 milliliters daily after every meal, and an anti-emetic like Domperidone 10 milligrams daily half an hour before each meal for one to two weeks.
I also wanted to know why you had upper gastrointestinal endoscopy a few years ago. Were you experiencing similar problems at that time? I also suggest you go for a repeat endoscopy.
Kindly consult a specialist, talk with them, and take medicines with their consent.
Thanks and regards.
Patient's Query
Hello doctor,
Thank you for your reply.
I had an endoscopy due to two H. pylori infections and heartburn. The test was done to see if any ulcers were present. I had two H. pylori tests which were both negative. I feel constant gas moving up and down my esophagus, pain in my chest, and sometimes a cough that comes and goes. What other tests can I do? Do you think this is alarming? Can I take milk with magnesium, also?
Please help.
Hello,
Welcome back to icliniq.com.
So, responding to your questions one by one.
1) H. pylori (Helicobacter pylori) is an infection of the stomach. It will not cause chest tightening or chest pain.
2) Your recent CT scan with contrast for lungs was normal. So If the CT scan was negative, I feel your stomach and esophagus are relatively normal, especially considering your cancer concern.
3) Tightness in the throat may be because of singing and talking. It can be a laryngeal spasm, for which I suggest you practice voice rest and do warm water gargles with a pinch of salt, etc.
4) Typical symptoms of esophageal cancer include food that will be stuck into the esophagus every time you eat. It will gradually progress, starting from solids to semi-solids and then liquid. It will not be episodic.
5) Pantoprazole and Gaviscon are excellent medicines, and I suggest you use them for four to eight weeks. They will not lower your acid too much.
6) If you persistently have a voice problem, I suggest you visit a specialist for a laryngoscopy so that he can better examine your throat.
7) I also suggest you repeat the endoscopy if the symptoms are persistent and you have difficulty swallowing.
I hope this has helped you.
Thanks and regards.
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Medical Gastroenterology
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