# Chest Pain/Burning in Epigastric & Umbilical Region/Nausea



## MyOwnSaviour1144 (Nov 13, 2013)

Hello,

Long story short: I've had IBS & Gerd since 2004, diagnosed in 2006. Been on Nexium since probably September 2006 and Cymbalta 20 mg from Sept. 2006 - Feb. 2008. Changed to 30 mg of Cymbalta and my symptoms were mostly stable. Yes the IBS stuff was still annoying, but the GERD was pretty much under control (read: pretty much nothing as far as GERD symptoms; MAYBE if I exercised too soon after eating but really I don't remember very much).

July 2013: I decide that maybe I don't need the Cymbalta anymore - parents said I had some "suicidal ideation" because I was stressed out about my job and angry at my life circumstances. So, I tried to cut off the Cymbalta. As SOON as I cut from 30 to 20 mg I noticed some weird feelings in my chest... kind of like a pressure. So I tried cutting off Cymbalta and I got to the point where I was down to 1 20mg pill, once a week. But I was so depressed - weeping, crying, guilt, etc. - that I had to resume the Cymbalta. So I built it back up until eventually - when on 2 October 2013 I was put on 60mg of Cymbalta because even my old dosage of 30mg was not doing it anymore.

All through the time that I messed around with the Cymbalta, I've been having weird symptoms in my chest. Specifically...

burning in the epigastric and umbilical region. It's not all the time, maybe once in a while. (say, 2-3 times per week on isolated occasions).

Chest pressure - sometimes worse when I do deep breathing (which I thought was supposed to help GERD). For the past few weeks this chest pressure has been pretty much constant. Literally the only time during the day that I do not notice it is when I first get up in the morning, before I take my Nexium (40mg - that dosage has never changed). After I take the nexium and get up and start moving, the chest pressure starts again. It doesn't seem to be related to either eating food or not... If I had to guess it might be worst when I'm hungry - but it's nearly always constant.

Right sided back pain - This is fairly recent and only been going on for maybe the past week, so it's probably not significant. Nonetheless about 2 weeks ago I had pain in my right side; around the lower part of my rib cage. This pain has since kind of moved to my back - only on the right side - and exists between my shoulder blade and my spine. At the moment, I don't notice it (it seems to come and go) - so the pressure on the front is always there, but this pain on the right side is not there consistently... It's probably related to GERD in some way but, honestly*, I don't even know if pain in the back is associated with GERD at all, or if instead it's only pain on the front side of the chest.*

Very rarely - spitting up blood - This has happened on and off even before my ... experiment... with cutting off Cymbalta this past July. However I've spit up blood approximately twice in the past two months - and each time it has been immediately after eating a meal. It stops after a very short time period, but it is a bright red blood when it is happening. *Is spitting up blood sometimes a symptom of GERD? Should I be worried - or is GERD (gastritis, whatever they want to call it) sometimes going to result in this?*

So, I just don't know what to think. I'd be worried - except I know this all only happened since I messed with the Cymbalta, and I know that stress can affect GERD. However, I did not know that stress could affect it to this degree... and also, I'm not only back on Cymbalta but I'm on a dosage that is twice what I was on before, so theoretically my depression/anxiety should be under control even more. And my mood DOES feel better: I'm nowhere near as angry as I was on 30mg of Cymbalta. I feel anxious once in a while - mostly when I wake up in the morning, but when I get going for the day I'm usually pretty good.

I'm not sure what to do. Yes, I'm sure "check with the doctor" would be a good idea... but what would the dr. even be looking for? An increase in GERD symptoms? And if GERD has increased (for whatever reason) what would the answer be? Nexium is top of the line for PPI's, is it not? I know you can take two or even 3 doses per day, but I know that doing so greatly increases the risk of osteoporosis and such and since I'm only 27 years old I do not believe doses that high would be appropriate... especially since as little as six months ago I was literally having no problems at all with GERD (at least none that I noticed).

Thank you very much for anyone that takes the time to read through this textwall here (lol) and can offer me constructive advice. It's very much appreciated.

Regards~

-J


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## Kathleen M. (Nov 16, 1999)

Have you had the GERD checked on with an endoscopy? It can cause damage over time, and for me, at least, the blood would have me go back and be rechecked unless the scope was done very recently.


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## MyOwnSaviour1144 (Nov 13, 2013)

Thank you for the reply, Kathleen.

The last EGD I had was like February or March 2008. At the time there were very rare instances of spitting up blood immediately after eating. At the time I was told "Nexium is doing great; your esophagus is fine" or something to that effect. So - of course - the question of what caused the blood was never discovered. In fact I even had my lungs checked and had a CT scan as well as a bronchoscopy - all of which came back fine (except for the CT scan - they said I had a "deformed nodule" or something that accounted for a very small "dot" on the CT - hence what caused the doctor to want to do a bronchoscopy to ensure everything was ok, which evidently it was). All this was despite the fact that I was and still am a non-smoker.

The odd part was that, when my esophagus really WAS damaged (prior to being on a PPI, back in 2004-2006) there was no spitting up of the blood, despite having severe symptoms of stomach and left sided abdominal pain (which was relieved, often, after the passing of gas following me laying down on my left side). So, it worries me now... I was told after my first EGD in 2006 that if I had not gotten treatment with a PPI when I did then I probably would have developed Barrett's because there was severe erosion present in my esophagus. But yet I was not spitting up blood and had no symptoms of actual reflux, only abdominal pain...and nothing, at that, present in my epigastric or umbilical region... symptoms exclusively occurred in the left lumbar and left iliac regions...

I guess the only thing to do is talk to the doctor and have them do another EGD or barium swallow or whatever... I just worry about those tests too, because I know there are risks involved in any procedure...









I guess I just don't know that much about GERD, other than the basic tips for living with it once you have it (avoid carbonated beverages and hot drinks, don't exercise after eating, sleep with your head elevated, avoid high fat and acidic foods, etc.). I never am able to find information, though, about when to seek medical advice for GERD symptom flare ups. And of course when you search the internet for things like "spitting up blood" it gives you information about cancer or whatever... but of course what I need is information about whether or not such events can occur with GERD or not... or if the presence of such events indicates something beyond the presence of that... :/


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