[21M] Experiencing persistent chest pain and GERD symptoms

Patient Description

A 21-year-old male reports persistent, sharp chest pain rated 5/10, reproducible with certain movements and alleviated by lying down. The patient has been diagnosed with GERD by a doctor and is experiencing associated symptoms, including heartburn, difficulty swallowing, and a burning sensation in the throat, particularly after eating or lying down. Additionally, the patient describes a tingling sensation and intermittent pain around the wisdom tooth region in the jaw, worsening in the evening and also rated 5/10. The throat pain is described as a burning sensation at the front, which improves with water intake. The patient has been taking antacids, Rupain capsules, and Kashayam tablets, all 500mg twice daily. He maintains a healthy diet, smokes minimally, and does not consume alcohol. There is no family history of cardiac or gastrointestinal diseases, no known drug allergies, and no other medications or supplements are being taken.

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Arora's Assessment

What might be happening

Based on the information you've provided, the most likely diagnoses include:

  • Gastroesophageal Reflux Disease (GERD): This is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus. Symptoms include heartburn, chest pain, difficulty swallowing, regurgitation of food or sour liquid, and a sensation of a lump in your throat.

    • Treatment typically involves lifestyle modifications and over-the-counter medications. If these don't help, your doctor might recommend prescription-strength medications or surgery.
  • Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes chest pain that can be reproduced by pressing on the chest wall. Pain is typically localized and sharp.

    • Treatment usually involves pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy.
  • Dental issues: Your jaw pain and tingling sensation around the wisdom tooth region could be due to a dental issue, such as impacted wisdom teeth or temporomandibular joint (TMJ) disorders.

    • Treatment depends on the specific dental issue and may involve over-the-counter pain medications, dental procedures, or physical therapy.

What you can do

Here are some steps you can take to manage your symptoms:

  1. For GERD, try to identify and avoid foods that trigger your heartburn. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine. Also, try to eat smaller meals and avoid lying down for at least two hours after a meal.

  2. For costochondritis, over-the-counter pain relievers such as ibuprofen or naproxen can help reduce inflammation and pain. Applying heat to the affected area can also help.

  3. For your dental issues, consider scheduling an appointment with a dentist to get a proper evaluation and treatment plan.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe chest pain or pressure, especially if it radiates to your arm, jaw, or back
  • Shortness of breath, dizziness, or fainting
  • Unexplained weight loss
  • Difficulty swallowing or pain with swallowing
  • Vomiting blood or black, tarry stools

Remember, while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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1 yr ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What are common symptoms of GERD and how can they be managed?

Common symptoms of GERD include heartburn, chest pain, difficulty swallowing, regurgitation of food or sour liquid, and a sensation of a lump in the throat. Management typically involves lifestyle changes such as avoiding trigger foods, eating smaller meals, and not lying down after eating. Over-the-counter medications like antacids can also help.


What is costochondritis and how is it treated?

Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone, causing sharp, localized chest pain that can be reproduced by pressing on the chest wall. Treatment usually involves pain relievers such as NSAIDs and physical therapy.


What could cause jaw pain and tingling around the wisdom tooth area?

Jaw pain and tingling around the wisdom tooth area could be due to dental issues such as impacted wisdom teeth or temporomandibular joint (TMJ) disorders. Treatment may involve pain medications, dental procedures, or physical therapy, depending on the specific issue.


When should I seek immediate medical attention for chest pain?

You should seek immediate medical attention for chest pain if it is severe or accompanied by symptoms like pain radiating to the arm, jaw, or back, shortness of breath, dizziness, fainting, unexplained weight loss, difficulty swallowing, or vomiting blood.


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