Intermittent chest pain

A 52-year-old female came with the complaint of dysphagia to both solids and liquids with chest pain for 7-8 months due to which she lost 6-7 kg weight. Pain is burning in nature and is not radiating to anywhere. Some other doctor prescribed Omeprazole for 10 days, but it was ineffective. She has h/o HTN and is on medication for the same. She is not taking any other medication and no other past medical history or family history. No habit of smoking or drinking. We have done 2 12-lead ECGs, and an exercise stress test was normal. BP and temperature are normal. Upper GI Endoscopy shows the normal esophagus. What is your suggestion?

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IT'S A..CASE OF.. DYSPHAGIA.. UPPER GI ENDOSCOPY.. NAD .. ? ACHALASIA CARDIA.. ? UPPER GI .. MALIGNANCY.. ? OESOPHAGEAL MOTILITY DISORDER.. NEED'S .. * MRI..CTCE..STUDY.. * OESOPHAGEAL MANOMETRY.. * BARIUM SWALLOWS..

? episodic oesophageal spasm manometry studies maybe diagnostic.can give a trial of a calcium channel blocker keeping in mind her hypertensive status.

SUGGESTIVE OF HYPERTENSIVE OESOPHAGEAL LOWER SPHINCTER AND SUPPOSED. TO. PROGRESS. SLOWLY WITH TIME

Oesophyeal motility disorders Needs further investigation and evaluation to conclude and line of credit.

Achalacia.. Malignancy.. Oesophagal motility disorder..

CA oesophgus

As upper G.I endoscopy is normal and patient is female- most likely Diagnosis is GLOBUS HYSTERICUS OR FUNCTIONAL DYSPHAGIA. An anti - anxiety medication like clonazepam 0.25 mg B.D can be tried But before that do esophageal manometry to rule out esophageal motility disorders .. Addition of liq mucaine gel and a prokinetic like levosulpiride will be helpful. Also rule out anaemia with CBC as esophageal webs can be there

Dysphagia with endoscopy showing normal finding It can happen in oesophageal motility disorders Such as Diffuse oesophageal spasm, Nut cracker oesophagus Oesophageal manometry would help in further diagnosis Alternatively one can give a trial of motility agent such as Itopride 50 mg three times a day

Dysphagia to both solid and liquid with retrosternal chest pain and weight loss with normal variant endoscopy is suggestive of a motility disorder. Do an esophageal manometry for deciding further management.

oesophageal spasm and treat with Itopride and digeplex(pepsin liquid) Simethicon Try to take around the 1 litter water in the morning empty stomach

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