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Acid Reflux / GERD Message Board


Acid Reflux / GERD Board Index


Hopefully this post will help others here.

I have suffered from esophageal spasms due to acid reflux for 16 years. I'm a very small person. 5'3 105 pds, athletic, non drinker, non smoker, consistant blood pressure of 103-110/58-64, pulse ranges in mid 60's.

Anyway....I have taken Xanax .05mg on a PRN basis over the course of these 16 years, whenever I had a bad attack. The first 3 sent me to the ER thinking I was having a massive heart attack. They have tried me on every proton pump inhibitor that has been released over the years, but I cannot tolerate them. So I learned to stay away from the known antagonists....ie...caffeine, spicey foods, greasy foods, citrus, yada yada yada.

Thursday evening around 5pm, we ate at a well known chain restaurant....I had loaded baked potato soup and a yeast roll. About 9pm I started feeling some burning in my chest. I took a xanax and tried to relax and forget it. By 11pm I had severe chest pain radiating into my left jaw, shoulder and wrist. The pain was so intense I started feeling sick at my stomach, sweating, etc. I kept telling myself.....it's acid reflux.....it's not a heart attack....you've been thru the tests before.....:dizzy:

By 7am.....I was exhausted.....pale and no better. Called my internist...and was told to report to ER immediately. They rushed me into a room and started a line in my hand, did EKG, gave me 4 baby aspirin to chew up and sprayed nitro glycerin under my tongue. They drew blood for heart enzymes. EKG was reading normal. Sent me to ultrasound for gallbladder, liver,pancreas, right kidney ultrasound.

Back to ER holding room to await results. Doc comes in and say's gallbladder is "pristine". Not even 1 gallstone.:confused: And my heart enzymes are perfect as well. Chest pain is starting to return. They give me another shot of nitro under my tongue and give me a GI cocktail (liquid maalox and .05mg Xanax). Within 2 minutes I start feeling really bad....both arms go numb and my heart feels like it's laboring. My blood pressure dropped to 90/47. Doc said it's ok....this is actually good, if it was cardiac.....nitro would not drop your bottom number. Within a few more minutes....those sensations went away. Now they come in and do a chest xray. She comes back in and say's chest xray is normal, but they are admitting me for at least 24 hours for observation....but she feels it's gastrointestinal. Up to the cardiac floor I go. Next morning, Sat, yesterday, they schedule me for a 10 minute treadmill stress test. Aced that...cardiologist said "I'll see you when your 90".

Now it's back into the wheelchair and down to GI for an endoscopy.:dizzy:
OH I HATE THAT TEST!!!!!!!!! Gag city. Results show healthy pink tissue in esophagus, and hiatial hernia still small. Final diagnosis.....massive esophageal spasms due to acid reflux. Instructions to continue xanax for spasms, and now an added pain medication for the severe chest/back/jaw pain. I'm sitting here typing....with chest pain. I guess the southwestern cobb salad I had for lunch today is disagreeing with me. :yawn:

Hopefully my experience will help some of you with the anxiety side of our condition. :)
Hi Karen. Yes the pain radiates to my back...between my shoulder blades. It's doing it right now along with the chest pain. Back in 1990 they tried me on Zantac, and it did nothing. Prilosec caused severe abdominal pain. Next they tried Aciphex...that gave me terrible diarreah, Prevacid made my face and lips swell. At the hospital yesterday the gastro gave me a scrip for Nexium. I have not filled it. And I'm not sure I'm going too.....as every other PPI has caused unacceptable sides effects.

The reason it's called esophageal spasm is because the acid actually causes the muscle of the esophagus to go into a spasm. Since this sits directly over the chest wall...it mimics a massive heart attack in almost everyway. But once diagnostic tests rule out cardiac as the cause...they can diagnose esophageal spasm. Like IBS.....esophageal spasms can only be diagnosed once other disease is ruled out.

Xanax is a central nervous system suppresent....therefore it by nature relaxes muscle. Most of the time that alone stops the symptoms within 10 minutes. In all these years I have never had to increase the strength or dosage. But within the last 2 weeks, I have had 2 of the worst attacks in my 16 year history. The xanax didn't put a dent in it. So now, I guess it's going to be xanax and pain medication if it starts to get to bad.
Karen.....the Xanax is not a pain reliever. What it does is relax the muscles of the esophagus and chest wall. Spasms cause pain. When the spasm stops so does the pain. My recent problem for what ever reason, the xanax which has worked for 16 years....did not stop the spasm. This is why I ended up with a hospital workup.

Maybe I should also explain that the first episode 16 years ago that landed me in the ER, was diagnosed as esophageal spasm, when the doc found out that I had been sitting in a movie theater eating buttery popcorn.
Blam.....out of no where with no previous symptoms of any kind.....my chest felt like an elephant stomped on it. It bore thru to my back and the pain was so intense I could barely breathe.

EKG was normal.....other tests were as well. They gave me a GI cocktail of maalox and xanax......almost immediately (not more than a few minutes)......pain totally gone. That confirmed the doc's diagnosis. The rich popcorn had caused stomach acid to splash into my esophagus and my body reacted by sending the muscles of my esophagus into a severe spasm. I didn't even know the acid had splashed into it.

Within a few months I started to have "water brash". And spicey food...citrus....and tomato based foods started giving me indigestion. That's when the acid reflux diagnosis was added to the esophageal spasms.

As I said in my OP....I am now still to take the xanax when the episode hits...as I have always done, but if the pain continues or increases, obviously the spasm is not stopping, and they have now added a pain med to my medical management for those episodes.

Sorry if somehow you thought the xanax would control the "intense" type pain. My situation may be quite different from others here with basic acid reflux. I have a combo of acid reflux plus diffuse esophageal spasms.:wave:
Hi Moe. My GI suggested the Xanax .05mg. That was 16 years ago. I have never had to increase the strength or frequency. I have had zero side effects from the xanax. I am exquisitely chemical sensitive. Many many drugs I cannot tolerate. I thankfully do not suffer from anxiety or depression.

My esophageal spasms are a result of nerve damage. I can only imagine how awful it must be to have this problem and then have it compounded with anxiety disorder. :eek:

My spasms are very much like yours. Thank God they do not happen every day. In the past the Xanax would relax the esophageal muscle, and that would stop the pain. Think of it like a severe spasm in your calf muscle, ya know. Then it all makes sense. Once you stop the spasm....the pain goes away. However....I have evidently taken a downward step. Most esophageal spasms are due to either acid reflux, and/or damage to the nerve endings in the esophagus. I have both.

None of my Dr's have suggested use of AD's, since I don't suffer depression. The CNS (xanax) as I have said, took care of the problem for 16 years. Evidently the nerve damage has gotten worse, so now I'm going to occasionally need a narcotic along with it to handle the severe pain that now is going to accompany the worst of the attacks.

Over the years as they have been approved, my GI has tried me on many PPI's. Everyone has caused awful side effects. So I basically did a total lifestyle dietary change. No citrus, tomato based foods, greasy foods, spicey foods, no caffeine. It really was not hard to do.....because as you well know.....the attacks are so horrible, it was actually easy to eliminate them from my diet. :)





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