Gastroenterologist needed for Chest Pain- non cardiac

[thaigators]

Having chest pain for about a month here in Chiang Mai. Being treated at BKK Hospital Chiang Mai for 3 weeks with no improvement. Actually getting worse. Having difficulty swallow or maybe better describe as feeling like something is stuck in my throat. Does anyone have current information on an appropriate Gastroenterologist in BKK or Chiang Mai. Doctor here has me scheduled for gastroscopy, but said if that’s negative I’ll need to go to Bangkok for an upper GI motility series. Thanks heaps!

[Momofarang]

I am getting followoed by this great Doctor, for my Barrett's oesophagus: https://www.bumrungrad.com/doctors/Charkaphan-Osangthamnont

 

[thaigators]

Thank you Momofarang. Anyone have experience with BKK Hospital? Dr. Parit Mekaroonkamol?

Edited October 21, 2019 by thaigators
Wrong Dr name inserted

[Sheryl]

Dr Jaruwat Yossombat at RAM  has been recommended by several TV members.  I haven't had any feedback on GI docs at Bangkok Hosp CM (bearuin mind it has only been open a few years now). However any qualified GI doctor can do a gastroscopy and diagnose or rule out gastritis/ulcer, GERD, esophageal and gastric  cancer.

 

Gastritis/ulcers and even GERD  are a frequent source of chest pain and easily mimic the pain associated with heart disease.

 

Dr. Parit is an exceptionally well qualified GI specialist but news to me if he is at Bangkok Hosp CM.  I know he is at Bumrungrad. Trained in some of the  best US hospitals.

 

If the gastroscopy comes back negative for anything before moving on to a motility specialist, given what you describe feeling in your throat,  and tests I would suggest you   see an ENT specialist to rule out a mass in the larynx or trachea. Especially (but not only) if you have a history of smoking. 

 

I assume you have already had a chest Xray that was negative?    if you are or were a smoker - even with negative CXR should consider getting a low dose CT to screen for lung mass.

 

 

[thaigators]

48 minutes ago, Sheryl said:

Dr Jaruwat Yossombat at RAM  has been recommended by several TV members.  I haven't had any feedback on GI docs at Bangkok Hosp CM (bearuin mind it has only been open a few years now). However any qualified GI doctor can do a gastroscopy and diagnose or rule out gastritis/ulcer, GERD, esophageal and gastric  cancer.

 

Gastritis/ulcers and even GERD  are a frequent source of chest pain and easily mimic the pain associated with heart disease.

 

Dr. Parit is an exceptionally well qualified GI specialist but news to me if he is at Bangkok Hosp CM.  I know he is at Bumrungrad. Trained in some of the  best US hospitals.

 

If the gastroscopy comes back negative for anything before moving on to a motility specialist, given what you describe feeling in your throat,  and tests I would suggest you   see an ENT specialist to rule out a mass in the larynx or trachea. Especially (but not only) if you have a history of smoking. 

 

I assume you have already had a chest Xray that was negative?    if you are or were a smoker - even with negative CXR should consider getting a low dose CT to screen for lung mass.

 

Thanks heaps for the advise Sheryl! Yes, because of the possibility of mimicking cardiac symptoms (left sided chest pain radiating to left upper back), I had a full cardiac workup with chest X-ray, ECG, stress test, and CT with contrast. But it never felt like my heart- no shortness of breath, etc. I do find it disconcerting that PPIs, antacids, and the other prescribed meds have seemed to worsen symptoms. Initially no difficulty swallowing, no feelings of trapped gas in my throat until about a week ago.

I’ve not smoked in years and was only ever a “recreational smoker”. However, I have a history of breast CA (small stage 1 tumor successfully treated with lumpectomy and radiation) 14 years ago-treated at Bumrungrad. 

Ill go ahead with gastroscopy tomorrow am. The question of Dr Parit is if they refer me to BKK hospital in BKK ????

 

 

[Sheryl]

If you have been on the PPIs 2 weeks or more with no improvement that makes gastritis/ulcer/GERD much less likely.

 

With a history of CA an aggressive workup would be indicated including -- if the gastroscopy sheds no light --  lung scan and bronchoscopy IMO. You might want to consult an oncologist.

[BritManToo]

4 hours ago, thaigators said:

Having difficulty swallow or maybe better describe as feeling like something is stuck in my throat. 

Sounds more like cancer.

[Sheryl]

Sounds more like cancer.

Actually thus sensation (called globus) is common and can have many causes. Sometimes no cause can even be found.

But of course with her history the index of suspucion for cancer is above average and it needs to be carefully and thoroughly excluded.



Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[thaigators]

21 hours ago, Sheryl said:

If you have been on the PPIs 2 weeks or more with no improvement that makes gastritis/ulcer/GERD much less likely.

 

With a history of CA an aggressive workup would be indicated including -- if the gastroscopy sheds no light --  lung scan and bronchoscopy IMO. You might want to consult an oncologist.

The Gastroscopy showed an erosive esophageal lesion, reflux esophagitis and gastritis. I guess that’s good news? My meds were changed and I have follow up in a week.

[Sheryl]

Good news in that, much better than not finding a cause and certainly better than finding an obvious tumor. But erosive changes to the esophagus can be pre-cancerous. I assume he will have boipsed the erosive lesion.

 

Both reflux and gastritis can cause significant chest pain.

 

And reflux can cause the swallowing discomfort  you mention, as can esophagitis.

 

 

[thaigators]

2 hours ago, Sheryl said:

Good news in that, much better than not finding a cause and certainly better than finding an obvious tumor. But erosive changes to the esophagus can be pre-cancerous. I assume he will have boipsed the erosive lesion.

 

Both reflux and gastritis can cause significant chest pain.

 

And reflux can cause the swallowing discomfort  you mention, as can esophagitis.

 

 

Yes, he did biopsy and I should get results next week. He also mentioned the lesion was an “inlet patch”. My sister in the US sent me an article that recommends endoscopic surgical ablation of Gastric Inlet Patches...

I’m not sure?

[Sheryl]

Ablation will often relieve the globus sensation.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app