Q: I am 27 years old male and recently had acidity problems. I quit smoking and drinking and got a chest pain that radiates down to my shoulder, arm and back. I have been to the doctors and they have done all the tests to rule out cardiac issues and my reports came negative. After all this, the doctors suggested that I have costochondritis. The pain in the chest gets severe at times. I have joined gym to keep myself fit but the other day I noticed that the pain increased after I did some weight training. I have stopped going to the gym as well. I take combiflam and apply voveron gel on the chest area. And also apply some heat to the affected area. I want to get rid of this pain. Are there any more tests required and can I go to the gym and do my normal cardio exercises? Please help.

A:You have non-cardiac chest pain, the commonest reason for which is oesophageal spasm secondary to acid reflux. The next commonest cause is oesophageal dysmotility, as a primary condition, without reflux. In the first instance, I would recommend a trial of acid suppression with Pantoprazole 40 mg twice a day for one month. If your symptoms do not get better, you will need oesophageal pH monitoring (preferably an extended 48 hours monitoring using BRAVO capsule) and an oesophageal manometry. I do not see any reason why you cannot do exercises, although I would advise against bending down exercises and those that require abdominal wall muscles to contract vigorously.