Q: I have been experiencing chest pain and uneasiness for the past eight months. I underwent all kinds of tests (ECG, TMT, 2D ECHO, complete blood and other tests, etc.). All the reports were normal. I am also suffering from acidity for the past six months and have been on medication (Gastactiv and Pantodaq) post my endoscopy (which was also normal) since the last month. However, the pains are not subsiding and I feel uneasiness and lethargy throughout the day. What could be the cause and treatment?

A:I note that endoscopy and your ECG have been normal and you are still getting your symptoms of chest pain and uneasiness as well as some acidity. It could well be your symptoms are due to acid reflux where stomach acid flows up into the gullet. Endoscopy cannot pick this up unless there is also associated hiatus hernia where a tiny part of the stomach gets pulled up into the chest, which would have been noted at the endoscopy. The diagnosis is made by oesophageal manometric studies. I suggest you consult a gastroenterologist in a hospital with the available facilities.