Hiccups, Chest Tightness, and Stomach Ulcers: A Patient's Journey

Gastric ulcer / chest tightness / belching

Hello Dr.
Chen, last month I experienced persistent hiccups, chest tightness, a sensation of a foreign body in my throat, and black stools.
I visited a gastroenterology clinic, where the doctor performed an ultrasound that came back normal.
However, during an endoscopy, they found a mild gastric ulcer and some ulcerative bleeding.
The doctor prescribed medication, and after taking it for a week, I felt better and no longer had black stools.
I also noticed that my appetite decreased, possibly due to the gastric ulcer, leading to weight loss (I was about 86.5 kg, and now I'm around 80.x kg, but I've remained at 80.x for the past month).

However, a month later, I started experiencing hiccups again, although not as frequently or severely as before.
This has been ongoing for nearly two weeks.
Recently, I've also felt chest discomfort or tightness, especially noticeable before sleep, and my weight has slightly decreased again, about 0.3 kg.

I've undergone numerous tests, including a full-body MRI, abdominal ultrasound, and a health check (which included an abdominal ultrasound), all of which were mostly normal, except for sinus arrhythmia, mild fatty liver, and a polyp in the gallbladder (less than 0.5 cm).
My previous two ultrasounds were normal—one at the gastroenterology clinic and one during the health check—but during the full-body MRI, another ultrasound revealed the polyp.

I'm wondering if my symptoms of chest tightness and hiccups could be psychosomatic or if there might be an issue in another part of my body.
I hope Dr.
Chen can provide some advice.

Lao Wu, 20~29 year old female. Ask Date: 2017/08/31

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, if it has been confirmed that there are no heart issues, you may take antacids to see if it improves the chest pain, which could be due to gastroesophageal reflux.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2017/08/31

More Info

Understanding the symptoms of hiccups, chest tightness, and stomach ulcers can be quite complex, especially when they are intertwined with psychological factors. Your experience highlights a common scenario where physical symptoms may have both physiological and psychological components.

Firstly, let's address the hiccups and chest tightness. Hiccups can be caused by a variety of factors, including irritation of the diaphragm, gastroesophageal reflux disease (GERD), or even anxiety. Given your history of stomach ulcers, it’s plausible that your gastrointestinal issues could be contributing to your hiccups. When the stomach is irritated, it can lead to spasms of the diaphragm, resulting in hiccups. Additionally, the sensation of chest tightness could be related to esophageal irritation or spasm, which can occur alongside gastric issues.

The feeling of a lump in the throat, often referred to as "globus sensation," can also be linked to anxiety or stress. This sensation can be exacerbated by gastrointestinal problems, as the esophagus and stomach are closely connected. The fact that you have experienced a decrease in appetite and subsequent weight loss may also contribute to feelings of anxiety, which can further amplify your symptoms.

Regarding your stomach ulcers, it’s important to understand that they can cause significant discomfort and may lead to complications if not properly managed. The presence of black stools (melena) is a concerning symptom, as it indicates bleeding in the upper gastrointestinal tract. It’s good to hear that this symptom has resolved after starting medication. However, the recurrence of symptoms like hiccups and chest tightness suggests that your ulcers may still be causing irritation or that there may be other underlying issues at play.

Your weight loss, while it may seem like a positive outcome, can also be a sign of underlying distress. Weight fluctuations can occur due to changes in appetite, stress levels, and gastrointestinal function. It’s crucial to maintain a balanced diet and ensure you are getting adequate nutrition, especially when dealing with ulcers, as they require proper healing.

Given your comprehensive testing, including MRI and abdominal ultrasounds, it seems that significant structural abnormalities have been ruled out. However, the discovery of gallbladder polyps and fatty liver should not be overlooked. While these findings may not be directly related to your current symptoms, they could indicate a need for lifestyle modifications, such as dietary changes and weight management, to prevent further complications.

In terms of psychological factors, it’s not uncommon for individuals with chronic gastrointestinal issues to experience anxiety or stress, which can exacerbate physical symptoms. It may be beneficial to explore stress management techniques, such as mindfulness, cognitive behavioral therapy, or relaxation exercises. These approaches can help address the psychological aspects of your symptoms and improve your overall well-being.

In conclusion, your symptoms of hiccups, chest tightness, and stomach ulcers are likely interconnected, with both physiological and psychological components. It’s essential to continue working closely with your healthcare provider to monitor your ulcers and manage your symptoms effectively. Additionally, consider seeking support for stress management to help alleviate some of the psychological burdens you may be experiencing. Remember, healing takes time, and addressing both the physical and emotional aspects of your health is crucial for recovery.

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