NCCP post - it's a classic!

[Guest guest]

everything you wanted to know about NCCP's - thanks yet again to pepto deb for

writing it.

for future reference - its in the files section - just scroll down a bit and

it's called 'debs NCCP post'

happy reading!

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Chest pains, heartburn, acid reflux, spasm pains, NCCPs.... what the heck is all

of this stuff anyway????

(aka: Debbi's Dissertation on Dysfunctional Dysphagia Diagnoses)

Here's some info I've put together on differences between " heartburn " and the

" chest pains/spasm pains " that are related to achalasia. The official medical

term that I've found for the " spasm pain " is " NCCP " or Non Cardiac Chest Pain.

There are multiple terms used for " heartburn " including: acid indigestion, acid

reflux, GERD/GORD, etc.

In my pre-achalasia days, I would have " indigestion/heartburn " once in a while

(after a particularly large, fatty, acidic meal, etc.), maybe once or twice a

year. I would have that nasty acid taste in my mouth when I burped, and a

hot/burning sensation in the area of my breastbone. While not particularly

comfortable, it wasn't an excruciating, debilitating pain, and taking some Tums

or other antacid would neutralize it and both the taste and the discomfort would

go away.

When I had my first NCCP, I had been having problems swallowing for a few years

but hadn't yet been diagnosed with anything, and I had no clue that the pain was

related to my swallowing problems. I thought the pain was some gawd-awful gas

pains -- felt like something was stabbing me from the inside out! The pain

seemed to start in the ribs and almost squeeze my chest with searing pain that

seemed to shoot up into my neck, too. (note: everyone can experience NCCPs in

varying degrees and in various parts of the body, including stomach, chest,

shoulders, neck, back, jaw, tongue, teeth, and roof of the mouth.) I lived

alone at the time, and I drove to a convenience store and bought three rolls of

Rolaids and ate two whole rolls. That didn't have any effect at all, and it

took a couple hours for the pain to go away.

Another time, I have a distinct memory of standing in the kitchen holding onto

the countertop and just WAILING at the top of my lungs because it hurt so bad,

and my knees buckling from the pain. My wailing turned into one big repetitious

prayer: " Please, Lord, Please, Lord, Make It Stop, Lord, I Can't Take It

Anymore, Lord, Please, Lord, I Need You To Please Help Me! " over and over and

over again while sobbing. This was almost a decade ago and I don't know how

long it went on, but I'm thinking that it was well over an hour of that constant

wailing. Boy, those were the days, huh? ;o)

For people whose doctors believe that NCCPs are an " atypical " (not normal)

symptom for achalasia patients, point them in the direction of this informal

poll here on our group:

achalasia/surveys?id=1037310

The poll is now closed, so who knows how many more would be added to it if it

were still accepting votes. If you scroll down to the end, 38 people reported

that they have these " spasms " , and 5 people reported that they don't have

spasms. So out of 43 people who answered the poll, 88% have spasms and 12%

don't have spasms. Doesn't sound like a " rare " or " atypical " symptom, does it?

In another poll (

achalasia/surveys?id=1011383 ) of people

who went to the Emergency Room due to extreme chest pains, 2 were given

intravenous Valium, 3 were given Demorol or other narcotic injection, and 7 were

given no treatment whatsoever.... isn't that sad? 58% of the people who were in

such severe pain that they went to the E.R. were given NO TREATMENT at all!!!

That is SO unnecessary!!!!

Here's some info that I copied from an old post of mine -- if your doctor will

bother to do some simple web searches, he'll see that calcium channel blockers,

nitroglycerine, and anti-depressants are all documented ways to treat NCCP in

people with esophageal disorders! Maybe if you print it out and show it to him,

he'll be willing to offer you some help in dealing with this.

=============================================

Here's some basic info that I've posted in the past -- different things work for

different people, so it's basically just an experiment to find what works for

your own particular situation.

Here are some different coping methods to try:

-- Swallowing something warm or something cold (in my case, I chug warm --not

hot-- water as fast as I can).

-- CCB medication (calcium channel blockers) -- when I'm having NCCPs, I prick

the shell of a nifedipine capsule and squirt it under my tongue. It absorbs

into the bloodstream under the tongue (this is called a " sub-lingual "

medication, meaning under-tongue) and relaxes smooth muscle tissue (which is

what the esophagus is made up of). You can also just swallow the capsule, but

since we have trouble swallowing in the first place, I've found the

under-the-tongue method works best (then you just swallow when you've held it

there as long as you can and your saliva requires a swallow). Unfortunately, it

can also lower your blood pressure (usually only a problem if you already have

low BP to begin with) and cause a headache afterwards -- some people experience

this, some don't. CCB's can also be tried in the " slow release " formula as a

preventative to having NCCPs start in the first place.

-- Nitroglycerin medication -- works in much the same way as the CCB mentioned

above, and can also be taken sublingually for fast relief.

-- Certain anti-depressant and anti-convulsant medications -- some people don't

have NCCPs when on these types of medications, believed to be a function of the

medicine's effect on serotonin in the brain (antidepressants such as

Nortryptaline, Amitryptaline, Imipramine and Trazodone have been studied;

Neurontin is being studied in a similar way for " phantom limb pain " in amputees,

etc.) People in the group have had luck with Paxil, Ativan, Nortryptaline, etc.

The dosage needed in this case is generally lower than the dosage that is

normally used to treat depression.

-- L'Argnine supplements -- some people have found these relieve NCCP symptoms.

-- If symptoms are debilitating and none of the methods above help, you may need

a narcotic pain reliever, but definitely try all the options above first, b/c if

you're on narcotics you can't drive, work, etc., and the vast majority of people

can find relief in a way that doesn't involve narcotics.

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In the last few years I've taken three different drugs that affect serotonin

(one of which isn't considered to be an anti-depressant medication, but which

does have a serotonin effect nonetheless); any time I was on one of those drugs,

my NCCPs have either disappeared entirely, or been nearly eliminated. And each

time I discontinued a serotonin-effect drug, the NCCPs started up again within a

month's time. One member here who was in the E.R. repeatedly for debilitating

NCCPs finally had a doctor prescribe a low-dose daily antidepressant; her NCCPs

have been eliminated.... no more pain, no more narcotics, no more trips to the

hospital.

There are soooooooooooo many things that can be done to reduce NCCPs, but

doctors don't even bother to TRY to find a solution for us. I say let THEM curl

up in a fetal position making plea-bargain deals with their Maker at 3:00 in the

morning just ONCE, and you can bet your booty that they'll find a solution REAL

fast!!! :oP