<s>[INST] Hi, I m 33 weeks pregnant and was given Gertac 3 days ago for reflux. since then I ve had sharp pain in my right shoulder and chest when I swallow. When I lie down it feels like my gut is having spasms or something. When I wake in the morning I m fine and then I eat breakfast and it starts all over again. What can this be? It s very sore. Thank you for you help. [/INST] Hello, and i hope I can help you today.Many women get pain in their chest from reflux or gastritis. When your stomach starts to secrete acid, like when you eat, the pain may get worse.Acid reflux literally means that the acid from your stomach sloshes up into your esophagus, and that can cause it to spasm, which you are feeling when you lie down.Taking your Gertac at the full adult dose (150 mg) daily will gradually help the symptoms, but i also suggest you purchase a calcium-containing antacid (like TUMS) and take two whenever you feel the spasms or pain in your shoulder.  Trying to only eat upright and staying upright at least 2 hours after eating will help to reduce the reflux as well.  If you always feel the pain when you lie down, try to prop yourself up on pillows so your head is higher than the rest of your body.I hope I was able to adequately answer your question today and that my advice was helpful.Best wishes,Dr. Brown </s>