### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello Dr.I am 29 years old. I am 62 and weigh 230 and for the past 6 months I have had very intense chest pain. I have gone to the ER numerous times and have followed up with my Cardiologist. The following exams have been done: bloodwork, EKG, catscan of the heart, stress test, sonogram of the chest, chest x-ray, and a I wore a 24 hr heart monitor. All test continue to come back negative and I am sent home each time with a clean bill of health. A few months ago, I went to a GI and was diagnosed with GERD, esophaghitis, hiatal hernia, and mild gastritis. I also went to a therapist since my chest pain continued. I have been prescribed Nexium, Adavan, and Zoloft to treat the GI problems and anxiety. But I can not understand how my GI issues can be causing such intense chest pain. I keep thinking that maybe there is another underlying cause that is being overlooked. I am still concerned that I may have a cardiac related problem. I am eating much better and taking medicines as prescribed. What else could this intense chest pain be? I have read it could be muscular. I just want answers so that I can move forward. Who else should I follow up with and are there other tests that I should have done?Armando

### output:

Thanks for your question on Chat Doctor. I can understand your concern. First, no need to worry about heart diseases as a cause for your chest pain because your extensive cardiac work up is normal. In my opinion, you are mostly having HERD (gastroesophageal reflux disease) related symptoms. HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of intense chest pain. Only Chat Doctor.  1. Avoid hot and spicy food. Avoid junk food. 2. Avoid stress and tension, be relaxed and calm. 3. Avoid large meals, instead take frequent small meals. 4. Go for walking after meals. 5. Keep 2-3 pillows under head in bed to prevent reflux. Follow all these and you will mostly improve. Sometimes, musculoskeletal pain can also cause similar kind of pain. So avoid movements causing pain. Avoid bad postures in sleep. Take painkiller like ibuprofen. Apply warm water pad on affected areas. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.