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

### input:
I had a stomach ache earlier in the day then came home argued with my husband about the dog peeing all over the house & then colored my hair & then had back pain in the mid back area & chest pain. I m being treated with physical therapy for ribs that keep coming out of place from a few falls I had over the past few years. I am concerned I could be having a heart attack. I m 40, on Glumetza 500 mg bid to keep my blood sugar low because I was pre diabetic, also take 125 mcgs synthroid Recently lowered my cholesterol. I m also on Wellbutrin for depression. I am also taking a supplement with Green tea extract in it. Maybe too much caffeine?? It hurts to take a deep breath in front of chest straight through to my back.

### output:

Thanks for your question on Chat Doctor. I can understand your problem and situation. In my opinion you are having HERD (gastroesophageal reflux disease) mostly. But since you are prediabetic and had high cholesterol, it is better to rule out cardiac cause first for your chest pain. So get done ECG and 2d echo. If both are negative than no need to worry much for cardiac cause. GERD seems more appropriate cause in you. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms like central chest and back pain. Try to follow these steps for better symptomatic relief.1. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals.2. Avoid stress and anxiety.3. Start proton pump inhibitor.4. Go for walk after meals.5. Keep 2-3 pillows under head in bed to prevent reflux.Don't worry, you will be alright.