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

### input:
I have had heartburn since 2011 it is not heartburn because it burns every single day of the week even.when I don t eat anything I can.just walk or bend over and get bad burning in my chest plus the chest pain and it apears that underbmy left arm pit is a burninh and it feels as if blood.vessels are swollen to.touch I can feel.them moving when I put my hand there and.rub it up and down also when I touch it my chest starts to hurt very badly I have been.sweating none.stop all day and feel very hot when I have the air on and tired.. I have no clue what this could be

### output:

Hello. Thank you for asking on Chat Doctor. I read your query and understand your concern. Now, the description of the heartburn you provided, is with the highest probability from the stomach, as the origin. This symptom is called paresis, and is produced when the highly acid content of the stomach is returned to esophagus or, sometimes, throat and mouth. This can happen from various reasons, mostly from a disbalance between acid-producing and acid-inhibiting factors in the stomach and from the lower esophageal sphincter insufficiency. Without digging further more into theoretical details, I would suggest you to refrain from certain food and beverages that favor acid production and/or inhibit acid-inhibiting factors and/or lower the pressure of the lower esophageal sphincter:- alcohol and tobacco-chocolate- tea, coffee (Anthony derivatives)- spicy and grilled food, and pickles would also recommend you to start a course with a proton pump inhibitor (PPI): omeprazole 20 mg x 2 tb/d for the first two weeks, then 20 mg x 1 tb/d for four other weeks, and accompanied by risperidone x 3 tb/d. Also, you should not lie down, but sit up or stand, for at least 90 minutes after you have had your last meal. If the symptom persists after all these measures are undertaken, I would recommend an upper gastrointestinal (GI) endoscopy, for further investigation. I hope I was helpful with my answer. Best regards.