<s>[INST] i have almost constant chest pain . Sometimes light sometimes extreme sharp pain in either side of my chest. I also get an ache in the lower left side of my neck, not sore but uncomfortable. I also notice it seems to worsen or be brought on by the slightest strain when using the toilet. I have had a camera down my throat and have been placed on nexiam 40mg for approx 2 months now. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. By your history and description, possibility of HERD (gastroesophageal reflux disease) related chest pain is more. But better to first rule out cardiac cause for chest pain. So get done ECG and 2d echo. If both are normal than no need to worry about cardiac diseases. You are taking medium. It is having pantoprazole. Better symptomatic relief, along with pantoprazole, you need to follow these lifestyle modifications. 1. Avoid stress and tension. 2. Avoid hot and spicy food. Avoid junk food. 3. Avoid large meals, instead take frequent small meals. 4. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. 5. Avoid smoking and alcohol, if you have these habits. 6. Lose weight if you are obese. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. </s>