Download FREE Practo app
Get ₹200 HealthCash
Block jam feeling
My father, (79 yrs), has been experiencing a persistent “block” or “jam” feeling between his upper abdomen and lower chest, mostly after lunch and an afternoon nap. The discomfort is not associated with chest pain, sweating, or fatigue, and it gradually subsides with time or distraction.His cardiac and respiratory evaluations — ECG, 2D Echo (EF 58%, no RWMA), Chest X-ray, BNP — are all normal. Endoscopy showed gastric erythema and erosions, RUT negative.
Over the past two months, he has tried several gastric and motility medicines:Voltapraz 20, Razo-L, Omez DSR
Sucral-O, Mucaine Gel
Acogut (Lupin), Itovyom
Bloatpill
Ganaton (Itopride).
Despite these treatments and lifestyle changes (light diet, sitting upright for 2–3 hrs post-lunch), the “block/jam” feeling continues to appear almost daily after meals.Kindly advise whether this could be due to reflux-related diaphragm pressure or something else ?
(a photo with a red marked line showing the area where this discomfort happening)
Answers (12)
Get your queries answered instantly with Care AI FREE
20000+ health queries resolved in last month
Complex case. Since cardiac/respiratory causes ruled out and endoscopy shows gastric issues, this is likely REFRACTORY GERD with possible HIATAL HERNIA or ESOPHAGEAL DYSMOTILITY.
Why medicines not working:
- Wrong diagnosis or incomplete treatment
- Hiatal hernia causing mechanical obstruction
- Esophageal motility disorder
- Delayed gastric emptying
Further Investigation Needed:
1. Barium swallow study - check for hiatal hernia
2. Esophageal manometry - check motility
3. 24-hour pH monitoring - confirm GERD
4. Gastric emptying study
5. CT abdomen if not done
Treatment Modifications:
1. Combination therapy:
- PPI (Pantoprazole 40mg) BEFORE breakfast
- Add H2 blocker (Ranitidine 150mg) at bedtime
- Prokinetic: Domperidone 10mg before meals
2. Lifestyle (already doing but reinforce):
- Head elevation while sleeping (6 inches)
- No lying down 3 hours after meals
- Small frequent meals
- Avoid tight clothing
3. Consider:
- Baclofen 10mg (reduces reflux episodes)
- If hiatal hernia found, may need surgery
Age 79 - also rule out cardiac ischemia definitively with stress test if not done recently.
Next Steps
1. Consult Gastroenterologist Urgently: - Request Barium swallow study - Esophageal manometry test - Discuss refractory GERD management 2. Modify Current Treatment: - Take PPI 30 min BEFORE breakfast (empty stomach) - Add Ranitidine 150mg at bedtime - Take Domperidone 10mg before each meal 3. Strict Lifestyle: - Sleep with head elevated 6 inches - No food/water 3 hours before lying down - Small meals every 3 hours - Avoid: coffee, tea, spicy, fried foods 4. If No Improvement in 2 Weeks: - Consider Baclofen trial - Surgical evaluation for hiatal hernia 5. Red Flags (ER immediately): - Severe chest pain - Difficulty swallowing solids - Vomiting blood - Black stools - Unintentional weight loss
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Didn't find the answer you are looking for?
Talk to experienced doctor online and get your health questions answered in just 5 minutes.
+107
You can consult me directly on Practo, or reach out via WhatsApp:
Eight Seven Six Two Seven Four Nine Nine Seven Four
I’ll guide you step-by-step with easy-to-follow treatment plans.
Early consultation helps avoid complications — feel free to connect.
Only whatsapp message no calls
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Need few more details
Kindly consult
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Hello,
For consultation
1. Pay ( ₹ 500 only, 50 % off ) and consult by practo.
2. Or pay ( ₹ 500 only, 50 % off ) and send message by GPay. My mobile number is +91959508739nine.
3. If required call to +91959508739nine.
Take a glass of milk daily.
Thanks.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Does he have constipation as well, if that is so, needs to be corrected.
Give him frequent small meals, with no fats or spices, less of sugary food, avoid late evening meals, heavy meals in evening, much of tea, coffee.
Let him take tab pantaprazole 40mg one before Breakfast for 4 to 6 weeks.
Tab dom d.t one morning and one evening for 10 days.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
He is on all necessary medicine. Please have some patience.
Or consult superspecialist like MD physician.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Sir, this might be due to the valve and reflux only, he is already on medication that will support in resolving the issue. All necessary investigations are normal as said by you. If u still have questions, kindly consult with me on 94 two six 86 seven eight 96.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Use prebiotic
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Do connect and consult
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Needs to be evaluated
Do consult
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
Answered
Flag this answer
0/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Sohan Kulria
General Physician
5 yrs exp
Firozabad
If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a free detailed discussion
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Articles you may like
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
The question asked on this page is a free question. You can ask a free health question by downloading the Practo app.
Articles you may like
Tell us what's troubling you
Tell us what's troubling you
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.