hi i have been having chest pain (tightness) some nausea off and on fatigue the feeling of butterflies in my stomach off and on my sleep habits have changed i have been having a hard time falling asleep or staying a sleep and I have been having paranoid thoughts that something real bad is going to happen what can this mean?
Thanks for your question on Chat Doctor. I can understand your concern. You are mostly having stress and anxiety related HERD (gastroesophageal reflux disease). 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 chest pain, tightness, pressure, burping, nausea etc. These symptoms are more common in night during sleep because of recumbent posture. So first we need to control your stress and anxiety. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic Chat Doctor.  S avoid stress and tension, be relaxed and calm. For HERD take proton pump inhibitors and prokinetic