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feeling of heartburn, nausea, like I'll fall, plugged ear

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Every once in a while (like 2-3 times a month or more or less frequently) I get a feeling of heartburn, nausea, I feel like I am going to fall down and the earth is going off of under my feet. And all this is accompanied by plugged ear (always my right ear). It has happened in various situations (when I was tired or well-rested, hungry or full, sitting or walking, etc), so I believe it is not dependent on my current tiredness or something. It happens for a minute or two, and after that it all passes, I just need to sit down in order to not fall when it all occurs. I don't know what is wrong with me and I have been to a few general check-ups, where it showed my health was OK! Any idea what the problem is and why it happens? Thank you in advance.

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replied May 25th, 2014
General Q and A Answer A47438
Hi, and thanks for your query on eHealth forum!

In all probability you have a bad gastric reflux which triggers a vaso-vagal attack when the stomach contents come up into your esophagus. It could also be hiatal hernia. Treatment is a combination of drugs to reduce the acid and lifestyle changes. You will need to take a combination of medications (under medical supervision) like a proton pump inhibitor such as omeprazole, lansoprazole or pantoprazole empty stomach in the morning and an antacid gel after meals or H-2 blocker such as ranitidine for complete relief. Possibility of H pylori infection too should be looked into by a carbon urea breath test and a combination antibiotic tried. Many a times a persisting H pylori infection can be the cause behind acidity not responding to treatment. This can be diagnosed through blood test, carbon urea breath test and endoscopy.

Also you need to make some life style changes such as taking a late night snack, drinking cold milk, avoiding heavy meals and eating frequent small meals, avoiding too much of caffeine, tea, smoking, fried food and drinks both alcoholic and non alcoholic fuzzy ones, avoiding heavy exercises within 4 hours of a heavy meal, raising the head end of the bed by pillows to 30 degrees, and avoiding lying down for least 2 hours after food. If these tips help, then please consult a gastroenterologist.

Also this needs a detailed evaluation of heart and nervous system. A tilt table test, holter monitor, echocardiogram etc are done for confirmed diagnosis. Certain lifestyle changes such as raising the head end of bed while sleeping, avoiding sudden change in postures, avoiding an empty stomach, doing moderate isometric and aerobic exercises etc usually help. Drink plenty of water, clear soups, juices (fresh), and herbal tea etc. Please discuss this with your treating doctors. Hope this helps. Take care!

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