Digestive Disorders / Gastroenterology Expert Forum
Belching and throat tightness
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Belching and throat tightness

Hello,

For the record, I am a 30-year old male and a smoker for about 8 years at 1 ppd.  I am overweight.  I was worked up for gall bladder attacks about 8 months ago, but the US was negative and the attacks abated after a few weeks of a changed diet (no grease) and some alternative treatment (not the olive oil and lemon but some specialized supplement pills).  The general opinion was that if I did have stones, they may have passed.

My symptoms go back about 2 months.  It was originally a lot of deep throat irration (like not the back of my mouth but down by my larynx) such as transient hoarseness, throat clearing, occasional soreness, and a globus sensation.  These symptoms were not constant but I felt it most of the day.  The only real relief was simply by eating.  A good mean gave me some good time of relief.  I did some research and learned that this could be cause by GERD so I began to take Pepcid (I do have a long history of frequent heartburn and nighttime reflux).  About a month ago, I vomited - but that was from some Chinese food that did not agree with me and the vomiting itself was not related to all this.  But the vomiting totally irritated my throat. That day and the next it hurt to talk and it probably took a good week for that irritation to completely go away.  I am not sure of that part is related as I have never had that kind of reaction to vomiting before

The Pepcid worked in that my irritation subsided and my symptoms were going down, but I did begin to feel as through I had a burp stuck in my throat and my upper esophageal sphincter was spasing a lot - especially worse during times of stress.  I switched to taking Prilosec about 10 days ago (20mg q24h) and that has really done wonders.  Any lasting larynx irritation has abated, my upper sphincter seems to have settled down I would say about 90% (I occasionaly still get it a bit), and the feeling of burp stuck in my throat has also been slowly but consistently improving. I do still belch a lot however.  Just in case this has anything to do with my symptoms, I helped lift a couch the other day and since then I have been having an occasional dull ache (especially when leaning forward) in my upper abdomen, just below my breast bone - but that is minor and it is very occasional and seems to have improved since then.  Maybe that is just a pulled muscle, but the couch was not that heavy, and I would rather give too much here then leave something out that may be a clue.

I have no trouble swallowing and if anything, eating or drinking (especially carbonated beverages oddly enough) relieves my symptoms.  

I know I put a lot of information in here and perhaps a lot of it was not necessary.  But I was wondering if anyone had a clue as to what this can be.  My biggest fear, of course, is esophageal cancer.  But whatever it may be, I would like any input anyone can provide. Thanks!

              - Ben
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GERD certainly can cause the majority of your symptoms.  Prilosec and other proton-pump inhibitors are normally quite effective.  

Tests to consider would be an upper GI series, to evaluate whether a hiatal hernia can lead to the GERD, or an upper endoscopy (evaluating for ulcers or inflammation).

If there continues to be a non-revealing diagnosis, a 24-hr pH study is the definitive test for GERD and can be discussed with your physician.  

There is also room to move in terms of dosage.  Increasing the dose of the Prilosec, or changing to another medication (i.e. Protonix), may lead to some improvement.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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