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GERD/Hiatal Hernia/Urge to Belch
Thank you again for answering my prior question. I just wanted to clarify something on the previous post and ask a new question. Additionally, I understand the posting limitations on this forum. This will be my final post.

For reference, the facts were the following:
* 26 year old male.
* 14 months ago: upper endoscopy and barium swallow revealed esophageal irritation and hiatal hernia. At this time, biopsy was negative for H Pylori.
* was prescribed Nexium, but did not consistently take it.
* reflux symptoms are usually mild. sore throat, and occasional need to sit up in bed to burp.

* 1 week ago, I woke up with bad nausea and feeling of bloating. Felt the need to vomit, but didn't.
* I started taking the Nexium at 80mg per day (1 40mg capsule in morning, 1 at night).
* Since then, I have had a frequent urge to belch/feeling of air trapped in my stomach/upper chest. However, I am usually unable to belch except for small amounts. Often the belching comes with fluid if I have eaten within a few hours.  This frequent urge to belch symptom just began this week and has never occurred before.
* Went to see my gastroenterologist, who will perform another upper endoscopy in a few weeks to see if the irritation on the esophagus has healed from the Nexium.

Specific questions:

1) Concerning stomach cancer: you said that the negative studies from last year made stomach cancer unlikely. Is this true despite the fact that they are now a bit old? It is my understanding that this is something that usually takes years to develop, and thus it seems that something would have been visible even a year ago. Can I then still infer some comfort and reassurance from the fact that the tests were negative?

2) As the "urge to belch" only started after I started taking the Nexium, could it be a side effect? I have read that PPIs can cause gas, and it seems as though my dose is toward the higher end of the spectrum.

Thanks again. I am hoping to calm my anxiety until the endoscopy.
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1 Answers
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1760304 tn?1316457159
Dear caoimhinnn,

Thanks for getting back.

1) A symptomatic gastric cancer does not develop so fast. I would like to reassure you that what you are experiencing is simply gastroesophageal reflux and given your age and current complaints, the possibility of you having gastric cancer is almost nil.
2) Belching can occur either because of either an incompetent lower esophageal sphincter or reduced gastric compliance. Both of these may be seen in a case of bad reflux
3) PPIs (proton pump inhibitors) can lead to small bowel bacterial overgrowth, if used over long term and hence can lead to flatulence. Belching is not a side effect of PPIs.

Hope that this information helps and hope that you will get better soon.

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Best Regards,
Dr. Poorna Chandra
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