Sudden indigestion and nausea. Gastric cancer?

[caoimhinnn]

Facts:
--26 year old male.
--14 months ago, I had a sore throat that persisted for weeks and noticed that food was occasionally slow to go down my esophagus (would get stuck if I didn't drink water to force it down). Eventually had an upper endoscopy as well as a barium swallow fluoroscopy. Doctor noted a hiatal hernia. Was given diagnosis of GERD/LPR and Rx for Nexium.
--I took the Nexium for a short time, but stopped a short while later when the symptoms abated.
--Since then I have occasionally had issues with mild indigestion at night, but nothing unusually concerning. Usually, I would need to sit up to burp, but that was the extent of it.

--Last week, the persistent mild sore throat (of the same type as before) returned.
--3 days ago, I woke up hours after going to sleep with intense nausea and feelings of indigestion. It was more severe than I have ever felt before. I felt as if I would vomit, but never did. Eventually, I took antacids and fell back to sleep. Earlier that night, I had drank alcohol and eaten a large meal.
--Since then, I have had mild GI discomfort and occasional light belching (even in the morning, when I haven't eaten for a long time).
--I have a tight, anxious feeling in my stomach. (I am an anxious person, so I don't know if this is physical or psychological).
--I have resumed the Nexium,

The internet has given me cause to think that I have stomach cancer, because of the sudden onset of the new nausea and painful indigestion that I never had before. What could it be? The thought of that is making me even more anxious.

[Poorna Chandra, SMD, DM]

Dear caoimhinnn,

Thanks for writing back.

As you are anyway going to have an endoscopy, I think it is wise to wait for it and not do any other investigations. On the endoscopy, I would expect to see a hiatus hernia with some reflux esophagitis.

Hope this information will be of help.

Best Regards
Dr Poornachandra

[caoimhinnn]

Thank you Dr. Chandra.

A quick point of clarification: the two studies I mentioned were conducted around 14 months ago. Is that recent enough for me to still infer some reassurance?

Thank you again.

[Poorna Chandra, SMD, DM]

Dear caoimhinnn,

Thanks for the query.

Given that the endoscopy and barium studies were normal, I would like to reassure you that the possibility of you having stomach cancer is extremely low.

Your symptoms currently correlate with that of recurrent reflux episodes due to hiatus hernia. The clinical information provided correlates with the endoscopic finding of a hiatus hernia and the associated reflux disease.

Hiatus hernia compromises the integrity of the lower esophageal sphincter and hence may predispose to the reflux. Hence, people with hiatus hernia tend to have recurrent reflux episodes. Reflux esophagitis may cause throat irritation, and a feeling of food being stuck in the throat.

Performing diaphragmatic exercises will tone up the diaphragm and counter the effects of the hiatus and may help to prevent reflux. Meanwhile, add a prokinetic tablet like domperidone to Nexium after consultation with your GP.

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

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Poorna Chandra