Digestive Disorders / Gastroenterology Expert Forum
Throat Flutter
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Throat Flutter

9mos,agoI went into the emergancy room with middle back pain into the chest they ran tests and found out it was my gallbladder.So I had it removed.Before that I was experiancing a fluttery fallin feeling in my chestand now that I've had my gallbladder removed I'm still getting a fluttery feeling it seems to manly start out in my throat moving to my chest...I also noticed I've been belching alot which sometimes it seems to help get rid of the flutter.I also been having trouble with airbubbles in my stomach it feels like theres something pooking out of my stomach and I'll feel my heart rate speed up down in my stomach..at times I can't even lay on my stomach.I've been to a gastronalogist and they did a colonoscopy and said everything looks fine.He told me I probably have IBSand prescribed pamin 2.5mg. But this flutter feeling is still bothering me and causing alot of anxiety and worry. If you could help me figure out what it could be from or what to tell a doctor that would be deeply appriciated.  Thank you.
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To evaluate the palpitations, you may want to consider an evaluation by your personal physician.  An electrocardiogram can be considered as a baseline test.  I would also consider an event monitor - which is a portable device that you wear which records the heart rhythm during the "fluttery" periods.  This can determine whether an arrhythmia is present or not.  I would also consider an echocardiogram to evaluate the heart anatomy.

Regarding the stomach discomfort, you can consider an upper endoscopy or upper GI series.  Various causes of dyspepsia - such as GERD, an ulcer, or inflammation of the upper GI tract can cause these symptoms.  

You may want to discuss these options with your personal physician.

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.

Thanks,
Kevin, M.D.
7 Comments
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Avatar_n_tn
How interesting.  What you describe is similar to what i have been going through, except I got here through the route of heart palpitations.  I also get the fluttery in my throat.  I am curious to see what the dr. has to say.  I was thinking hiatal hearnia, but maybe not.
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Avatar_n_tn
I am so glad to know that I am not the only one who feels this.  I too went to the ER with pain in my back/ chest (In August) and after a month of tests determined that it was my gallbaldder.  I had it removed in November 2003.  I was told that I could eat anything I wanted after 4- 6 weeks. When that time came and I still was having a lot of loose BM's I was told that it takes 6 months to 1 year to be completey cured of this.  I was and still am following a low fat diet (the one I began when my gallbladder began to act up) I was getting concerned becasue through out the course of this time I could not eat anything and lost about 25 lbs. In the mean time I began to have the flutter that you describe.  Mine starts in my chest and seems to move up to the throat.  Sometimes it is the opposite.  It is very freaky and I start to panic when it occurs causing rapid heatbeat, shortness of breath, dizziness etc.  My doctor has declared (with no tests to confirm) that this is GERD and has me taking Prilosec twice a day for the last two months.  I am skeptical however it does seem to be reducing the intensity of the fluttering.  I still have it occasionally (every few days) however it is very slight in comparison to what it was before.  If I was sure that this what it is I would not worry and have the anxiety.

Anyway I just wanted to let you know that you are not alone and I will be curious as to what the Doctor tells you.

Good luck
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Avatar_n_tn
Hi, everyone.  I, too, have experienced many of the same symptoms you discuss.  It began in July, 2003 when I awoke with pain in my mid-back.  After 2 hours, I experienced what I thought was a heart attack (sudden onset substernal pressure which radiated out both arms, fast and pounding heart rate, sweating, dizzy).  I woke one of my children, had them call EMS, family, and went to ER.  After many months, aproximately $40,000 in tests and surgery (including EKG's, treadmill with ECHO, holter monitor, medicine, a lap chole, endoscopy and more), many uncomfortable/anxious days and 2 more trips to the ER, we are now down to a diagnosis of esophageal spasms, perhaps complicated by some long-standing IBS, a hiatal hernia and GERD.  I have learned a lot....esophageal spasms (typically a symptom, not a real diagnosis) can mimic cardiac pain.  The nerves (or at least one part of them) that innervate the esophagus pass in/out the spinal cord at the same level as a group of nerves that serve the heart, thus pain and other symptoms can/will feel very similar.  I think I learned somewhere, too, that when the esophageal nerve fibers are in a heightened/abnormal state that you get a sympathetic reaction out of the cardiac nerves...helping to explain the rapid/pounding heart. (I think a little adrenalin speeds this along, too, literally!)  I know what you have been through....the symptoms are absolutely distressing when they occur, and it is very appropriate for medical folks to err on the side of checking out the heart first.  

However, my symptoms, like yours, kept recurring.  Finally, in the documented absence of anything cardiac, my getting a little less panicky when they occured - meaning that I could sit back and really start to notice some other smaller but very significant happenings within my body - we started a GI work-up.  I was found to have a gallbladder full of sludge.  Great!  Fairly straight-forward answer....get it out and symptoms will go away!  Not so simple :-(.  Some folks do get total relief of these types of symptoms with a cholescytectomy (removal of the gall bladder) but a significant number get only partial or no relief.  I got partial relief.  

About one week after my cholecystectomy, I had a horrible night.  That same pain in the mid-back...radiated up both sides of my neck, made my ears feel full and painful.  I also heard ringing in my ears.  The symptoms seemed to worsen slightly if I allowed my head to turn to the side.  No amount of Maalox, etc seemed to help.  Felt at times like I had goopy movements going on in my mid-chest, but the galloping feeling in my stomach/heart was gone.  I noticed that swallowing was difficult.  After an entire night of this, I was back in the surgeon's office in the am.  He suspected esophageal spasms and something called globus hystericus.  Globus hystericus can also be called cervical dysphagia.  If I understood correctly, it accounts for the tight chest, can't swallow, can't take a good deep breath feelings I would get with all this going on.  While it is psychogenic in origin, the feelings are real and distressing and usually come in response to some true organic or functional change in our bodies.  

So, back to the gastroenterologist I went.  I had an endoscopy with esophageal mannometry.  The mannometry measures pressures and coordination of swallowing.  The gastroenterologist told me (my sister actually, since I was gorked after the endo:-) that I had a hiatal hernia.    I've also had a CTscan which was negative. Right now, I'm waiting for my follow-up appointment to hear what diagnosis for my esophageal spasms the gastroenterologist will make.

Esophageal spasms can occur in response to an organic issue...tumors, strictures or narrowing of and part of the esophagus in response to GERD, and many others.  Everything I'm reading seems to say the the vote is still out on the role of hiatal hernias with this...it actually looks like hiatal hernias may not be the all-in-one culprit they've been made out to be in past years.  Esophageal spasms (which present in many ways...from a slight sticking of the food when swallowing, to fluttering, to out-and-out incapacitating pain) can also be due to functional, or movement issues.  Poor coordination or weakness of the esophageal muscles are what is happening in this scenario.  Abnormal movement problems in the esophagus can be secondary to some pretty hefty diagnoses, like Myasthenia gravis, or scleroderma, but more typically gets lumped in a broad diagnosis of diffuse esophageal spasms (DES).  The pathophysiology of DES is poorly understood.  I've read where some medical folks believe that we may find that sufferers have a number of different things going on, once there's enough research to pick it all apart.

Anyway, for the person whose doctor said there's nothing to be done....not so.  First, it is very important that anything cardiac/vascular be ruled out.  These symptoms can come from things that are absolutely life-threatening.  Then, the organic side out to be checked out...to ensure that there are no masses, GERD, stricture, etc. via endoscopy and other testing.   Once all of that is put behind you, the movement, or motility issues, warrant investigation.  The main diagnostic test for esophageal motility is the mannometry test.  While a little unpleasant, it is quite simple and very do-able. You can actually finish it in 2-3 hours and immediately return to work.  A small tube is place down your nose and into your esophagus.  Then a tech runs the test while you take sips of water. The easiest way to get the tube down (which is yuck if you're awake and have to swallow it down) is to have the MD place it while you're sedated for an endo.  Then, after you wake up and wait a bit for medicines to clear out of your system, you're ready to go.  

Speaking here on out about motility-based esophageal spams (ie, not cancer, not strictures, etc):  There are definately medicines to control symptoms and you should have them with you at all times so you can achieve control and feel good.  There are antispasmotics which target the gut, like Levsin.  Also, for really tough episodes, when all of us tend to get tight in response to the immense pain, a skeletal muscle relaxant, like Flexeril, can help.  It is not unthinkable to have a mild narcotic on hand, too, for the really bad hours.  Depending on the reason behind the spasms, other medicines and treatments (including surgery) may be indicated.  

Stress definately aggrevates and can even precipitate the symptoms of diffuse esophageal spasms.  So, lifestyle changes to reduce stress, yoga, meditation, prayer...whatever helps you control stress will contribute to control of esophageal spasms.  All of you, like me, probably have hectic lifestyles (one of the things about our Western lifestyle that is NOT good)....I finally had to admit that situational anxiety/stress was setting my symptoms off.  I now have an antianxiety med that I use just as needed.  It's not that I have more stress than other people, just that I react to it strongly with my gut...and end up feeling physically bad in additional to the mental stress I'm under.  

My gastroenterologist said that once IBS, always IBS.  Given my history of IBS, and another gut motility issue called proctalgia fugax (horrible hemorrhoid like pain that wakes you up at night), I have finally accepted that my entire gut is sensitive and I will just have to deal with the medicines, testing, diet changes, stress reduction activities, etc. that will help me have good control.  I also hope to learn more about how to anticipate times/situations that set me off so I can avoid or change them from the start.

Okay, just wanted to share what I've learned so far.  Hope it might help someone!  take care out there,
Andora
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Avatar_n_tn
Thanks for the info Andora!  This helps me out alot.  My fluttering is in the right side of my chest and throat.  I had an EKG prior to my lap chole and it showed that my heart is fine.  The part that concerns me is that without having seen my Upper GI results, HYDA scan results or my ultrasound, my new doctor assumes that the fluttering is GERD and gives me Prilosec.  When I asked about a 24 hour Ph- study she looked at me like I was nuts and wanted to see the results of all of the other tests.  Once she saw them she says these are the appropriate tests and I should continue with the Prilosec.  I continually mention to her that I am stressed and I have periods where I feel so stressed that I am short of breath and cannot relax.  Her answer was to learn to relax.  I asked about taking Zoloft since I worry alot and all of the women in my family who are worriers take this and it helps alot.  She told me I was too young for this (I am 31) and to just relax.  When I asked how long I will have to take the Prilosec she said possibly forever.  This would not be a problem expect for the fact that I would like to have a baby someday in the near future and the effects of taking this medication while pregnant is not known.  My husband and I had just begun trying to conceive when this whole gallbladder thing came up so I wanted to "get well" before we tried again.

At the last appointment the Dr. told me to quit smoking (I smoke 5-10 cigarettes per day) and gave me Zyban.  I don't want to take any more pills.  I go back on 5/3 and think I am going to insist on seeing a gastro specialist.  What do you think?

I just want to be sure that the right sided fluttering is nothing serious.  If I know that it is spasms and I can control it with diet etc with no long-term effects then I will be able to rest easier.

Thanks for your info.
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Avatar_n_tn
I had the same symptoms...fluttering in my chest...for about 2 months. One day I even passed out!   I am now on a caffiene free diet and have had NO fluttering.
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Avatar_n_tn
I too am on a caffiene free diet and have been since my first gallbladder attack in August 2003 however I still get the fluttering in the right side of my chest and throat.  Like I said it has gotten better with the Prilosec and my dr. told me to quit smoking (which I am trying to do w/o the Zyban).  I did not smoke yesterday or today and have not felt the fluttering-- so maybe this is the answer for me.  I will let you know.

Thanks for all of your support.  It makes it easier knowing that I am not going crazy and that others have experienced the same symptoms.

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Avatar_n_tn
I just found this website.  I have been going through numerous test to try and find out what is going on with my throat and stomach.  I too have had lots of fluttering in my throat and difficulty swallowing.  In my situation I also have lots of nausea and sometimes I vommit after I eat.  I've had all this for 5 months now and do not have an answer.  My doctor is stumped and she is running out of test to do.  I'm on Lexapro and she's prescribed Prevacid and Nexium but they didn't help at all.  I'm hoping maybe someone has some advice as to what to check for.  These situations are very frustrating and it does make lots of sress just because you know there is something not right and the doctors cannot find anything.  Good luck to all of you!
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