Nausea, Lack of appetite, Burping

Starting 3 weeks ago I started noticing this feeling in my throat, something that made me want to gag.  I've always had a very bad gag reflex, so I thought something was just agitating it.

I've probably had 4 vomits that have produced food, etc over the past 3 weeks, and 6 or so total dry heaves, where I actually burp when I retch.  

Going along with this was a feeling of not really craving food, a lack of appetite.  Not entirely so, my stomach still growls if I wait too long, but I definitely am eating less than I used to.  I think I've dropped about 5 pounds over this 3 week period.

The OTHER thing I noticed was that I was burping a lot.  It wasn't uncontrollable, but if I wanted to I could bring up a lot of air.

I've had some good days where the gagging feeling is absent, and I eat fine.  Then I have days where it's very present, and sometimes it's all I can do to stifle a dry heave.  I should mention that usually it's much more noticeable in the morning.  By 6 p.m. the throat feeling seems diminished.

I saw a Doctor today, and he thought it was all related to acid reflux.  He said the acid could be irritating the throat and the gag reflex, as well as suppressing my appetite (brain confused by what's going on in the stomach?)  I have had ZERO heartburn, though I have noticed occasionally when burping or just lying in bed at night a bit of acid coming up into my throat.  Despite his optimism, and recommendation that I take Prilosec for a few weeks and see if it all goes away...I'm not convinced.

My mom died of a rare cancer around her heart (doctors said it absolutely wasn't hereditary) when I was 20, so I have to admit that cancer is very present on my mind.  I have a hard time distracting myself, and I am the definition of a "worrier".  Thank you very much in advance for any advice.

[Kevin Pho, MD]

Acid reflux would be the first thing that would come to my mind as well.  Even though you do not have any heartburn, it can also cause the symptoms you are describing.  I would want to rule this out before proceeding onto other diagnoses.  This would include an upper GI series and/or 24-hr pH study (which would be the definitive test for GERD).  An upper endoscopy would be the most comprehensive test to ensure there is no cancer in the upper GI tract.

If those tests are negative, I would consider a gastric emptying scan to evaluate for delayed gastric emptying, as well as an abdominal ultrasound to evaluate the liver/gallbladder, both of which can cause your 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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[RobH]

Forgot to mention some personals:

Just turned 29 years old.
6'3, 190.
Walk around a lot at work, but I don't exercise regularly.

Thanks again!

[rainbowscribe]

A related discussion, NOT REFLUX - Morning gagging/retching was started.

[zoeyshinn]

A related discussion, Maybe Not GERD? was started.