Re: Strange esophagus symptom

Posted By Allen on May 07, 1998 at 22:42:04:

In Reply to: Re: Strange esophagus symptom posted by HFHSM.D.-rf on May 07, 1998 at 19:37:36:






: : I get a strange symptom in my esophagus.  It is like a rising feeling of a bubble in my esophagus/throat.  It can come on anytime but most often happens right after I begin eating or particularly when I am under stress.  It can be severe enough to be jarring to my system and I feel a little weak afterward.  It usually only lasts a second or two but occasionally longer which causes anxiety in that I feel that I may have some type of a seizure?  I am particularly concerned about this being a life threating attack or a serious problem.  My allergist has seen signs of Acid Reflex in my throat.  Can this be a caused by that?  I do not have the burning, indigestion or acid taste usually associated with GERD.  Anticids help to a degree and my doctor suggested Prilosec.  Are there any downsides to taking Prilosec?  Your help in identifying the cause of the symptoms or any advice you can give is appreciated.



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Dear Allen,
: I was very interested in your letter.  The sensation of a bubble in your throat with eating is very suggestive of swallowed air although some additional information is needed.  Is the symptom painful or merely unusual?  How frequent is this problem?  Is it something new or a chronic condition?  Do you feel better if you belch or does the symptom subside spontaneously? It is quite common for people to swallow air and to have symptoms related to air in the GI tract. (If you have other symptoms related to swallowing, weight loss, or vomiting then we would need to consider other possible explanations).  Your symptoms are not those that we usually associate with a seizure.
I do not think that your symptom is related to acid reflux into the esophagus.  Reflux symptoms are usually a burning sensation in the pit of the stomach or behind the chest bone.  Patients may complain of swallowed food returning to the mouth.  Sometimes, the food will stick in the chest during swallowing or the act of swallowing will be painful.  Voice hoarseness and inflamed vocal cords can also be manifestations of reflux.  
If antacids improve your symptoms, I would continue with this therapy.  Based on the symptoms that you describe, I would not prescribe Prilosec.  Although this drug does not have any major common adverse side effects, it is not evident to me that the drug will improve your symptoms.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.
HFHSM.D.-rf
*keywords: esophageal reflux, acid, Prilosec
: 0.3
Thank you for you reply.  I'll give you some additional info.  The symptoms do not just come on when eating.  I can just be sitting or standing and feel them coming on.  The symptom is not painful, just unusual and frightening.  It can come on at times when I make a jarring move such as bending or a physical activity.  It seems to start in the middle or upper part of my esophagus and move upward but not exactly like gas.  I don't have any burning or food returning to the mouth.  I do have a feeling of flem (phlegm) in by throat and a slight cough at times.  I notice that at times it can come on when I am stressed.  I find it a very frightening feeling.  Also, it appears to me that sometimes when I get it my heart skips a beat but I don't have any pain or shortness of breath and a recent echo treadmill was excellent.  I recall having it off and on for over 25 years but it is becoming more troublesome lately.  I remember years ago it used to come on after eating a large meal.  My allergist saw evidence of minor acid damage in my throat and she felt it was acid reflux and put me on Prilosec 20 mg. twice a day.  It does seem to provide some relief.  Thanks for any help or direction you can give.  If it is cause by swallowing air, what can be done about this?  Thanks again.      
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: Dear Allen,
I am not certain that I can provide much more information.  Based  on your description, I do not believe that your problem represents significant disease.  I am also reassured by the fact that your treadmill test was normal.  If you are concerned regarding the symptom, you might consider obtaining a GI consultation.  Work-up could include an asophagogastroduodenoscopy to evaluate mucosal inflammation due ti reflux.  Additionally, you could have a motility stud (either a cine -esophagram [X-ray] or a motility study.  Either of these tests would exclude an incoordination of esophageal muscle as the cause of symptoms.  My suggestion would be to take a conservative approach and not have any further testing.  If the symptom is due to swallowed air, you could consider purchasing over-the counter treaments such as simethicone.
This information is provided for educational purchases and does not represent a medical evaluation. Contact your personal physician for the answers to specific medical issues.
HFHSM.D.-rf
0.3
Thank you for the information and help.  I will take the conservative approach.  I will also try the simethicone.  It is reassuring to know that the symptoms do not stand out as a serious condition.  If it persists or gets worse, I'll seek a GI consultation.  Thanks again.