Recurring burning in throat despite medicine/treatment

For appr. 1 yr. I have been experiencing heartburn-like symptoms. Should state that I am in overall good health, non smoker, non drinker, not overweight, good physical shape, 58 years old. Initially started with chest pain, thought I was having a heart attack.  Ever since, I have had burning in my upper chest and throat. My doctor has done a procedure where he went down my throat and into my stomach.  He said everything looked fine.  Had a little reflux, but not bad.  Then, I wore a monitoring device which stayed on for 24 hours. It was to record any belching, coughing, and heartburn.  It had an attached tube, which went down my throat.  The test showed nothing.  I have been on Prilosec OTC (4 per day), Zelnorm, Prevacid (2 per day), Nexium (2 per day, just made me nauseated w/headache, then tried one per day), and also tried Doxepin 50 mg once a day.  None of these worked at different mgs and dosage times.  Might as well not have taken anything!  I do not have the "heartburn" at night when I sleep. Have also noticed some hoarseness.  Generally symptoms begin after breakfast and persist through the day.  Sometimes I'll have it 4-5 days in a row, and sometimes not at all for 2-3 days, then have it again.  No reason or idea of any precipitating factor.  Gastro Dr. appears to have run out of ideas.  Dr. said at one time I probably did have it, but no signs of it now, and states that my "mind is telling my body that I still have it, like a person might still feel his leg after it has been amputated..."  This is about to drive me nuts!  I have had every possible test that he has suggested, tried every pill, but to no avail!  I am wondering if I am even seeing the right kind of doctor?????  Prior to seeing the gastro Dr., my Internal Med. Dr. ordered a stress test (when this began).  All results were normal. Should add that I was taking Fosamax 70 mg once/wk for 4-5 years for Osteoporosis.  I quit taking that a year ago (when symptoms appeared, and have not taken it since).  Am also taking: Doxepin 20mg and Atenolol 50 mg for migraines, and Levothyroxin (levothyroxine) .88 for thyroid. Am I seeing a Dr. in the right field; is there some condition that I or my Dr. is unaware of; please help me with any ideas regarding treatment of this persistent any very annoying condition!

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation already with the upper endoscopy.  

GERD continues to be a suspicious cause.  The definitive test for GERD would be a 24-hr pH study.  If this test is positive, and you are still having symptoms despite taking the Prevacid/Prilosec/Nexium, you may want to consider surgical therapy to correct the problem.  

Another consideration would be chronic post-nasal drip leading the burning and GERD-like symptoms.  A referral to an ENT physician can be considered to evaluate for this.

These options can be discussed 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.
kevinmd_

[Aub]

I have had heartburn for about 20 to 25 years.  It was discovered recently I have a hiatal hernia of medium size.  I had some scar buildup (Shotzkies Ring- not sure of spelling).  I guess this can get worse and make things  like swallowing difficult in extreme cases.  I think I will have the surgery to address this.  It is called Nissan.   Being 55 and in good shape also.

[yoshi]

As we get older,our stomach produces less acid.
Nexium makes you nauseated and sick,this could be too little acid,not to much.
One way to find out is to drink some cranberry juice ,if it makes you feel better,than you have too little acid,as cranberry juice raises your stomach acid level.
Eating a RED DELCIOUS apple helps some folks.

[Aub]

I took Nexeum and some others similiar.  It didn't make me sick or do anything.  It just blocked acid production.