tight throat-reflux or anxiety?

  I was diagnosed about 5 months ago with GERD, with some
  esophagitis, after an upper GI.   I have never had heart-
  burn, per se.  My symptoms were substernal pressure and the
   feeling of having an air bubble in my esophagus. I began at 300 mg of Zantac per day but after 3 months or so, I began to
  have other weird symptoms like a burning in my throat.  I am now
  up to 600 mg per day and those symptoms are gone.  However,
  this whole business, coupled with a new job, has resulted in
  periodic panic attacks so I now take BuSpar each day. (I am
  rapidly becoming a hypochondriac!!)  Over the past few weeks,
  I have begun to have periodic problems with swallowing. I can swallow, but it feels as if there is a tight band across my throat.
  I never have it in the mornings, but it seems to develop about lunch time and sometimes seems to be made worse by the smell of food.  Food is rapidly becoming my enemy.  I try to eat as
  much food as I can in the morning because, by evening, it is no
  longer appetizing. The tightness sometimes seems to be relieved
  by lying down and relaxing. I have read that reflux can cause swallowing problems, but wouldn't that be more constant than intermittent?  I am beginning to think it is more anxiety related???????  
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Dear Ann,
Esophageal reflux can cause trouble swallowing by two different mechanisms.  If there is a lot of inflammation, scarring of the esophagus may result leading to a narrower lumen and difficulty swallowing solids.  This condition is usually treated by esophageal dilation.  The second mechanism for trouble swallowing is impaired muscle contractions due to the esophageal inflammation.  TReating the esophagitis should make this condition better.
In your situation, it would be appropriate to know exactly what is going on.  The necessary information can be obtained by having an iupper endoscopy (to look for structural causes) and an esophageal motility study and 24 hour pH probe to check for impaired esophageal motor function and reflux.
This information is presented for educational purposes.  Always ask specific questions to your personal physician.
HFHSM.D.-rf
*keywords: esophageal reflux, swallowing
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