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Pain in esophagus when swallowing food
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Pain in esophagus when swallowing food

I'm new to this board, but not new to GERD.  I'm a 34 yr old wife and mom, short at 5'1" and overweight but losing it slowly.  Started taking PPI 7 yrs ago for reflux and + hpylori.  Dr never did treat the hpylori back then.  Over the years I've been off and on the different kinds of PPIs.  Loss of Ins in 2006 forced me to switch to the Prilosec OTC, for a while it worked.  Started having more substantial problems last Nov.  Lots of burping, stomach bloated, reflux and heartburn in spite of the 20mg Prilosec OTC.  Dr I saw retested for Hpylori, + again of course, treated it with the 2 antibiotics and 14 day Prevacid.  She also did an abdominal and chest xray.  Never got retested, didn't know I needed to.  Symptoms settled down some.  Feb 2008 started having lots of chest pressure relieved with burping, pain/spasms in espophagus, lots of reflux, even water coming back up.  Went to cardiologist, part because I have a bicuspid aortic valve and wanted to make sure chest pains/pressure weren't related... but to be honest I mostly went to the cardio because I knew he'd be the more likely dr to listen and do something.  Other dr (actually a Nurse Practitioner) blows me off every time.  Anyway, cardio doc didn't think it was heart related, sent me for a barium swallow.  Had that done around the end of March.  Showed severe reflux and small hiatial hernia.  Got me an appt to see gastro dr.  Took 2.5 months to get in.  Saw him May 27, Gave me Prevacid 30mg samples, told me to take 2x a day, while we wait for Ins to pre-auth Prilosec 40mg 2x daily.  I can't say I've seen a huge improvement, it's been 2 1/2 weeks.  I will say it's helped "some".  The chest pressure and spasms have stopped.  And I don't feel reflux as much, but...

shortly after starting the Prevacid I noticed a pain on the left side of my espophagus.  It hurts in that one spot when I swallow a larger size bite of food, when I apply a lot of pressure to my chest to get up a burp sometimes I can feel the pain there.  It's a specific spot, not a general area.  And I'm certain it's in the esophagus and not the throat, but it is up higher closer to the throat rather than lower into the chest, not in the neck.

Of course my biggest fear is a tumor.  But wouldn't the barium swallow have showed that?  I think I remember when the nurse called on the phone with the barium results, her saying specifically, "... no tumors or anything...".

Do any of you know if GERD or small hiatial hernia related things that can cause this kind of pain?  My stomach also still feels full and/or bloated most of the time.  I'm trying to stay away from what we all know as the "trigger foods" I'm not 100% on that but really trying.  I walk a treadmill every evening and usually drink a lot of water, a lot of times I can feel the coolness of the water coming back up the esophagus after it's went down.  But my main concern is this pain.  I'm scared but find comfort in reading posts here and other reflux boards.

Thanks for any help!
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16 Comments Post a Comment
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Avatar_m_tn
Burping is most probably again from H. pylori. H. pylori digest some food you eat and produces gas, which causes bloating and burping. It also stimulates acid secretion what causes burning stomach and heartburn.

You should discuss with gastroenterologist why you get repeating H. pylori infections, and about appropriate therapy (antibiotics again for full 2 weeks). Maybe the first time it was just not eradicated and slowly regrowed.
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Avatar_f_tn
Thanks for posting!  I burp like crazy even on an empty stomach.  Yes I will talk to him about it, the first time I was dx with H Pylori (2001) that Dr did not treat it.  I don't know why, I didn't know then to question him about it, it was only in Nov 2007 that a different dr (nurse practitioner) checked me for it and was very surprised to hear that the first doc didn't treat it, said, "I've never heard of not treating it, it won't just go away on it's own."  I'm in the hands of a gastro specialist now.  I'm not due to see him again till next month, but may have to go in earlier with this soreness problem that's just started.

I'm fascinated by the breath test for H Pylori, I've had blood test both times that I had it checked.  Anything that can save a stick is fine by me.  But my main worry right now is this pain, maybe a better word is soreness or sore spot.  

And I forgot to mention in my first post that I'm NOT having any trouble swallowing, like the food isn't feeling like it's getting stuck mid way or anything.  I've never been the type of person who couldn't swallow pills or get choked a lot.  I can swallow several pills at once whereas my husband has to take it one at a time.  There's just something sore down in there that hurts sometimes (about 70 % of the time) when I swallow a bite of food and even on occasion when I'm just drinking (usually water, can't drink anything else).

Does no one have any thoughts, ideas on this one?  Could it be inflammation, esophagial ulcer, any other things that I've just not heard of?  Something that wouldn't have showed up on that barium swallow I did 2 months ago?  Anything to get my mind off the worst?  I've read some about a hole in the esophagus, but that sounds more like an emergency situation...
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Avatar_m_tn
It goes like this: H. pylori >> gastritis >> gastric or duodenal ulcer >> cancer. H. pylori can be tested with a beath test (blood test is somewaht less reliable and it also shows antibodies from already healed old infections). On the other hand, the nature of gastric lesion can be determined only by endoscopy/biopsy.
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Avatar_m_tn
You have a confirmed Hiatial hernia and Reflux showed up in the Bariam swallow.  You have GERD.  Need to stay on the PPI's to get that Esoph. healed.  The stomach acid is making your Esoph tender and yes it can cause pain all the way up to your tounge.  I know this because I have been through it.  I had a nissen fundo in 2003 to correct hernia and tighten LES.  I had pain in esoph. and actually in middle of night stomach acid would reflux up into my mouth.  Would actually wake me and I would have to get up to spit it out.

Here is what helped me back then.
Lose the weight.  
Elevate bed for sleeping.  I actually slept in a recliner for 3 years.
DO NOT eat or drink anything after 6:00 pm.
Stay away from trigger foods.  You know what they are by now.
Nothing tight around the waist.  
Stay on the PPI's as prescribed.
Extreme burning/pain can be slightly relieved with some antiacid.  Tums malox etc.

You need to have an endoscopy if you have not already done so.  This lets the docs get a good look at what is going on.  Do not assume cancer.  It just freaks you out and aggrivates your system more.  Any large mass or narrowing would have shown up on the Barrium swallow.  

One more thing.  I don't know much about the H.Pylori thing, but I do know that after several rounds of antibiotics your intestines are depleted of the "good type" of bacteria needed for good digestion.  These can be restored by eating things like yogurt and garlic.  I had success with yogurt once a day for at least a month.  I will not even try to spell the item in yogurt that is good for you.  Just read the label in the grocery store.  You will see what I mean.

Shoot me an email if you want to know more about my experiences.  ***@****
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Avatar_m_tn
Antibiotics may cause what you've described. On the other hand H. pylori won't heal just like that. If anyone has any experience or have scientific proven info about non-antibiotic teatment of H. pylori, let's say it here publicly. I really hate when some people sell remedies which doesn't work, or work when you actually have no disease.

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Avatar_m_tn
It was never my intent to suggest that someone should not take the antibiotics as prescribed by a physician.  If anyone read my post that way I apologize.  Antibiotics are absolutely needed to cure infections.  That is fact. I am selling nothing.  It is a simple suggestion for promoting good digestion - post antibiotic regime.  It is my belief (based on my experiences) that good digestion plays an essential role in the amount of symptoms one experiences with GERD.  
I was, long ago, tested for H. Pylori and found not to have it.  It played no role in my GERD experiences.  Therefore I will offer nothing for any possible treatment of that infection.  As far as yogurt being good for you, it was a doctor who told me this.  Perhaps it is not true.  I did not do any research into it, I more or less just took his word on the subject.
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Avatar_m_tn
I believe you that you don't want to trick anyone. There are occasional posts here, like "check this site for a solution" and when you go there you see only: this pill $$ that pill $$. Even this would be OK maybe, but most of those things don't work.

I've search really, really a lot about probiotics. From what was tested in clinical trials, I've found that only:
- Bifidobacterium bifidus
- Lactobacillus GG and
- Saccharomices boulardii
showed some improvement in diarrhea after these probiotics (compared with placebo).

Diarrhea goes away in most cases sooner or later. So it is hard to claim by the user , if probiotic was the one which helped him, or it was just - nature. Because, he just can't say what would happen, if he wouldn't take probiotic.

Antibiotic associated diarrhea actually IS, beside food poisoning, disorder where probiotics (only above ones) are officially recommended.

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Avatar_f_tn
Thank you for your posts as well to boron.  I am having an endoscopy tomorrow morning.  I'm not nervous about the procedure itself but am anxious about what he might find.  

Still having that pain, feels like a burning, sore spot.

Any advise on sleeping with wedge pillow?  Like are they any good, where to get one?  First let me say that I've never had any night time reflux problems.  I don't know why with all the problems I have during the day, but anyway maybe that's a good sign, but with how weird GERD can be, the whole "silent reflux" and all... who knows, right.

Anyway, even though I'm not having problems that I'm aware of at night to be on the safe side we tried putting the bed up 6", but could NOT sleep like that, couldn't get used to it.  So my husband lowered it to 4", that seemed to do the trick for me and I got to where I can sleep just fine like that, but my poor hubby can not sleep very good at all.  We've still got the bed up but if wedges are good and have a good success rate I may try that so he can sleep too.

Any thoughts?
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Avatar_m_tn
I'd say just have an endo with biopsy to check for H. pylori, wait for results, get treatment, and then you'll see. No reason to invest in pillows. Avoid acidic and protein food and whatever irritates you.
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Avatar_f_tn
Well, I had the endoscopy today.  Worst part was the IV.. Ouch!  The dr only spoke to me a moment in recovery and said "...everything looked pretty good, there was one small area of inflammation that I biopsied, should have the results of that in a couple days, stomach looked good..."  I said, "So you didn't see any sign of barrett's?"  And he said "No, but we took the biopsy and well see what that says."

So what do you think that means?  Wouldn't they know barretts just by looking?  Why do they take biopsies of inflammation?  If the rest of the esophagus looked good wouldn't it stand to reason that there's no chance of this "small area of inflammation" being barretts?  I guess I just didn't get to "20 question" him like I'd like to have.

Would anyone like to comment?
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Avatar_m_tn
May I?

Barrett's is not necessary a "Hey Barret's!", so give an endoscopist a due time...
Write down 20 q. and doin't miss an opportunity next time. :)
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Avatar_f_tn
i had burning inmy esophagus to i had a endoscope done and i have inflammation of the esophagus
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Avatar_m_tn
Hope your feeling better now.  I hope also you have results from endo.  If Dr. tells you that you have Barretts remember that it is a pre-condition.  Which basically means you have time to reverse the condition.  Dr's can not do an endo and just let you know on the spot.  Anyway you probably already know since this post is a few days past your endo.  Post the results so we can know.

On the topic of silent GERD.  You may not ever feel GERD as a true "heart burn", but one symptom that is often overlooked is a very light sore throat in the morning when you wake up.  A chronic one you have almost every day.  The sore throat usually clears up after eating and drinking something.  Most people just blame it on dry air or allergies etc.  Dry air and allergies can cause sore throat, but GERD often is not thought of as an initial cause for this.  Dr's often used to give me nasal inhalers and allergy pills etc.  Of course this did nothing for the GERD.

Anyway keep on eating properly by staying away from things that bother you.  The biggest thing that will make a difference in your life will be to continue to lose the extra weight.  That pretty much holds true for almost any condition.  Extra weight is just not that good for us.  

I know exactly how your husband feels about the elevated bed thing.  My wife was rolling all over the place when our bed was put up.   6" is about the max I think anyone could take.  Funny how sometimes you wake up at the foot of your bed.  

Hope the esoph is feeling better by now.  The endo itself can very much irratate the esoph.  It is actually more like a rope burn/bruise.  If your stomach can take it a little ibuprofen will help.  Remember that ibuprofen can also upset your stomach.  So maybe a 1/2 dose if you can tolerate.
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Avatar_f_tn
Hello.  Are you saying that you no longer sleep with your bed elevated?  

Well, I hadn't heard anything from my dr's office about the biopsy... so I called this morning and the nurse called me back and said it hadn't come in yet.  She said they usually take 3 to 5 days.  I had it done last Wed... seems like it would have been in by now.  I was feeling pretty confident about it since they hadn't called because I'd always heard that if the dr's office doesn't call right away with test results there's usually nothing to worry about, that they only call right away with something that's got an alert on it otherwise they don't get in any hurry.  Oh well, so much for that.  I'm just praying it comes back ok.

I guess you could say I'm better but still have some kind of pain down in there.  It's not as bad as it was, I don't feel it as much when I swallow food, but certain ways that I move my chest or shoulders around I can feel it, if I have a big/hard burp to come up I can sometimes feel it... I wonder if it may just be something muscular.  I've got to stop dwelling on it or I'm going to drive myself crazy.

Thanks for you post, I will post again as soon as I hear from them.  I'm kind of irritated it's taking so long.
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Avatar_m_tn
No I no longer sleep with the bed elevated, but I had surgery to fix my problems.  I have had bouts of GERD since my surgery, but nothing that does not clear up with a little attenion.  Eating right etc.

Don't worry about the biopsy. Your absolutely right in the fact that they do call right away if they want to run some additional testing or see something suspect.  You have more or less been put on warning by your body though.  Time to make some changes in lifestyle.  That is how I viewed it.  Mostly I started to eat properly and do some exercise.  Nothing radical, just walking everyday and getting veggies and fruits in diet.  It has helped.

I just reread your post.  Burping is something that really used to happen to me alot.  It is essentially your weakend lower esoph. sphinter (LES) valves inability to keep normal gas in your stomach.  The problem with burping is each time your burp you bring a tiny amount of stomach acid into your esoph.  This continues the irritation.  I know that it is sometimes impossible to not burp, but really try to not burp.  That was something I did and it helped.  It does not make your stomach feel all that great, but it helps with pain.  To alleviate gas pressure, when you drink fluids make sure your mouth is evacuated of air before your first swallow.  This is a major source of burping.  Basically swallowing air.  Also stay away from carbonated beverages.  Another major source.

You stay on the meds and things will start to feel better.  I know it sounds like a long time, (especially when you are suffering) but sometimes when I had bad bouts of GERD it took 3 plus months to start feeling better.  As boron stated, make sure that you do not have H pylori or anything else.  Just ask the docs and they will tell you or give you additional testing.
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Avatar_f_tn
Well, I finally got the results of my biopsy. Never heard of one taking a week and a half to come back... but anyway, the Dr himself called me which I appreciated. The biopsy was as he said "normal". So that really takes a load off my mind! He said again that there was a small area of inflammation and the hiatial hernia was small. He said for me to give the Prevacid more time. But he said short of trying a few of the other meds, surgery was all there was left for me. I really would like to avoid that.  So it's diet and exercise. The pain is so much better... I adjusted the times of when I took my prevacid (twice daily) and that seemed to make a big difference. Seems like if I take them less than an hour before I eat either breakfast or dinner that it doesn't work as well.  So that's the adjustment I'm saying that I made.  Plus I got some gaviscon and that works real well too. I know that if I can't get control of this reflux via weight reduction and staying away from the "trigger" food (although I reflux just about anything right now, even water) then one day the endoscopy & biopsy won't be as favorable. Thanks to everyone who replied to my post.
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