Belching and Nausea

[Trimbaud]

For a couple of years now, I have had a pretty severe problem with belching. I belch all the time, it seems - except when I sleep. The belching can cause pain below my sternum. Often (maybe twice a month)the pain caused by the belching is so severe that I vomit. I don't feel nauseuous - the chest hurts, i get a lot of saliva, and I vomit for a while.
I don't know what other info is relevant, so here is everything I can think of.
I don't get symptoms of heartburn. I don't get any acidy taste in the back of my throat - the things that seem to be associated with GERD.
I had a run of tests 1 1/2 yrs ago - ultrasounds, colonoscopy, endoscopy - all negative (stomach cancer is in the family).
I had an upper GI last week which showed a hiatal hernia. Obviously there is some connecton here, but I'm worried about just attributing it to that. The symptoms I see re: hiatal hernia don't really include mine. If it IS the hernia - great. I just don't want my doc to take the easy evaluation and not fix the problem.
The pain and belching is worse when I exert myself - and lessens when I rest. I noted a somewhat similar post where the forum doctor stated that was highly suspicious for cardiac disease - should I be checked for that, too?
My blood pressure is pre-hypertension -syst 150's to 160's, diast high 80's to 90's. This was just noticed about a month ago - I am on Diovan 160 mg (started at 80). I have been getting moderate dizzy spells for months - maybe b/c of the bp.
I cracked my sternum a few years ago in a car accident - I think it was a hairline crack. The accident was a few years before the onset of the belching.
I am 39, in fairly good shape - a little overweight.
Like I said, I don't know if all of these pieces are relevant to my gastro problem - I just wanted to give all the info I had.
What do you think my problem could be? What are the things my doctor should have me check out? What can I do?!

Thanks,

[dmj999]

Hi
I had the exact same symptons. Constant belching especially after exertion, couln't mow the lawn without resting to allow the belching to subside. ( no nausa though) I also was diaganosed with a hiatus hernia, I had elevated blood pressure (150/90) and took atenol fo a couple of years. I didn't follow up with my doctor and took the 1/2 dose atenol until the presription ran out, about two years. Still belching for over a year and really uncomfortable after exertion and lots of sticky saliva when exerting. I associated it with the hernia and tried to live with it.
5 months ago went to the dentist for a wisdom tooh extraction and they took my bp. He said get to the hospital or your doctor immediatley. 220/150.  GP started me on additional bp pills to get bp down. It is now a 150/90 and THE BELCHING, STICKY SALIVA AND DISCOMFORT DISAPPEARED ALMOST IMMEDIATELY.

Not saying it's your bp but I am convinced my symptons were bp related and tha my bp was sky high for almost two years. You may be reacting to the higher bp.

[krisg]

No, my original post is no longer here.  I have many comments under "Severe stomach cramps for 5 years with no diagnoses". You can check them out towards the bottom of the page of posts.  Good luck with your problem.  If you have any more questions feel free to ask away.....

[Trimbaud]

just from that, it sounds similar. is your original post still on here?

[krisg]

The MRI of the biliary tree is another name for the MRCP.  It is simple and checks for any blockages in the bile duct area, such as stones, etc.  When I first had my "attacks",  I had extreme chest (sturnum area) pain and alot of belching.  Then I would vomit and feel better for alittle while until the pain hit again.  It came in waves and lasted for a couple of hours.  Thought this might be a possibility for the source of your pain.

[Trimbaud]

no - i've never even heard of that one!

[krisg]

Have you had an MRI of the biliary tree to make sure there are no blockages??

[Trimbaud]

they may have when the first series of tests were run a year and a half ago. not recently - although there was a barium upper gi, where they identified the hiatal hernia.

[yoshi]

did you take any xray??

[Trimbaud]

I thought I posted everything - I should add, the problem does not seem to be related to what or when I eat. Thanks.

[Kevin Pho, MD]

You note a normal upper endoscopy, colonoscopy and ultrasound.  With the symptoms worsening on exertion and better on rest, I would suggest a cardiac evaluation first - some kind of exercise stress test would be reasonable.  If negative, you can consider further GI evaluation of the belching.

This would include a 24-hr pH study to definitively exclude the possibility of GERD, as well as tests for malabsorption (i.e. a blood test for celiac disease).  

If these tests are negative, you may want to consider irritable bowel disease - this can certainly give you increased sensitivity to intestinal gas.  Discussion about the possibility of increased fiber intake or antispasmodic agents should be discussed.  

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.

Thanks,
Kevin, M.D.