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Avatar universal

constant belching...gerd causing aerophagia?

In early March, I started to get really nauseous after eating food.  Then about 2 weeks later, in addition to the nausea, I started producing gurgling-sounding belches which I feel in my chest and throat.  This belching would occur for hours after I ate anything.  I would "belch" every few seconds and it continued for several days, at which point I went to see a doctor.  The doc thought it was due to GERD (even though I hadn't had frequent heartburn) and gave me prilosec.  After using it for 2 weeks, my symptoms hadn't improved, so I had blood tests and stool tests done; the blood tests showed elevated bilirubin but otherwise normal (doc thought it was Gilbert's), and stool was normal.  Then I got referred to a gastroenterologist.  Took Aciphex for 2 weeks, also with no effect on the belching.  I also began to feel pain in my chest a lot and felt some difficulty breathing.  
I had an upper GI done then and it showed no stricture or hiatal hernia, but showed moderate reflux.  
Then he put me on Reglan (5 mg doses) and I got off Aciphex.  Reglan originally helped a bit but got less effective.  After about 2 weeks, the belches started to cause a burning in my throat.  In addition, Reglan caused very painful dry mouth so I stopped using it.
In early May, I went home to see my family doctor.  Then, I got on Protonix and reduced Reglan to 2x/day at most.  Like with Prilosec and Aciphex, I didn't have any heartburn but I still had constant belching, nausea, and feeling of chest tightness.  I don't think the chest tightness is a cardiac problem; I'm 21 years old, non-smoker, 150 lb, plus I had an EKG (normal).  I went to see another GI doc and had several more tests done:

Endoscopy - showed mild inflammation around lower esophagus and in stomach, biopsies were negative.  I'm surprised there was any inflammation because I didn't have any heartburn.
Stomach emptying scan - 86 minute halftime (doc said under 90 min was normal)
Chest x-ray and CT scan of chest and upper abdomen - normal
Esophageal manometry (results aren't in yet)

The belching/chest tightness now occurs all the time.  I belch well over 1000 times a day, even though I eat very little.  The only way to make it stop is to lie down.  The specialist said that since PPIs and Reglan haven't done very much I should consider having stomach surgery to fix it.  I went to get a second opinion and the doc noticed that a large amount of air was going through my esophagus when I breathe (not swallowing!), he said that's the only way I could be belching to such an extent.  Belching doesn't stop even when I breathe through my nose or clench a pencil between my teeth, techniques to control aerophagia.  I'm literally inhaling air into my stomach when I breathe and constantly belching it and I don't know how!  So frustrating!  Why? Does this mean both sphincters are busted?  Would a fundoplication help or would I likely have gas-bloat?  And would stretta or enteryx be effective/safer to try? Advice?
58 Responses
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You have had a pretty comprehensive evaluation for your symptoms.  The other test I would consider would be a 24-hr pH study to document the severity of the reflux.  If there continues to be reflux despite appropriate medications, then surgery can be pursued stronger.  Regarding the stretta or enteryx procedure, that would be dependent on the severity of the reflux as well as the skill of your physician.  The data regarding these procedures are still emerging, and the long-term efficacy has not yet been established.

Another consideration would be irritable bowel syndrome - which can cause the sensation of increased bloating.  If the 24-hr pH study is non-revealing, you can consider optimizing treatment for IBS - such as antispasmodic agents.

These considerations 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.
Avatar universal
i had a fundiplication for gerd and had gas bloating for a couple of years - was painful for a couple of months - gas working it's was DOWN and out. Eventuially the LES slackened up enoughto allow belching UP - a great relief. I had to learnt to chew very throuroughly and try not to swallow gas - but things are back to normal now. I would be sure to check out all the risks and side effects of the op before going ahead.
Avatar universal
So sorry to hear of your problems.  I think I can only be empathetic towards you, regarding the lack of the medical professionals to diagnose, and therefore be able to treat you.  

Six weeks ago, I myself have been experiencing trouble in my GI, starting in my throat, where I found it difficult to breath, like I would choke if I tried to eat anything.  I went to an internal medicine MD and he asked me what I went to him for, and have I seen a GI?  He didn't understand anything about not being able to swallow, and difficulty breathing.  All he did was accuse me of being confusing and not telling him what was the matter.

I had an endoscopy as well, which showed nothing.  Still, I couldn't eat.  So I continued losing more weight.  Everything else was fine-blood pressure/pulse, because I am ordinarily a strong, healthy person.  I dropped 30lbs in 1.5 months.  I was only 160lbs before, so I lost 30lbs of valuable, healthy muscle/body weight.  

Another GI looked at my tests and said, "The tests show nothing abnormal, so what's the matter?"  What a jerk!  That's why I am paying him $400, and I only got 4 minutes with him, before he just said I need more tests.

Now I'm having abdominal pain, yellowing of hands, tingling, which is coming from my losing weight, and not from the original problem.

So, now I have these other issues that have resulted from where  the doctors couldn't find original problem.

Modern medicine, even with all it's advancements, is still run by imperfect, not omniscient people, who most of the time can only treat what they see, and are poor investigators.

I'm just sitting here waiting for a gallbladder attack, or something worse, so the ambulance can get me in the hospital and someone will take seriously what I have been trying to tell them-that something isn't right in me!  

Good luck and God bless you.
Avatar universal
have you been tested for hector pylori bacteria??
you can get a simple breath test in doc office these days.
symptoms for too much acid and too little acid are similar,one happens right after you eat(not enough) and one happens 2 hours after you eat.

Avatar universal
I'm pretty sure that the endoscopy biopsy checked for H pylori, which came up negative.  I haven't done a breath test, but I have tried health foods such as P73 oregano which are effective against many infections including h pylori.
Avatar universal
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