constant belching...gerd causing aerophagia?

[wassupwassabi]

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?

[wassupwassabi]

Yeah, food comes up for me too... taking Reglan helps a "small" amount with the regurgitation but not significantly.  Although I've heard it's worked well for other people, you might ask your doc about Reglan.

[reader23]

For me, this just started last evening.  We were out to dinner and after having a roll, I started coughing.  I thought perhaps something might have gone down the wrong way.  Once we got home, I started belching but everytime I belched, some of the food would come up as if I was throwing up.

I woke up this morning and my throat felt awful.  I belched and instead of food coming up, I had heartburn.  I took two Rolaids.  Then I ate a bagel for breakfast and now I'm belching again and the bagel is coming up with each belch.  I have to work today and I can't imagine what I'm going to do all day as I belch and have food in my mouth that I will immediately have to spit out.

Please help if anyone has ever had this part of it.

[Kees]

In my case for 7 years I

[bizzy]

Most people in this discussion seem to be on some proton blocker (Prevacid, Nexium, etc).  One thing that appears to be effective is to take the pill first thing in the morning and then wait for at least an hour before you eat anything. I used to cut corners and only wait 15 or 30 min but I think giving it a chance to work without diluting it by food really helps.

Let me know if you try this and it work- as it appears we all have to work out our own treatment plan for this annoyance.

[burpmaestro]

Well, this is certainly interesting.  Sorry to hear you are all suffering from the same or similar thing I have been for about 4 years now but it's nice to know I'm not alone.  In my case, endoscopic exam showed evidence of hiatal hernia and mild acid reflux damage.  Doctor prescribed Prevacid but the problem isn't that I have an acid problem and I have since had my gall bladder removed as testing showed it to be 90% clogged - no help though.  My condition began with pain and fullness followed by a belching fit a couple of hours after meals and has deteriorated over the last four years to extreme muscle spasm on the left side of my chest [you'd swear you're having a heart attack!] and I can literally belch for hours now.  This appears to be some sort of diaphramatic spasm that results in literally inhaling air into my stomach.  I'm wondering if the catalyst wasn't the hiatal hernia in my case.  It is aggravated by carbs and starches - not so much by veggies and meats.  Sad thing is that I use to swim a mile Tues/Thur and lift weights Mon/Wed/Fri but I had to give it all up because upper body exertion aggravates the **** out of this bizarre condition too.  At times it gets so severe that I develop a really bad case of malaise.  I'm considering seeking out a laproscopic hiatus surgeon at this point.

[maestro]

tears are swelling up in my eyes.  i thought that i was the one person who was experiencing the belching drama.  i am in my 6 years of trying to determine what is going on with me.  i've tried it all (diet, meds, chiropractor, meditation, accupunture), so I am waiting in my belching mode for relief that I am hoping will come from this forum.