Around June 2010 I developed LPR symptoms but no heartburn or stomach complaints. I had recently increased daily dosage of the benzodiazepine clonazepam to 1.5 mg from 1 mg. I had sore throat and chronic cough. After about 4 days of 40mg prilosec these symptoms evaporated. The symptoms always returned unless I maintained a 20mg dose of prilosec daily. I eventually learned on my own that benzos can relax the LES and UES, contributing to reflux, especially at night. I began slowly tapering off the klonopin. Shortly after completing a four month taper I developed chest pains, bloating, and burping frequently, all pointing to GERD. However, upping my dosage of prilosec made my symptoms worse if anything. H2 blockers, tums, and gaviscon also provide zero notiecable relief. I considered the possibility that I was suffering benzodiazepine withdrawal symptoms but taking klonopin again also provided no relief (not taking it presently). An endoscopy showed retained food after 12 hours suggesting gastroparesis, but doctor eventually dismissed this as stress-induced. My stomach appeared to work normally during a small barium swallow (which showed only a small amount of reflux). There was no evidence of stomach or esophegeal damage after repeat endoscopy with no retained food that time. CT scan of abdomen and abdominal ultrasound also normal. I am scheduled for SmartPill motility study and 24hr PH study with a new doctor next month.
The bloating symptoms get better from taking a prokinetic such as Reglan, suggesting gastroparesis is the correct diagnosis. But the chest pain is still present, and PPIs/H2 blocker/antacids still can't touch it. The chest pain is also not correlated with lying down or eating schedules; it can happen on an empty stomach, full stomach, etc. It can be continuous for days. I have experimented with eating GERD-unfriendly foods to see if that triggers it or makes it worse, and it does not, at least not in an acute way. Could this stlll be GERD? I basically never had heartburn before this started 9 months ago, but it feels like what others describe--burning sensation under the sternum. It is not aggravated by exercise, but I have not had any cardiac testing. Also, the LPR symptoms no longer resurface when I go off acid suppressors.