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Burping, Heartburn with Anxiety and Irregular food habits

Male 34 years.

Have a history of burping after food and when I am hungry. This usually happens more frequently when I am irregular with my food.
Also have a history of anxiety. Used to have diarrohea when I get up before every important event in life (Like exams, important meetings, etc).
This is not continuous. Happens may be 1-2 times a year -- but very predictable based on anxiety levels.
Mild heartburns once every 2 years or so. Have had severe pain in the chest once (about 5 years back) which was relieved immediately by Eno
(Sodium bicarbonate + citric acid).

Since last five months, because of a job change and family issues I had severe anxiety that was very long lasting. My food habits become
irregular mainly because of the job change (Often taking breakfast at 11, lunch at 4PM, etc). I also now get up earlier than usual
(get only about 5.5 to six hours of sleep). I also lost about 7 pounds in six months.

Since last 2 weeks, when I got up, I am very hungry and burp many times. This burping also continued all through the day with a feeling of "gas"
in stomach. Visited a primary doctor. (I was visiting him for the first time because I moved to new area. He didn't ask me about my history of
anxiety and diet changes and at that time and I didn't feel it was important enough to tell him) He put me on Omeprazole 20 mg once a day.
Blood work all came negative. H. Pylori -ve. After around 15 days on Omeprazole now, the burping has definitely reduced (only just before food and immediately after), but now I feel a lump in
my throat sometimes, followed by a mild burning sensation in chest (highest when hungry). I also have a cough when I talk. I have
since then become regular with food habits (same time every day, dinner 2.5 hours before bed time, etc.) -- But this has not helped. I also once felt a slight pain in the
pelvic area couple of days back (for about 1 hr, which stopped). When I talked to my PCP after 10 days of Omeprazole, he suggested getting
an appointment with Gastroentologist for an endoscopy. When I asked him if a higher dosage of drugs can help, he made a prescription for 20 mg
Omeprazole twice daily (I weigh 105 pounds now. 5 feet 3 in) I haven't increased increased my drug though.

Current symptoms are mild buring sensation in chest when hungry.

What is the diagnosis here? Is it GERD? or Irritable Bowel Syndrome? I heard that GERD patients feel worse after food (which is not happening in my case)
Please let me know if more info is needed. Is 40mg/day of omeprazole needed (given my weight and conditions)? I currently take one 20 mg tablet right
when I get up with food 2 hours later. What is the right time to take
the second dose of the day?

Also, I will be moving back to my old city again in 2 months. Can a visit to Gastroentologist wait for 2 months?
1 Responses
Avatar universal
Welcome to the gastroenterology community!  Yes this could be GERD or IBS.  They can both be made worse by anxiety.  What have you done to try and treat the anxiety?

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