Dr. Eisner Answers Your Questions
For the last 3 months I have been struggling with the feeling of a thick sore throat, clearing my throat, pressure at the base of my throat and in my chest, burping, every once in awhile the impression after I swallow of bubbles coming up and occasionally feeling like I have a hard time swallowing especially liquids and soft foods. I did the swallowing barium tests which showed only a slight liquid drop towards my esophagus. The gastroenterologist thought my swallowing muscles were moving a bit slow for a 50 year old woman so I was sent to a neurologist who tested me for MS and MGravis both negative. I was then sent to an ENT doctor who said my upper throat looked good and was tested for allergy and autoimmune, both negative. He suggested I might have acid reflux. When this first all started, I used Mylanta for a couple weeks then took Zantac for three days, which made me feel worse so I stopped that. The ENT suggested trying Prilosec. I tried that two days and felt pressure! in my head, upset stomach and difficulty focusing mentally so I stopped taking it. I'm waiting to hear back from my gastroenterologist on what to try next. I have raised my bed, am watching my diet. I exercise regularly and am small in build. Do you have any suggestions for me? I am at a loss....
These symptoms, while non-specific, need further evaluation by a certified physician. Acid reflux disease is a possibility, but motility disorders of the esophagus need to be considered as well, and a final diagnosis can only be established by the treating physician. Another option, despite a negative barium study, would be an upper GI endoscopy which looks for esophagitis. If there is no evidence of acid reflux on endoscopy, then another possible step would be 24 hour esophageal pH monitoring. The purpose of that test would be to see if the non-specific symptoms are related to acid in the esophagus. This would involve placing a pH probe via the nose and leaving it at the end of the esophagus for 24 hours. At that time, the pH is measured, and would determine the presence of acid in the esophagus. If that was negative, other disorders of the esophagus can be ruled out by measuring pressures in the esophagus by a similar technique. Changes in pressures in the esophagus can represent motility disorders of the esophagus. A gastroenterologist can best arrange all of these studies to confirm a final diagnosis.
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Published On: September 13, 2006