Feeling of Throat Obstruction and Increased Burping After Meals: GERD Concerns?

Sensation of a foreign body in the throat, increased frequency of belching after meals, and slight stomach pain when fasting?

Hello Doctor: On the evening of the 30th of last month, I ate fish, and after finishing, I felt a sensation of a foreign body in my throat, although it was not painful.
I initially thought it was a fish bone, but after visiting both an ENT clinic and a hospital for examinations (laryngoscopy), the doctors found no fish bone and only noted mild throat irritation and increased phlegm.
However, the sensation of a foreign body in my throat has not disappeared.
In the past few days, I have experienced increased burping, occasional stomach pain when fasting, slight dizziness, and yesterday (September 5th), I had intermittent chest pain.
Could this be related to gastroesophageal reflux?

Niming, 20~29 year old female. Ask Date: 2017/09/06

Dr. Chen Qifeng reply Gastroenterology and Hepatology

In principle, gastroesophageal reflux should not occur suddenly; it is suspected to still be related to the fishbone injury, although it does not necessarily have to be lodged in the throat.

Reply Date: 2017/09/06

More Info

It sounds like you're experiencing a complex set of symptoms that may indeed be related to gastroesophageal reflux disease (GERD) or other gastrointestinal issues. The sensation of a foreign body in the throat, increased burping, and occasional stomach pain can all be indicative of GERD, which occurs when stomach acid frequently flows back into the esophagus, leading to irritation and discomfort.

Understanding Your Symptoms
1. Throat Obstruction Sensation: The feeling of something stuck in your throat can be caused by several factors. In GERD, the acid can irritate the lining of the esophagus and throat, leading to inflammation and a sensation of tightness or obstruction. This can also be exacerbated by anxiety or stress, which can heighten your awareness of bodily sensations.

2. Increased Burping: Frequent burping can be a symptom of GERD, as the reflux of stomach contents can lead to increased air swallowing (aerophagia) or the buildup of gas in the stomach. This can also occur due to dietary choices, such as consuming carbonated beverages or certain foods that may cause gas.

3. Stomach Pain: Occasional stomach pain, especially when empty, can be a sign of gastric irritation or gastritis, which can occur alongside GERD. The pain may also be related to the esophagus being irritated by acid reflux.

4. Chest Pain: The chest pain you mentioned could be related to esophageal spasms, which can occur in response to acid irritation. However, it is crucial to differentiate between esophageal pain and cardiac-related chest pain, especially if it is new or severe.

Recommendations
1. Dietary Modifications: Consider keeping a food diary to identify any specific triggers that may worsen your symptoms. Common culprits include spicy foods, fatty foods, chocolate, caffeine, and alcohol. Eating smaller, more frequent meals rather than large meals can also help reduce symptoms.

2. Lifestyle Changes: Elevating the head of your bed, avoiding lying down immediately after eating, and maintaining a healthy weight can help manage GERD symptoms. Additionally, practicing relaxation techniques may help reduce anxiety, which can exacerbate the sensation of throat tightness.

3. Medications: Over-the-counter antacids or proton pump inhibitors (PPIs) can help reduce stomach acid and alleviate symptoms. However, it is essential to consult with a healthcare provider before starting any new medication, especially if you have ongoing symptoms.

4. Follow-Up Care: Since you have already consulted with an ENT specialist and had a laryngoscopy, it may be beneficial to follow up with a gastroenterologist. They can perform further evaluations, such as an upper endoscopy or pH monitoring, to assess for GERD or other gastrointestinal disorders.

5. Monitor Symptoms: Keep track of your symptoms, including their frequency and severity. If you experience worsening symptoms, such as severe chest pain, difficulty swallowing, or unintentional weight loss, seek medical attention promptly.

Conclusion
Your symptoms could be related to GERD, but a thorough evaluation by a gastroenterologist is essential for an accurate diagnosis and appropriate management. By making dietary and lifestyle changes, considering medication, and closely monitoring your symptoms, you can work towards alleviating your discomfort and improving your quality of life. Remember, it’s important to communicate openly with your healthcare providers about your symptoms and concerns to ensure you receive the best care possible.

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