Esophageal Issues: GERD, Symptoms, and Follow-Up Care

Q: Esophageal Issues: GERD, Symptoms, and Follow-Up Care

Hello： 1. There is a possibility of recurrence; it is recommended to quit smoking, alcohol, and tea/coffee. 2. Based on clinical symptoms, regular follow-up is not necessary. Changhua Hospital cares about your health. Dr. Tsai An-shun.

Esophageal issues

Hello Doctor: I had an upper gastrointestinal endoscopy a year ago, which revealed a small polyp in my stomach, ulcers in my esophagus and duodenum, and gastroesophageal reflux disease (GERD).
The doctor prescribed a 4-month course of omeprazole, which I completed on schedule, and my condition improved.
The polyp was removed and tested benign, and there was no Helicobacter pylori infection.
Recently, after meals, I have been experiencing gastric discomfort and nausea.
Swallowing is not an issue, but after a while, when I drink water, I feel as if it is lingering in my esophagus, causing a sensation of a foreign body.
I also have a smoking habit.
I would like to ask: 1.
Is this a recurrence of gastroesophageal reflux disease? 2.
How often should I have an endoscopy? 3.
What could be the underlying condition?

kum, 30~39 year old female. Ask Date: 2018/12/06

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
There is a possibility of recurrence; it is recommended to quit smoking, alcohol, and tea/coffee.
2.
Based on clinical symptoms, regular follow-up is not necessary.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2018/12/06

More Info

Understanding esophageal issues, particularly gastroesophageal reflux disease (GERD), is crucial for managing symptoms and ensuring proper follow-up care. Based on your previous medical history and current symptoms, let's address your concerns systematically.

1. Is this a recurrence of GERD?
Your symptoms of post-meal discomfort, nausea, and the sensation of food or liquid lingering in the esophagus could indeed suggest a recurrence of GERD. GERD is characterized by the backward flow of stomach contents into the esophagus, leading to symptoms such as heartburn, regurgitation, and sometimes nausea. The sensation of food or liquid feeling stuck can also be related to esophageal motility issues, which can occur in conjunction with GERD. Given your history of esophageal ulcers and the recent removal of a polyp, it is essential to monitor these symptoms closely. If they persist or worsen, it would be prudent to consult your healthcare provider for further evaluation.

2. How often should you have an endoscopy?
The frequency of endoscopic examinations can vary based on individual risk factors and previous findings. Generally, if you have a history of GERD with complications (like esophageal ulcers), it is recommended to have an endoscopy every 1 to 3 years. However, since you have experienced new symptoms, it may be advisable to have an endoscopy sooner, perhaps within the next few months, to assess the current state of your esophagus and stomach. Your healthcare provider will consider your symptoms, the severity of your GERD, and any other risk factors when determining the appropriate timing for your next endoscopy.

3. What could be causing your current symptoms?
Several factors could contribute to your current symptoms. First, the recurrence of GERD is a likely culprit, especially if you have not made significant lifestyle changes or if your medication regimen has not been optimized. Additionally, the sensation of food or liquid feeling stuck could indicate esophageal motility disorders, which can occur in patients with chronic GERD. Other potential causes include:
- Esophageal Stricture: Chronic inflammation from GERD can lead to scarring and narrowing of the esophagus, causing difficulty in swallowing.

- Eosinophilic Esophagitis: This is an allergic condition that can cause similar symptoms and may require specific dietary changes or medications.

- Esophageal Spasm: This can cause intermittent chest pain and swallowing difficulties.

- Medication Side Effects: If you are taking other medications, they may contribute to gastrointestinal symptoms.

Given your smoking habit, it's also important to consider that smoking can exacerbate GERD symptoms and impair healing in the esophagus. Quitting smoking can significantly improve your symptoms and overall gastrointestinal health.

In summary, your current symptoms may indicate a recurrence of GERD, and it would be wise to consult with your healthcare provider for a thorough evaluation. Regular follow-up with endoscopies is essential, especially given your history, and addressing lifestyle factors, including smoking cessation, can greatly enhance your management of GERD. Always communicate openly with your healthcare provider about any new or worsening symptoms to ensure timely and appropriate care.

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