Esophageal Tightness and Digestive Issues After Medication

Esophageal stricture and gastric distension issues?

Hello Doctor: Recently, I experienced significant side effects from medication, leading to a week of severe nausea, during which I couldn't eat and lost about 5 kilograms.
The medication has been stopped, and while the nausea has lessened, I now feel a constant tightness in my esophagus, which is very uncomfortable.
I even experience this sensation 3 to 4 times a day, feeling hot and dry with pain that sometimes radiates to my ears.
Occasionally, I feel like there is water in my esophagus, but it disappears after a while (usually occurring about an hour after eating and lasting for some time).
I constantly produce saliva and have episodes of burping.
Sometimes, I feel like there is air trapped in my throat, which is also uncomfortable.
I experience a feeling of fullness after eating, slow digestion, occasional chest tightness, and a sensation of shortness of breath.
Could this be due to the frequent vomiting I experienced earlier, which may have affected my stomach? It feels somewhat like gastroesophageal reflux, but I do not have symptoms of acid reflux or heartburn.
These symptoms have persisted for three weeks.
I have avoided sweet, sour, and spicy foods, and I go to bed by 11 PM, but there has been no noticeable improvement, and it is severely affecting my daily life.
I would like to know what these symptoms might indicate.

Lisa, 20~29 year old female. Ask Date: 2019/03/10

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Typical symptoms of gastroesophageal reflux disease (GERD) and gastritis.
Please visit a gastroenterologist.

Reply Date: 2019/03/10

More Info

It sounds like you are experiencing a complex set of symptoms following a period of medication use that caused significant side effects, including nausea and vomiting. The symptoms you describe—esophageal tightness, discomfort after eating, excessive salivation, and a sensation of fullness—can indeed be distressing and may be related to several underlying issues.

Firstly, the tightness in your esophagus and the sensation of food being stuck can be indicative of esophageal motility disorders. These disorders can occur when the muscles of the esophagus do not contract properly, which can lead to difficulty swallowing (dysphagia) and a feeling of tightness. This can be exacerbated by anxiety or stress, which often accompanies gastrointestinal issues. The fact that you are experiencing these symptoms after a period of vomiting suggests that your esophagus may have been irritated or inflamed, potentially leading to a condition known as esophagitis.

Additionally, the sensation of heat and pain in the esophagus, along with the feeling of pressure in your chest, could suggest gastroesophageal reflux disease (GERD), even in the absence of classic symptoms like heartburn or acid regurgitation. GERD can cause a variety of symptoms, including chest discomfort and a feeling of fullness, especially after meals. The fact that you are experiencing these symptoms after eating may indicate that your stomach is struggling to process food efficiently, possibly due to delayed gastric emptying (gastroparesis), which can occur after prolonged vomiting or as a side effect of certain medications.

The excessive salivation and the sensation of having air trapped in your throat could also be linked to anxiety, which is common in individuals dealing with chronic gastrointestinal symptoms. Stress can exacerbate digestive issues and create a feedback loop where anxiety leads to more symptoms, which in turn increases anxiety.

Given that these symptoms have persisted for three weeks and are significantly impacting your quality of life, it is crucial to seek further medical evaluation. A gastroenterologist may recommend diagnostic tests such as an esophageal motility study or an upper endoscopy to assess the condition of your esophagus and stomach. These tests can help identify any structural or functional abnormalities that may be contributing to your symptoms.

In the meantime, there are several strategies you can employ to help manage your symptoms. Eating smaller, more frequent meals rather than large ones can help reduce the feeling of fullness and discomfort. Additionally, avoiding foods and beverages that are known to trigger symptoms—such as spicy, acidic, or very sweet foods—may provide some relief. Staying upright for at least an hour after eating can also help minimize reflux symptoms.

Lastly, consider discussing your symptoms with a mental health professional, especially if anxiety is a significant factor in your experience. Cognitive-behavioral therapy (CBT) and other therapeutic approaches can be beneficial in managing the psychological aspects of chronic gastrointestinal issues.

In summary, your symptoms may be related to esophageal motility issues, possible reflux, or anxiety. A thorough evaluation by a healthcare professional is essential to determine the underlying cause and appropriate treatment plan.

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