Unusual Sensation in the Esophagus: GERD Symptoms - Gastroenterology and Hepatology

Dysphagia or abnormal sensation in the esophagus?

Hello Doctor: I recently underwent an esophagogastroduodenoscopy (EGD) due to gastroesophageal reflux disease (GERD).
The outpatient physician informed me that the results of the endoscopy showed that the esophagus, stomach, and duodenum were all normal, indicating non-erosive gastroesophageal reflux.
My current concern is that when I eat, I experience a strange sensation in my back (corresponding to the area around the cardia) as food passes through the esophagus.
There is no difficulty swallowing and no pain; it just feels like the food is sliding through.
This sensation mostly occurs during the first half of eating, such as during the first few bites, and is less frequent in the latter half.
Additionally, it becomes more pronounced when my gastroesophageal reflux is severe (for example, when I have multiple episodes of acid reflux that day) and alleviates or even does not occur when it is mild (especially during breakfast, where it rarely happens).
I would like to ask the doctor: 1.
Could this be due to acid damage to the cardia or esophagus? Is it possible that the damage is so minor that it is not visible during the endoscopy? 2.
If I am on medication for treatment, how long might it take for the aforementioned strange sensation to improve? Thank you for your response.

Xiao Zhang, 40~49 year old female. Ask Date: 2019/03/26

Dr. Chen Shidian reply Gastroenterology and Hepatology

It may be related to gastroesophageal reflux, but it should not be a cause for concern.
You can start with medication treatment for a while and then see if your symptoms improve.
The Chiayi Hospital of the Ministry of Health and Welfare cares about you!

Reply Date: 2019/03/26

More Info

The unusual sensation you are experiencing in your esophagus, particularly during the early stages of eating, can indeed be related to gastroesophageal reflux disease (GERD). GERD is characterized by the backward flow of stomach contents, including acid, into the esophagus, which can lead to various symptoms, including the sensation of food moving through the esophagus.
1. Potential Causes of the Sensation: The sensation you describe, where food feels like it is sliding down your esophagus, may not necessarily be due to visible damage to the esophagus or the gastroesophageal junction (the area where the esophagus meets the stomach). While your endoscopy results indicated that everything appeared normal, it is possible that there is minor irritation or inflammation that is not easily detectable. This could be due to acid exposure, which may not cause significant erosive damage but can still lead to discomfort or unusual sensations. The esophagus is sensitive to changes in its environment, and even minor irritation can lead to heightened awareness of sensations during swallowing.

2. Duration of Symptoms with Treatment: The duration for which these unusual sensations persist can vary significantly among individuals. With appropriate treatment, particularly with proton pump inhibitors (PPIs) that reduce stomach acid production, many patients experience improvement in their symptoms within a few weeks. However, complete resolution of sensations may take longer, especially if there is underlying sensitivity or functional issues in the esophagus. It is important to continue your prescribed medication and follow up with your healthcare provider to monitor your progress. If symptoms persist despite treatment, further evaluation may be necessary to rule out other conditions, such as esophageal motility disorders or hypersensitivity.

In addition to medication, lifestyle modifications can also play a crucial role in managing GERD symptoms. These may include:
- Dietary Changes: Avoiding foods and beverages that trigger your symptoms, such as spicy foods, citrus, chocolate, caffeine, and alcohol.

- Eating Habits: Eating smaller, more frequent meals rather than large meals, and avoiding eating close to bedtime.

- Posture: Staying upright for at least 2-3 hours after eating to help prevent reflux.

- Weight Management: If applicable, losing weight can significantly reduce GERD symptoms.

If you continue to experience discomfort or unusual sensations, it may be beneficial to consult with a gastroenterologist who can provide further insights and potentially recommend additional diagnostic tests, such as esophageal manometry or pH monitoring, to assess esophageal function and acid exposure more thoroughly.

In summary, while your symptoms may be related to GERD and minor irritation, they can often improve with appropriate treatment and lifestyle adjustments. It is essential to maintain open communication with your healthcare provider to ensure that your treatment plan is effective and to address any ongoing concerns you may have.

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