Throat and Esophageal Issues: Symptoms and Concerns

Throat and esophageal issues?

Hello Doctor, I have been experiencing a bitter and foul taste whenever I swallow saliva for the past week.
I also feel a sensation of something being stuck in my throat or at the esophageal opening.
Pressing on the left side of my throat near the esophagus causes pain, but I'm not sure if that is the exact source of the pain.
Sometimes, I feel a sharp pain in my throat, but I'm uncertain if it's coming from the throat or the esophagus.
Recently, my stomach has also been noticeably uncomfortable and feels tight, accompanied by frequent burping and stomach noises.

During a health check on September 3rd, it was noted that there were no significant abnormalities in the oropharynx or hypopharynx.
However, there was gastroesophageal reflux disease (GERD) at the esophagogastric junction, superficial gastritis (erythema in the gastric fundus), multiple gastric ulcers in the fundus, and scattered linear gastric erosions in the body and fundus.
There was also a mild hiatal hernia and duodenitis (erythema in the duodenal bulb).
The recommendation was to follow up in six months.
Currently, I am taking over-the-counter ulcer medication, Oxycodone, one tablet daily.

Doctor, could I possibly have a serious condition? Is there a need for another endoscopy? Given that my health check was only two months ago, can we rule out the possibility of a serious issue? Should I see an ENT specialist? Could the bitter and foul taste be related to kidney issues? (The health check only indicated slightly low glomerular filtration rate, with advice to avoid salty foods and excessive exertion, and to follow up next year.)
I am very worried about my health as I have a young child to care for, and I have been experiencing oral abnormalities for about ten months.
I only have an unusual sour and salty taste on the left side of my tongue, with a tingling sensation on the edge of my tongue, and the oral mucosa feels burning and painful.
Despite seeing various doctors, no definitive treatment or cause has been found, and it has been suggested that it might be a neurological issue.
Therefore, I have been very concerned about the oral abnormalities, fearing that it might be something serious.

Thank you for helping me analyze my situation.
Will my esophagus and stomach face major issues? Could this be affecting the bitter and foul taste when swallowing saliva? Thank you.

Miss Lin, 40~49 year old female. Ask Date: 2019/10/27

Dr. Chen Shidian reply Gastroenterology and Hepatology

First, try using gastric medication to observe the response.
You can then follow up with an otolaryngologist or gastroenterologist to rule out other issues, and pay attention to oral hygiene.

Reply Date: 2019/10/27

More Info

Dear Patient,
Thank you for sharing your concerns regarding your throat and esophageal issues. Based on your description, it seems you are experiencing a complex interplay of symptoms that may be related to both gastrointestinal and possibly psychological factors. Let’s break down your symptoms and concerns to provide a clearer understanding.

Symptoms Overview
1. Throat and Esophageal Discomfort: You mentioned a sensation of something being stuck in your throat, along with pain when pressing on the left side near the esophagus. This discomfort can often be associated with conditions like gastroesophageal reflux disease (GERD), which you have already been diagnosed with. GERD can cause inflammation and irritation in the esophagus, leading to pain and discomfort.

2. Taste and Odor Issues: The bitter and foul taste you experience when swallowing saliva could be attributed to acid reflux, where stomach acid backs up into the esophagus and even reaches the throat, causing a sour or bitter taste. This can also lead to a sensation of bad breath or an unpleasant taste in the mouth.

3. Gastric Symptoms: Your description of stomach discomfort, including bloating and gurgling sounds, aligns with your diagnosis of superficial gastritis and multiple gastric ulcers. These conditions can cause significant discomfort and may contribute to your overall symptoms.

4. Oral Symptoms: The burning sensation and unusual taste on the left side of your tongue could be linked to several factors, including nerve issues, oral thrush, or even side effects from medications. It’s essential to consider that anxiety and stress can exacerbate these sensations, leading to a heightened awareness of discomfort.

Potential Causes and Considerations
Given your medical history and current symptoms, it’s crucial to consider both physical and psychological factors:
- Gastroesophageal Reflux Disease (GERD): This condition can lead to chronic throat irritation, which may explain your symptoms of pain and discomfort. The reflux of stomach contents can also cause a bitter taste in the mouth.

- Anxiety and Stress: Psychological factors can significantly impact gastrointestinal health. Anxiety can lead to increased stomach acid production and exacerbate symptoms of GERD and gastritis. It can also heighten your perception of discomfort, making you more aware of sensations that might otherwise be negligible.

- Oral and Throat Health: Persistent oral symptoms, such as a burning sensation or unusual taste, warrant further investigation. Conditions like oral thrush, geographic tongue, or even vitamin deficiencies could be contributing factors.

Recommendations
1. Follow-Up with a Gastroenterologist: Given your history of gastric issues, it would be prudent to follow up with a gastroenterologist. They may recommend further testing, such as an upper endoscopy, to assess the state of your esophagus and stomach more thoroughly.

2. Consider Psychological Support: If anxiety is a significant factor in your symptoms, seeking support from a mental health professional could be beneficial. Cognitive-behavioral therapy (CBT) has been shown to help individuals manage anxiety and its physical manifestations.

3. Dietary Adjustments: Pay attention to your diet, avoiding foods that trigger reflux (such as spicy foods, caffeine, and alcohol). Eating smaller, more frequent meals may also help alleviate symptoms.

4. Hydration and Oral Care: Ensure you stay well-hydrated and maintain good oral hygiene. If your symptoms persist, consider consulting an ear, nose, and throat (ENT) specialist to rule out any underlying conditions affecting your throat.

5. Regular Monitoring: Since you have a family history and personal concerns about your health, regular check-ups and monitoring of your kidney function and overall health are essential.

Conclusion
Your symptoms are multifaceted and may stem from a combination of gastrointestinal issues and psychological factors. It’s essential to approach your health holistically, addressing both physical and mental health aspects. Please consult with your healthcare providers to develop a comprehensive treatment plan tailored to your needs.
Wishing you good health and peace of mind as you navigate these challenges.

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