Is It GERD? Symptoms and When to Get Tested - Gastroenterology and Hepatology

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Gastroesophageal reflux disease (GERD) is a chronic condition where stomach acid or, occasionally, stomach content flows back into the esophagus, leading to symptoms that can significantly affect quality of life. Your symptoms of frequent belching and the sensation of liquid rising in your throat are indeed consistent with GERD, even if you do not experience heartburn frequently.
The fact that you have had a 24-hour Holter monitor (ECG) that showed no issues with your heart is a positive sign, as it helps rule out cardiac causes for your palpitations. However, it is essential to consider that GERD can sometimes mimic or exacerbate heart-related symptoms, which is why it is crucial to differentiate between the two.

Your previous endoscopy (gastroscopy) two years ago showed normal results, which is reassuring. However, GERD can develop or worsen over time, and symptoms can change. The presence of symptoms like persistent belching and the sensation of acid in your throat suggests that you may be experiencing reflux. In many cases, patients with GERD do not have visible esophageal damage during endoscopy, which is referred to as "non-erosive reflux disease" (NERD).
Here are some points to consider regarding your situation:
1. Symptoms of GERD: Common symptoms include regurgitation (the sensation of acid backing up into your throat or mouth), difficulty swallowing, chronic cough, laryngitis, and the feeling of a lump in the throat. Your experience of belching and the sensation of liquid in your throat aligns with these symptoms.

2. When to Seek Further Testing: If your symptoms have persisted or worsened since your last endoscopy, it may be prudent to undergo another evaluation. An upper endoscopy can help assess the esophagus for any inflammation, strictures, or Barrett's esophagus, a condition that can arise from chronic GERD.
3. Lifestyle Modifications: In addition to medical evaluation, consider lifestyle changes that can help manage GERD symptoms. These include avoiding trigger foods (such as spicy foods, caffeine, and chocolate), eating smaller meals, not lying down immediately after eating, and elevating the head of your bed.

4. Medications: If GERD is confirmed, treatment options may include over-the-counter antacids, H2 blockers, or proton pump inhibitors (PPIs) that reduce stomach acid production. These medications can help alleviate symptoms and prevent complications.

5. Monitoring Symptoms: Keep a diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare provider in determining the best course of action.

In summary, while your symptoms are suggestive of GERD, a follow-up with your healthcare provider is essential for a comprehensive evaluation. They may recommend further testing, such as another endoscopy or a pH monitoring study, to confirm the diagnosis and assess the severity of your condition. Early intervention can help manage symptoms effectively and improve your quality of life.