Dysphagia, LPR, GERD and anxiety help!

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Hello,

 

I am writing here because I am currently suffering immense bouts of anxiety due to LPR and GERD prior to my upper endoscopy.

 

I have just turned 31 but I suffered symptoms for many years. I quit smoking 9 months ago after nearly 5 years of not-so-heavy smoking (average 4 cigarettes a day).

I am nearly 6.2 feet tall (187.5 cm) tall and my weight has varied between 71 kg (11.2 stone/156 pounds and 76 kg (and 12 stone/167.5 pounds). I walk a lot and exercise regularly.

 

My story started several years ago when I experienced thick phlegm in mornings however the symptoms came and went. I blamed it on hay fever or cold weather in Denmark where I studied.

During this time I experienced occasional light-headedness and weakness in my limbs.

In February 2012 I experienced strong primary herpetic infection with tenths of aphthous ulcers that left several lymph nodes on my neck swollen and since then I had persistent lymphadenopathy. Doctors had reassured me that there was nothing to worry about.

 

I started to notice more worrisome symptoms after food alleged food poisoning (cramps, diarrhoea) that I developed in Romania, June 2015 and later was treated in Prague(Czech Republic) without upper endoscopy.

My first bout with GERD was in August 2015 after my friend’s wedding when after binge drinking I attempted to vomit but could not and felt terrible pressure in my chest accompanied by fullness.

I went to gastroenterologist and he diagnosed me with GERD and set me on a month-long omeprazole treatment.

 

My symptoms were light-headedness and pressure in chest with inability to breathe. In that point I have suffered only rare and weak reflux.

In the past three years I had one unsuccessful endoscopy that inspected oesophagus and it came alright (October 2015) but they could not finish the endoscopy because of neck spasms.

The doctor assured me that the chance of any malignancy was really low at that point (now I start to doubt it since they could not fully inspect my stomach).

 

I had several ultrasound investigations and they revealed minor kidney stones, minor hiatal hernia and thickened gallbladder wall, particularly from the side of the liver – but without any other histopathological presentations.

Symptoms however had not subsided in the past three years despite occasional PPI therapy and new symptoms appeared.

 

In March 2018 I started to notice that there is oatmeal sticking in my throat and passing slower to oesophagus. I was had been going to gym really often and once after suffering football injury I woke up at night on horrible heart palpitations, shortness of breath and radiating pain in my abdomen and between shoulder blades. The next day I was referred to emergency services and had tests done where they ruled out any heart disease. The doctor however felt tenderness right under the left ribcage in proximity to a breast bone.

 

Since then (March – June) I developed dysphagia (mostly issues with oatmeal and occasionally larger pieces of vegetables) that leaves me with sensation of something stuck in my throat and something sticking out of my throat. I have frequent pains/aches/discomfort behind the breastbone, shoulder blades and under my rib cage– this is not usually right after the meal. I am constantly burping when doing some sport activity and after drinking/meals. Since then I felt that I have to eat a lot because my stomach is all the time empty – even after eating and produces more acid.

 

Three weeks ago I had sever anxiety attack after reading various studies regarding LPR/GERD and GI carcinoma (oesophageal cancer and cardia adenocarcinoma in particular) and being a data analyst I calculated various models of probability to be diagnosed with GI cancer.

 

My health anxiety got exacerbated by my NHS surgery failing to put referral for endoscopy through and it got postponed by two months so I can expect GI consultation or gastroscopy at the end of August). I have been on Lansoprazole double doses since April, but with no avail so on June 12th the doctor changed medication to Pantoprazole – double doses. The only heartburn and reflux I felt was one hour in the morning after taking PPIs.

 

I have had one strong bout of night heartburn and reflux in the beginning of this month (June) three days after severe anxiety attack and since then I was left with even stronger dysphagia, globus sensation, hoarseness, dry mouth and sore throat with brown phlegm in the mornings.  I have started to watch anxiously my weight to check for any potential weight loss and this has become a downward spiral. Sometimes, my weight fluctuates by 3 pounds in the same day and I feel that overall I have lost 3.5-4kg (7 pounds) since February.

The truth is that I started to walk more, do less strength training and reduced portions/do not eat training mode portions (140 g of proteins a day). I have been taking Gaviscon Advance syrup, 5ml in the afternoon and 10ml in the evening; however it feels as it gives me a bit of constipation. That is not good because I have suffered of rectal bleeding since my 13 (nearly 18 years) and adds up to my fear of colorectal carcinoma. (had sigmoidoscopy 2 years ago and they found a small fissure in the depth of 45 cm).

 

From all of the aforementioned symptoms I would point out dysphagia (weight loss? explained, unexplained – unable to put it in place), weakness in limbs, light-headedness, shortness of breath, heartburn after hour after taking PPIs(before meal), pressure or discomfort in chest and behind shoulder blades, sore throat in mornings, burping and occasional constipation/bloating.

 

I rarely drink anything else but water and eat (and always have had) lots of fruits and vegetables and high protein/low fat balanced meals. I am quite active and from a middle-class family where we cook fresh food. I quit even occasional/minor drinking I have never drank coffee and generally live a healthy life (despite 4.5 years of smoking). Recently I bought reflux pillow. All of this with minor to no effect.

 

I have a trans-nasal endoscopy 10th July prior to my brother’s wedding on 13th and I am worried sick of being diagnosed GI cancer. Can my anxiety make symptoms worse?

Can aforementioned symptoms be attributed to LPR/GERD amplified by anxiety? I am getting desperate. Anyone with similar symptoms/experience?

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  • Posted

    Why your doctors cannot complete your upper GI endoscopy? And yes anxiety can make our symptoms very worst you can't even imagine

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    • Posted

      Hi, kunal 13963,

      do you think my case could be also connected with anxiety.

      I am struggling with similar issues.

      In 2016 started heartburn after stressful time and hormonal changes due to inserted diu.

      2017 Endoscopy showed nothing, doctor prescribed me 30mg lansoprazol/day. I was taking it for a year ( half year 30 mg, and switched to  15mg because of nausea) than I weaned it for a month.

      I stopped smoking and drinking coffee a month ago. when i drank last coffee i felt horrible nausea and had a panick attack. Since than I have horrible reflux, and for the first time noticed night reflux with cough. 30mg of lansoprazole doesn’t help anymore. 

      had endoscopy two weeks ago which showed esophagitis and not working LES.

      I don’t know what to do now. what is happening with me. Tho whole month I was obeying all rules for gerd but noticed no difference. So I assume that it has to be something else. 

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    • Posted

      Hi Kunal, 

      they could not complete it because at that point I had pharyngitis and it caused strong gag reflex. I am about to have the trans-nasal one on July 10th so fingers crossed.

      No matter the result, I will have to do some even more radical lifestyle changes in my life....

      Thank you, 

      Martin 

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    • Posted

      Hi Aya, 

      apparently obeying the diet/lifestyle regimen appears to be a long-term commitment sad

      Many people reported that it took years of self-discipline to avert the future bouts of GI issues. And anxiety always plays part.

      Be strong and committed, 

      Thank you, 

      Martin

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    • Posted

      Yes because I am having some similar issues anxiety makes you feel more sick .,,, and it stimulates gastric hormones too and therefore it makes gastric symptoms worst ., I am currently under anxiety medicine and domparidom 20mins before meal for nausea and am feeling better now doctor have also ordered to do endoscopy and am terrified now am scared of endoscopy
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    • Posted

      Hi Kunal, 

      actually how old are you? Just to soothe you with some statistics that may play in your favour smile

      I am also terrified from the results of my endoscopy, but not by endoscopy itself. I am travelling abroad to have trans-nasal gastroscopy, because the regular one was a bit unpleasant at that particular time and  NHS has only few places where they can perform it in UK with abysmal waiting times.  Otherwise I would not say that the examination itself is anything horrible - I say that transnasal one may be more tolerated by people. I must say that colonscopy and sigmoidoscopy are also rather unpleasant, but the only difference is that you can yell profanities when being investigated since there is nothing blocking your mouth smile Just relax and ask your surgery to provide you with d*azepam or v*lium prior to investigation. Have someone with you so you will get home safely being high as a kite smile

      Take care, 

      Martin 

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    • Posted

      I am 26 year old and I had an appointment today for endoscopy I was so terrified that I ran from the clinic ., , I want to do it but I think I will die of gagging please tell me how does it feel
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    • Posted

      Kunal, 

      firstly, there are nearly NO cancers of upper GI reported (stomach, oesophagus) for your age group, so this may ease your worry (incidence is so low that it can be considered rarity). Secondly, it is bit uncomfortable, but it is no big deal. If you are so scared of this, ask doctors to provide some diaze*am or v*lium aforehand. This will ease the whole experience. Moreover, you can search for clinics providing trans-nasal endoscopy that is better tolerated. 

      Hope this helps, 

      Martin 

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    • Posted

      Thank you so much Martin .,, well actually I have weight loss so I was a bit worried .,., I have no pain anywhere in my body ,,. I just use to feel full before nauseated and have loss appetite ,., but my doct have prescribed rloc 150, domperidone for nausea, and anxiety tab am feeling much better now I only have one problem now and that is constipation change in bowel habits 
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    • Posted

      Hi Martin I did my life endoscopy today God I was so terrified but the doctor was so sweet he made me relaxed and laughed with me ,., I did it without sedation just the throat spray ,. I never gagged not even once during the entire process just some minor discomfort while he took a biopsy from my stomach ., , now my results they found antral gastritis and erosion the biopsy they took came negative on h.pylorie infection .,, I have my next appointment this Tuesday I feel much better now finally I overcame all my fears of endoscopy it went so well I never thought that it would be so easy so much of tension is for nothing now am laughing at myself
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    • Posted

      Hi Kunal, 

      that's great to hear! As you can see fear makes things only worse. Now when you have diagnosis they can work with it and customize the treatment to suit your condition and needs. You are really young and should not worry. Put your mind at ease and recover well! 

      Take care, 

      Martin 

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    • Posted

      Thank you so so much Martin ,, its for you that I got the courage to do it somehow talking with you made my mind so calm and tension free .,, God bless , , and yes fear makes things too worse .,, I was in very good hands today haha such a lovely day gone after so many bad days 
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