Mild frequent heartburn, tight throat with lump feeling?

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At the start of this year I started getting mild but frequent heartburn especially after eating, then shortly afterwards it came every day. After geting the courage to go the doctors I was put on Omperazole for a month which the symptoms went away. Once I had finished they came back again so I have been back to my GP and he recommended testing for h pylori, this came back negative. I have also been getting a tight throat with a lump feeling, one time it was so bad I thought it was going to close up!! I am seeing a consultant next week and am dreading that I will have to have an endoscopy done but also worried about that they might find. Any ideas or reassurance? 

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  • Posted

    I would agree that you need an endoscopy to find out what is going on. It's really simple. No prep just no food after midnight and you can eat/drink right away afterwards. I've always been sedated but I'm hearing not all hospitals do this. (I think it's better.) Sometimes I've had a sore throat afterward but that's it. I have had GERD along with a Hiatal Hernia, both of which were causing my problems. The doctor did do biopsy's just be be certain something else wasn't going on. Good luck!
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  • Posted

    Hi Ian

    I have had to have a endoscopy a few times and like you I was feeling worried about

    Having it done and also the results.

    The test its self isn't have as bad as I

    Imaged it would be it only takes a very short

    Time to have done. You can opt for sedition or spray to numb your throat.

    I have had it done with both options.

    The sedition made it so i was not aware

    It was been done I even asked my husband

    Afterwards was he sure I had the procedure

    I couldn't remember anything apart from

    Going in the room and lying down.

    The spray tastes horrid but does numb your throat. I found I had to try and relax and

    Concentrate on my breathing I did panic

    Slightly but the nurse reassured me that

    I could breath and it would be over soon.

    Afterwards I had a cup of tea and received

    The results and i could remember the

    Conversation with the spray.

    I would try and not worry about the

    Results they could be many reasons for

    Your symptoms. Mine was hernia and

    Reflux I have since had surgery Linx

    Procedure and I'm now recovering.

    Hope all goes well and try and

    Not worry.

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  • Posted

    Thank you so much for your quick replies! Is the sedtation normally done through IV or through taking a pill. I have never had anything like this before so am even nervous about potentially having an IV done. I suppose I am more worried that it might be the big C (I suppose most people do) even though the doctor said being 32 its more likely to be a relaxed muscle? 
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  • Posted

    PS glad you are both recovering well and have things under control, I hope to be doing the same soon!
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  • Posted

    I have had a very bad week.  Every night when gone to bed I've had terrible heartburn...coughing etc....got rid of it by sleeping on my left ISO my right but comes back again in the morning...today hasn't been to bad but it's been in the back ground. I am the list of endoscopy very shortly. Good luck next week. Let's us khow you get on.

     

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  • Posted

    Thanks John, here is hoping you get treated soon. Will let you know what happens next week!
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  • Posted

    I thought I was dying too. Mine started mild and then started feeling like a furnace was in my body. I had endoscopy and to my surprise it looked good. It was an easy procedure. I had the same as you with a lump feeling. Weirdly enough my heartburn came last. It's been a few weeks and I just started to see mild improvement. U might get a peace of mind if you do the endoscopy. Also, don't quit cold turkey on the meds. You have to slowly withdraw or you will experience rebound. Good luck and hang in there. Acid reflux is a crazy thing.
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    • Posted

      Oh, and the iv is easy! I'm a wimp and I actually enjoyed sleeping for a few.
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    • Posted

      Thank you Karen. Good to hear you actually enjoyed the sleep! My heartburn isnt even that bad its more a dull burn.... ive heard some people have a nightmare time with the pain. Do you also know if you have to stop taking meds before the endoscopy?
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    • Posted

      There are certain medications that want u to stop but not reflux meds. However, my procedure was at 9 am and they required that I didn't eat or drink after midnight the night before. Don't be nervous. It wasn't bad. I dont know how people wake up during the procedure. I took a long time to wake up.
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  • Posted

    Hi Ian,

    Sounds like reflux. Omeprazole (a PPI) is good at reducing the acid element but not the reflux.

    Your doctor has followed the recommendations. Often a 4 week course of a PPI is sufficient to heal any inflammation that may have been caused by acid + reflux. And H-Pylori is a possible cause.

    The enxt stage is to see a consultant who most probably will want to give yu an endscopy to find out what's going on and check there's no permanent damage (ie Barrett's Oesophagus which in some cases can lead to cancer).

    I'm assuming your first consultation with the consultant he'll just discuss the problem and possibilities and arrange for you to have a scope. If you have a scope, you'll be offered the choice of having sedation or just throat spray.

    With sedation, you'll need someone to accomany you afterwards and not drive or operate machinery for 24 hours.

    Some people manage with just the throat spray OK but you will feel like you're gagging. (For me, sedation has no effect so I have to manage with just the throat spray - which also means I can cycle to and from the hospital without problem.)

    As I suggested earlier, Acid reflux is actually a combination of acid and reflux.

    You can try to manage symptoms yourself. We all react to foods differently so you'll need to dscover what your particular trigger foods are that cause you heartburn, Keep a food diary. Common triggers are fatty foods, soda drinks, chocolate, tomatoes.

    Antacids like Rennie, Tums neatralise immediately but are not long lasting. Alginates like gavison liquid form a raft t o float on the stomach contents to help reduce reflux and coat the oesophagus to sooth inflammation in addition to neutralising the acid.

    Reflux occurs when stomach contents breach the lower oesophageal sphincter. There are many possible causes - the stomach my aget overfull, it may not empty rapidly enough, peristalsis movement of food down the oesophagus may be sluggish, bloating may be occuring in the stomach. Refiux doesn't have to be acidic.

    The lump in the throat feeling is probably "globus" and may be the cricopharyngeus spasming in an attempt to keep the upper oesophageal sphincter closed to prevent refluxate that has travelled the full height of the eosophageal column refluxing and aspirating nto the respiratory system.

    To reduce reflux, give up smoking if applicable, lose weaight if necessary, eat small portions and more frequently, avoid exercise after food that compresses the stomach including bending, avoid tight clothing, leave at least 3 hours between your last meal and going to bed, raise the head of your bed by 6 to 8 inches.

    Now as to what an endoscopy may reveal.

    If you have been refluxing bile along with your acid, you may have developed Barrett's Oesophagus. Bile is an emulcent and permits acd to dissolve meat (in the same way as detergent permits water to break down oil). Acid + bile coming into contact with the oesophagus wall may start to attack it. In an attempt to defend itself, the normal (squamous) tissues lining the oesophagus are replaced by columnar cells that present a smaller surfact area to attack whilst moving the nerve endings further away from the attacker (so providing some relief).

    These columnar cells usually constitute "Barrett's Oesophagus". The change cannot reverse itself so if you have Barrett's you'll have it for life (unless you have it removed by a process called ablation - which will be offered if dysplasia is seen).

    The problem with Barrett's cells is they have the ability to mutate in some people. For "ordinary" Barrett's the risk of progression to cancer, whilst 10 times higher than for those without Barrett's is only about 0.7% p.a. If mutation is going to occur, initial stages, "dysplasia",  are usually slow. Low grade dysplasia carries a 1% p.a. risk of progression to cancer. High grade dysplasia carreies a 6% risk of progression to cancer.

    If you are found to have Barrett's (whch will require lab results from biopsies taken at a scope), you will be put on a surveillance programme being scoped every few years to look for signs of dysplasia or early canerous changes.

    Those of us who have been thus diagnosed are the lucky ones as we'll probably never get the cancer. I've had 3 centimetres of non-dysplastic Barrett's for at least 21 years. I expect my next scope in a few days time will confirm no changes have occured.

    There may be 1 million people with Barrett's in UK and less than 10% know it. It's those who haven't been identified that are likely not to be identified until it's too late: diagnosis at the cancer stage provides a prognosis measured in weeks rather than years. Oesophageal cancer is the 5th greatest cancer killer in the Western world and UK has the worst statistics in the world with one person an hour dying of it on avaerage.

    Hope your consultation goes OK and you learn to cope with whatever they find.

    Cheers

    Chris (chairman on Barrett's Wessex patient support charity)

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    • Posted

      Thank you for all of the information! I am hoping it hasnt prgoressed that far but will have to see. I am pleased to hear yours is in control and all the best for your next endoscopy. 
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    • Posted

      HiChris.   What do you recommend to eat or not eat to help with the burning in my chest and throat.   I have just started taking nexium 20mg twice daily, and the burning is very painful.  Is there anything else I can do to help ?
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    • Posted

      The first line is slef help by identifying your own particular trigger foods to avoid.

      However, we are all different and foods affect us differently. There are many lists available of "banned" foods but they are all just recommendations based upon what have been most commonly found to be problematic, plus a few persistent myths that are propagated.

      Keep a food diary to determine your own particular triggers.

      These are most likely to contain fatty foods. Acid doesn't dissolve fat so these foods stay in the stomach longer being churned with more acid sprayed on them. Eventually some bile may be permitted to enter which acts in the same way as detergent and allows acid to help break down fats. (It's reflux od acid and bile that can cause Barrett's Oeosphagus.)

      Some people propagate the idea that hot spicy foods are bad because they feel the burn when it hits the back of the throat. However, their acidity is nothing compared to the acidity of the stomach. In fact many of the spices in foods like curries (eg turmeric) have been found to be beneficial and East Asia has a lower incidence of adenocarcinoma. Of course, if you already have oesophagitis, in the same way as pouring lemon juice on a graze, you would feel it but it's not doing more damage.

      Acidity and alkalinity of foods is another myth. In America, there seems to be a fad for alkaline water which has been shown to be a con by the companies to sell more bottled water: it has absolutley no affect (apart from possible placebo if you convince yourself it works).

      Some advocate milk to ease the burn but it contains fats which may produce more acid, and if you mix milk with acid you make plastic (casein).

      For me my main trigger food when I was experiencing considerable heartburn was pastry (again high in animal fat).

      Caffeine can relax the lower oesophageal sphincter making reflux easier so some advocate steering clear of coffee. Others say strong black coffee may actually be good. Alcohol is supposedly a muscle relaxant and many have advocated steering clear of it but studies have shown, althoughi t is implicated in squamous cell carcinoma (the other cancer of the oesophagus which is more prevalent in east Asia and affects the top of the oesophagus and unrelated to heartburn), studies have shown it has no implication in BArrett's Oeosphagus or adenocarcinoma.

      Nicotine is implicated, however, so advise is to stop smoking (if applicable).

      A free pdf download of a book "Cool Food" of recipes others have found helpful may be downloaded from the LINKS/Downloads page of the Barrett's Wessex website (BarrettsWessex org uk).

      Lifestyle changes may help. Lose weight if necessary. Avoid tight clothes. Eat little and often (eg 5 half sized meals). Avoid exercise after food that will put pressure on the stomach (including bending). Leave at least 3 hours between last meal and going to bed.

      These are all measures to reduce the reflux that carries the acid into the oesophagus. But your 40 mg esomeprazole daily should help but it can take a few days for the inflammation and burning to die down.

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