sore spot in esophagus, always thinking the worst

I'm new to this board, but not new to GERD.  I'm a 34 yr old wife and mom, short at 5'1" and overweight but losing it slowly.  Started taking PPI 7 yrs ago for reflux and + hpylori.  Dr never did treat the hpylori back then.  Over the years I've been off and on the different kinds of PPIs.  Loss of Ins in 2006 forced me to switch to the Prilosec OTC, for a while it worked.  Started having more substantial problems last Nov.  Lots of burping, stomach bloated, reflux and heartburn in spite of the 20mg Prilosec OTC.  Dr I saw retested for Hpylori, + again of course, treated it with the 2 antibiotics and 14 day Prevacid.  She also did an abdominal and chest xray.  Never got retested, didn't know I needed to.  Symptoms settled down some.  Feb 2008 started having lots of chest pressure relieved with burping, pain/spasms in espophagus, lots of reflux, even water coming back up.  Went to cardiologist, part because I have a bicuspid aortic valve and wanted to make sure chest pains/pressure weren't related... but to be honest I mostly went to the cardio because I knew he'd be the more likely dr to listen and do something.  Other dr (actually a Nurse Practitioner) blows me off every time.  Anyway, cardio doc didn't think it was heart related, sent me for a barium swallow.  Had that done around the end of March.  Showed severe reflux and small hiatial hernia.  Got me an appt to see gastro dr.  Took 2.5 months to get in.  Saw him May 27, Gave me Prevacid 30mg samples, told me to take 2x a day, while we wait for Ins to pre-auth Prilosec 40mg 2x daily.  I can't say I've seen a huge improvement, it's been 2 1/2 weeks.  I will say it's helped "some".  The chest pressure and spasms have stopped.  And I don't feel reflux as much, but...

shortly after starting the Prevacid I noticed a pain/sore spot on the left side of my espophagus.  It hurts in that one spot when I swallow a larger size bite of food, when I apply a lot of pressure to my chest to get up a burp sometimes I can feel the pain there.  It's a specific spot, not a general area.  And I'm certain it's in the esophagus and not the throat, but it is up higher closer to the throat rather than lower into the chest, not in the neck.

Of course my biggest fear is a tumor.  But wouldn't the barium swallow have showed that?  I think I remember when the nurse called on the phone with the barium results, her saying specifically, "... no tumors or anything...".

Do any of you know if GERD or small hiatial hernia related things that can cause this kind of pain/sore spot?  I do not have any trouble with swallowing the food or getting it to go down, doesn't feel like it's getting stuck or anything.  My stomach also still feels full and/or bloated most of the time.  I'm trying to stay away from what we all know as the "trigger foods" I'm not 100% on that but really trying.  I walk a treadmill every evening and usually drink a lot of water, a lot of times I can feel the coolness of the water coming back up the esophagus after it's went down.  But my main concern is this pain.  I'm scared but find comfort in reading posts here and other reflux boards.  Seems like I always think the worst and I guess I'd just like to know that other things can cause this other than cancer. 

Thanks for any help!

Good luck tomorrow. I hope there's nothing there. I have GERD that effects my throat and sinuses. It's a drag. I gave up on the bed thing too because it didn't work. I have a sore spot in my neck but nothing serious showed on my recent endo except a stricture which the doc dilated. I think I just have to get the Nissen and get it fixed that way.
Again good luck. Let us know how things turn out.

 Hi, i just read your post and i'm wondering what the results of your endoscopy biopsy was.  I have similiar issues and have the pain in the right side of my throat and sinus.  I also have sort of a pain in the right side of my chest that i sometimes feel in my back shoulder and belching after i eat.  I had been on aciphex for 3 years and recently switched to protonix.  I've also been taking Pepcid complete at nite.  I had a somewhat normal endoscopy three years ago but also was treated for h-pylori that they found at that time.  I was supposed to take the aciphex for 6 weeks but symptoms came back so primary dr put me back on aciphex.  I did just have a gallbladder ultrasound but I haven't heard results yet.  I really believe it is connected to my reflux.  I'm just so glad to find somebody with similiar issues!   

Misery loves company, I guess.

I've had GERD for I don't know how many years. Around 2000 I started having problems swallowing and was diagnosed with a stricture. A later scope revealed barrett's. I had a hard time learning to live with that, but in the three years since, I've become accustomed to it.

Last year around this time I started having trouble swallowing, sore throat, felt like I had to clear it all the time, seemed like there was a lump from time to time. I went to my GERD doc who said it sounded like allergies. It went away eventually and didn't return.

This year it came back, but the symptoms were worse. I chalked it up to the fact that my new job had me outside more frequently. (I do have a history of allergies; used to get shots when I was a kid.) I had a scheduled check-up with my GERD doc, who offered to do my scope early (I was due in November of this year). Not long after that I started experiencing reflux symptoms again. The actual burning has been pretty mild, but I know my esophagus is being irritated because I feel the pain in my chest and my back. I also have "low functionality" of the gallbladder and though most of the time it doesn't bother me, it has also been acting up over the past few days.

I'm very analytical about stuff like this, especially when it comes to my esophagus. And since my scope is two weeks away, I've been restless with anxiety over the whole situation. I'm sure that some of the pain and discomfort can be chalked up to stress; that makes anything worse, and when I do have anxiety attacks they are all consuming and overwhelming. But there is definitely something going on with my reflux because I can feel my esophagus aching. Now I've been on prevacid for maybe four or five years now and it has always controlled my reflux. If I miss a dose, I still feel the heartburn. I haven't missed a dose for weeks on end though, and it seems like its effectiveness is waning. I'm not having trouble swallowing but the whole passage just seems irritated at the moment. I've had some brief, mild (but still noticeable) pain in my stomach region, up near the center of my rib cage, indigestion, and excess phlegm. And again, my gallbladder is causing me some discomfort. Seems like all of my innards are conspiring to make me paranoid. And it's working; I have been a wreck for the past two weeks. I have a lot to lose: a wife and five kids. Part of me thinks it's a worse case scenario, that the barrett's has worsened. Part of me thinks it's a combination of factors: stress, allergies (or the upper reflux that causes the throat irritation and phlegm), and reflux symptoms that are probably exaggerated by the stress. I'm hoping and praying that the latter is correct, or at least that the former is not true.

Unfortunately, working against me I have a weight problem (after my stricture was fixed I actually gained weight because I was able to eat more foods again).

I've reached an impasse where I don't know which way is up, and waiting two weeks for the scope (and another week for the results) is really making all of this worse. Part of me fears my ticket is going to be punched when I do have that scope. If my reflux has gone silent, then there's no telling how long it's been eating away at me. The infuriating part about that is that I was scoped every four to six weeks after my barrett's was discovered, to determine if the prevacid was working... and it was working wonderfully. I've had a few mild symptoms of what would be the "upper" reflux... a few times I've woken up and food came back up. But those are few and far between. i've had no cough, and up until literally the day of my GERD doc appointment about ten days ago, no reflux symptoms at all.

Ugh. I get a headache trying to figure it out. I wish I could just let it go until the scope but that's not how my mind works unfortunately.

Post Edited (grimmly) : 6/20/2008 9:32:53 PM (GMT-6)

I will definitely post again. I actually studied up on Barrett's a bit more and learned a bit that has set my mind at ease somewhat. Generally there are no symptoms when Barrett's progresses; that's why it's so fatal. A great many people don't catch it until after it's progressed into cancer. Mine was, 16 months ago, considered to be minimal; a very small spot that showed no signs of displagia. There are two (maybe three?) levels of displagia Barrett's can go through before they consider it cancerous. There are treatments for those, though they are risky and not widely used.

So these symptoms I'm having probably relate more to my reflux acting up than to Barrett's progression - maybe. Hopefully. If I understand what I read right, it seems like that could be the case. Mind you, reflux flaring up can certainly prompt barrett's to get worse, so I'm not breathing easy by any stretch. But I think I can make it this last week to the scope. The results are what concerns me the most. i'm overweight and with high BP, neither of which is very helpful.

I'm also starting some therapy this week to deal with what I think is probably some form of generalized anxiety disorder. I have a perpetual fear of loss. Sometimes it's rational (in my opinion, my concern for my esophagus, while extreme, has a firm basis in reality) and sometime's it's not (I just wake up in the middle of the night and I'm terrified of something I can't pinpoint). Lots of loved ones passed away when I was younger so it's no surprise I have that fear of loss. I need help dealing with it better though.

That's off-topic though, sorry. I'll certainly post again after my scope and hopefully it will be good news. Or at least not awful news.

I'll share my original treatment method, maybe it will do you some good to hear how they go about making sure your reflux is under control so your barrett's doesn't get worse (if you even have it) and so you don't get it, if you don't.

During my first scope, the dilated my esophagus (it was strictured due to reflux damage) and also biopsied several portions of it. One spot came back as having barrett's. I was then scoped every four to six weeks for about a year. The purpose of these was two-fold:

- To continue dilating my esophagus, since it was a narrow stricture
- To ensure my medication was successfully healing the damage to my esophagus (I had several ulcers too)

I was on Carafate to help with the ulcers and gastritis, and prevacid for the reflux. After a year of constant improvement, my GERD doc deemed me ready to begin my "every two years" scope to ensure the barrett's was not getting worse. It's every two years for me because there were no signs of displagia. It seems an amazing coincidence that I'm coming up on the end of that two years now and experiencing these problems, but we'll see what happens.

What I have gleaned from my previous treatments and scopes is that:

- The carafate healed the ulcers; my esophagus was just fine except for the barrett's spot
- Prevacid successfully controlled my reflux.

My PCP told me that generally, your reflux doesn't "change" its symptoms. That is, if you've had heartburn associated with it in the past, that trend would likely continue in the future. And it's true; any time I missed a dose of prevacid, I would feel the heartburn.

Yet since January I have had very infrequent and sporadic signs of the silent type of reflux that affects your throat. The kind some people say you have to see an ENT for because the GERD docs don't check for it. The most notable sign thus far (aside from a few nights when some food came back to bother me) is the constant clearing of my throat that I've had to do the past few weeks. My GERD doc has said it sounds like allergies to her, but taken in context with my other symptoms I am not so sure. (Despite that the throat clearing came first, the chest/back/pain symptoms came later.)

So... either my prevacid has stopped working and my reflux has gone completely silent (which seems to contradict what my PCP suggested, though I don't know if he's even right in the first place)... or there's something else going on here.

The other alternative is that my esophagus is so messed up I don't even feel the heartburn anymore... but my reflux went for many years without any kind of treatment at all, so it seems hard to believe that in 16 months it would fall completely silent and eat me up that badly. I never rule out anything but this doesn't seem quite as consistent with what I've learned about how things behave.

That said, I'm no doctor and can honestly say I have no earthly clue what's happening. All I know is, I'm freaked out by it all daily and I'm at once dreading and anxiously awaiting the scope that will hopefully bring me some answers. Some good answers that don't invovle words like cancer. I certainly hope and pray this is the case.

Sorry for the lengthy post. I can get carried away sometimes. I hope somewhere in there was something useful.

Post Edited (grimmly) : 6/22/2008 12:26:10 PM (GMT-6)

Hi Grimmly,

I am a new member today and had to post just reading your stuff. I have always had bad allergy problems, so when I got sick last December and remained through January (sore throat, stuffy nose, pain in ears), I went from my family doc to my ENT. I saw him twice, we tried antibiotics and steroids for my inflammation, and I still felt terrible--my complaint to him the second time was that I had mucus not only in my nose but in my throat and it felt stuck. He did a CT scan of my entire head and throat area, and said I only had some inflammation--no infection, and then suggested I go see a Gastro doc because I may have acid reflux. Something I had never considered, because I never had heartburn up to that point. Unfortunately, I was only told to take OTC Prilosec (20 mg) once daily for 2 months. I did this while my symptoms got worse. Back to family doc, who sampled me with Zegerid 40 mg once daily. Symptoms persisted for next month and I went back and got Nexium samples 40 mg twice daily. After a month of this and not feeling better I just flat out quit and said "I must not have reflux". Well, I ended up in the ER with chest pain and shortness of breath and they determined it was acid reflux and gave me Pepsid through an IV. Prescribed Protonix 40 mg twice a day which I have now taken since Mother's Day (my day in the hospital). Never have had the heartburn again, but I still have the silent reflux VERY BAD. My throat always has that food-stuck-in-it feeling, creeping reflux coming up my esophagus, stuffy nose and ears, hard to swallow, etc. So I had a motility/manometry test last week and they called to tell me my results were totally normal! No spasms during test and spinchter seemed to be fine. Talk about frustrating! I am not fine! I seem to just have to live with this (at least for now). They (docs) tell me to give it 5-6 months on the protonix and eat correctly, sleep upright, and see. I hate to read your posts about how long you've had these issues because I am so hopeful of getting better. I am normal weight and just went through menopause last year, so I'm hoping it's something to do with hormones. I haven't had a glass of wine or coffee for 3 months, but I feel so deprived since I still feel like crap. I usually have to add pepsid in at night or antacids on top of the protonix to get through the night. I have tried lots of natural things too, like DGL licorice, and use probiotics. I hope you do get good news at your end, but wanted you to see I started in the reverse with the ENT first, and then progressed to find out I have GERD. Hoping the support here helps me through these hard times!

       

grimmly said...
I will definitely post again. I actually studied up on Barrett's a bit more and learned a bit that has set my mind at ease somewhat. Generally there are no symptoms when Barrett's progresses; that's why it's so fatal. A great many people don't catch it until after it's progressed into cancer. Mine was, 16 months ago, considered to be minimal; a very small spot that showed no signs of displagia. There are two (maybe three?) levels of displagia Barrett's can go through before they consider it cancerous. There are treatments for those, though they are risky and not widely used.

So these symptoms I'm having probably relate more to my reflux acting up than to Barrett's progression - maybe. Hopefully. If I understand what I read right, it seems like that could be the case. Mind you, reflux flaring up can certainly prompt barrett's to get worse, so I'm not breathing easy by any stretch. But I think I can make it this last week to the scope. The results are what concerns me the most. i'm overweight and with high BP, neither of which is very helpful.

I'm also starting some therapy this week to deal with what I think is probably some form of generalized anxiety disorder. I have a perpetual fear of loss. Sometimes it's rational (in my opinion, my concern for my esophagus, while extreme, has a firm basis in reality) and sometime's it's not (I just wake up in the middle of the night and I'm terrified of something I can't pinpoint). Lots of loved ones passed away when I was younger so it's no surprise I have that fear of loss. I need help dealing with it better though.

That's off-topic though, sorry. I'll certainly post again after my scope and hopefully it will be good news. Or at least not awful news.

I'll share my original treatment method, maybe it will do you some good to hear how they go about making sure your reflux is under control so your barrett's doesn't get worse (if you even have it) and so you don't get it, if you don't.

During my first scope, the dilated my esophagus (it was strictured due to reflux damage) and also biopsied several portions of it. One spot came back as having barrett's. I was then scoped every four to six weeks for about a year. The purpose of these was two-fold:

- To continue dilating my esophagus, since it was a narrow stricture
- To ensure my medication was successfully healing the damage to my esophagus (I had several ulcers too)

I was on Carafate to help with the ulcers and gastritis, and prevacid for the reflux. After a year of constant improvement, my GERD doc deemed me ready to begin my "every two years" scope to ensure the barrett's was not getting worse. It's every two years for me because there were no signs of displagia. It seems an amazing coincidence that I'm coming up on the end of that two years now and experiencing these problems, but we'll see what happens.

What I have gleaned from my previous treatments and scopes is that:

- The carafate healed the ulcers; my esophagus was just fine except for the barrett's spot
- Prevacid successfully controlled my reflux.

My PCP told me that generally, your reflux doesn't "change" its symptoms. That is, if you've had heartburn associated with it in the past, that trend would likely continue in the future. And it's true; any time I missed a dose of prevacid, I would feel the heartburn.

Yet since January I have had very infrequent and sporadic signs of the silent type of reflux that affects your throat. The kind some people say you have to see an ENT for because the GERD docs don't check for it. The most notable sign thus far (aside from a few nights when some food came back to bother me) is the constant clearing of my throat that I've had to do the past few weeks. My GERD doc has said it sounds like allergies to her, but taken in context with my other symptoms I am not so sure. (Despite that the throat clearing came first, the chest/back/pain symptoms came later.)

So... either my prevacid has stopped working and my reflux has gone completely silent (which seems to contradict what my PCP suggested, though I don't know if he's even right in the first place)... or there's something else going on here.

The other alternative is that my esophagus is so messed up I don't even feel the heartburn anymore... but my reflux went for many years without any kind of treatment at all, so it seems hard to believe that in 16 months it would fall completely silent and eat me up that badly. I never rule out anything but this doesn't seem quite as consistent with what I've learned about how things behave.

That said, I'm no doctor and can honestly say I have no earthly clue what's happening. All I know is, I'm freaked out by it all daily and I'm at once dreading and anxiously awaiting the scope that will hopefully bring me some answers. Some good answers that don't invovle words like cancer. I certainly hope and pray this is the case.

Sorry for the lengthy post. I can get carried away sometimes. I hope somewhere in there was something useful.

Well, I finally got the results of my biopsy. Never heard of one taking a week and a half to come back... but anyway, the Dr himself called me which I appreciated. The biopsy was as he said "normal". So that really takes a load off my mind! He said again that there was a small area of inflammation and the hiatial hernia was small. He said for me to give the Prevacid more time. But he said short of trying a few of the other meds, surgery was all there was left for me. I really want to avoid that!!!! So it's diet and exercise. The pain is so much better... I adjusted the times of when I took my prevacid (twice daily) and that seemed to make a big difference. Seems like if I take them less than an hour before I eat either breakfast or dinner that it doesn't work as well.  So that's the adjustment that I made.  Plus I got some gaviscon and that works real well too. I know that if I can't get control of this reflux via weight reduction and staying away from the "trigger" food (although I reflux anything right now, even water) then one day the endoscopy & biopsy won't be as favorable. Thanks to everyone who replied to my post.

Post Edited (Jencalem) : 6/30/2008 8:41:01 PM (GMT-6)

Hi Jencalem,

I'm glad to read your post. I will try taking my protonix further away from the times I eat also, because I reflux everything also, including water. Are you trying for 2 hours before breakfast and dinner or what timeframes seem to be helping? I am even thinking about just having a piece of toast and cereal everynight for awhile while I make something for my husband for dinner, because no matter what I eat for dinner, I am miserable. I've only been on the protonix twice daily since May 10. My endoscopy, biopsy and motility test were all normal. My doc says I have to give it more time also. I have lost 15 pounds since April. I am 145 now and am 5'6". Glad your biopsy came back normal too. Good luck with everything in this fight! I haven't tried Gavescon. I will have to look into it.

  

hi everybody,    (excuse me for my poor english)

In july 2007 , I ate very spicy food and I felt little pressure in my chest and burping all the day then next day I woke up in the morning I felt lot of pain and pressure in my chest ,oh my god , that pressure was there every day I went to doctor  30 times, allmost every day I goes to doctor they did all the test for me every thing was normal except  I have high level of h pylori and mild mitral valve prolapes. so I took two types of antibiotics and prilosec. but my pressure was still there ,its like no life. I cried every day and pray to god , I stopped eating spicy food , caffein and sweet things at all. I stopped taking medicine after 15 day I felt better and then I took nexium for 5 day  my  chest pressue was totally gone . but took 3-4 months come to normal . I drink milk at night time and elevate head of bed, but I have another problem I do not know if its related with gerd I have mild sudden sharp pains in chest just for one second and go away, any comments please keep posting

kindu said...

hi everybody,    (excuse me for my poor english)

In july 2007 , I ate very spicy food and I felt little pressure in my chest and burping all the day then next day I woke up in the morning I felt lot of pain and pressure in my chest ,oh my god , that pressure was there every day I went to doctor  30 times, allmost every day I goes to doctor they did all the test for me every thing was normal except  I have high level of h pylori and mild mitral valve prolapes. so I took two types of antibiotics and prilosec. but my pressure was still there ,its like no life. I cried every day and pray to god , I stopped eating spicy food , caffein and sweet things at all. I stopped taking medicine after 15 day I felt better and then I took nexium for 5 day  my  chest pressue was totally gone . but took 3-4 months come to normal . I drink milk at night time and elevate head of bed, but I have another problem I do not know if its related with gerd I have mild sudden sharp pains in chest just for one second and go away, any comments please keep posting

Kindu Welcome!  I hope you are feeling better now.  I felt a lot of chest pressure with my reflux and I've read that H Pylori does cause bloated feeling in the stomach which can add to the chest pressure.  I have had H Pylori before too, took the same meds you did back in Nov 2007.  I wonder if I don't still have the infection though because I still have bloated stomach, but my dr's office said I'd have to go off my Prevacid for 2 weeks to take the breath test.  I told the nurse I'd have to think about it.  I just don't know if I want to be that miserable for 2 weeks and it took over a month to get my symptoms under control on the Prevacid, so I hate to start that all over again. 

What tests did they give you besides the H Pylori test?  Did you have a Barium Swallow xray, where you swallow that nasty chalky stuff and they xray the esophagus and stomach?  Did you have an endoscopy where you're sedated and they run a scope/camera down your esophagus to take a look? 

Chest pain can absolutely be related to GERD, also anxiety can cause shortness of breath and chest pain much like you're describing, that last a few seconds and then goes away. 

Did you see a cardiologist to follow up with your mitral valve prolapse?  I have a bicuspid aortic valve and have to see my cardiologist once a year to keep a check on it. 

If you don't feel better, continue to look for help until someone listens to you and sets your mind at ease.  Try not to think the worst, I know that's hard, but in most cases the things we worry about never come to pass, so try to keep this in mind and if you trust the Dr you are seeing then follow his advise.  Continue to eat right and avoid the trigger foods that can make your reflux (if you have that) worse.  Drinking milk is fine if that doesn't bother you but I have read that milk can make some people's reflux/stomach problems worse... different people are different... not all foods bother everyone, just do what feels right for your body.  Keep us updated on how you're feeling.

Jen