Discussions By Condition: I cannot get a diagnosis.

chronic esophageal irritation and nausea

Posted In: I cannot get a diagnosis. 5 Replies
  • Posted By: mokele
  • December 14, 2007
  • 11:50 AM

I'm a 55-year-old male (as of December 2007) who was diagnosed (I'm not 100% sure correctly) with esophageal reflux disorder back in May 2002. At 1st I just took Zantac once or twice per day, and thought that I could overcome the acid reflux problem by losing weight. After I lost around 40 lbs. (going from around 200 lb. down to 160 lbs.) by the end of 2002 the symptoms of reflux (and other hard-to-describe secondary gastro-espophageal symptoms) didn't go away. I continued to take Zantac for another 9 or 10 months and it was around 80 to 85% effective, meaning that only occasionally did I have any burning in the throat and/or other symptoms of reflux.

Near the end of 2003 I switched from Zantac to protonix (a more powerful antacid) at the recommendation of my doctor, and the acid reflux was brought under almost complete control. However, other symptoms had arisen and they had my doctor and myself confused. I suppose that those other symptoms could be classified as upper-esophageal concomitants to the reflux disorder (such as frequent throat-clearing and coughing), but they also included periodic and recurring nausea with headaches. Over the next 2 to 3 years I experienced recurring episodes of itching, gnawing, irritation-inflammation-like symptoms in my throat that would persist for a few days, followed by a day or 2 of mild nausea sometimes accompanied by a headache, but without the itching and gnawing sensation. This would typically subside in 24 to 36 hours, and then I would often have a few days in which I was relatively symptom-free. However, the itching, gnawing, irritating throat symptoms would then return. This went on until some time in late 2005 or early 2006. Sometime in middle to late 2004 I had switched from protonix to Omeprazole, which was equally effective in treating the acid reflux. Omeprazole is available in generic form while (at that time at least) protonix was not, and was more expensive.

Sometime around early 2006 this irritation-nausea-headache syndrome became slightly more pronounced, and the irritation would persist for a longer period of time, a week or more. Sometimes the itching and gnawing would coincide with the mild nausea and/or headache.

During these years since 2002 I went through 3 different primary care physicians, none of whom seemed to have any particular insight into my problem. All of them made attempts to interpret the symptoms I've described and their best guess was that I had some sort of allergic condition to go along with the reflux disorder. Anti-allergy medications (such as Loratidine) were prescribed and taken and no alleviation of the symptoms resulted.

In late 2002 I had an upper gastrointestinal endoscopy. A lipoma was found at the lower esophageal sphincter, but no other irregularities were seen. Then in December 2005 a different gastroenterologist did another upper gastrointestinal endoscopy, and the only thing he reported was that I had a mild inflammation of the esophagus.

Anyway, I'm sure that this is both tedious and confusing to most readers. I just saw (Dec. 2007) my primary care physician (at Kaiser Permanente) and once again all he did was prescribe Loratidine to combat my symptoms. The Loratidine has once again provided no relief, and I'm at my wits end. Here are some of my hypothetical diagnoses, most of which are probably inaccurate:

hiatal hernia (??)
Barrett's syndrome (??)
auto-immune disorder resulting in chronic inflammation (??)
chronic mycoplasmal pneumonia infection (very unlikely)
Helobacter Pylori infection (tested negative a couple years ago)
Carnitine-acylcarnitine translocase deficiency (not tested yet)

Anyway, if anyone has any suggestions or insights they're welcome. :confused:

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5 Replies:

  • Have you seen an ear, nose throat doctor?
    aquila 1,263 Replies
    • December 14, 2007
    • 02:44 PM
    • 0
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  • Have you seen an ear, nose throat doctor? Yes I have, a doctor who works for Kaiser named Jivianne Lee, who prescribed an antibiotic (which was effective) for what perhaps was at that time a secondary sinus infection, and who also prescribed Nasarel. I took the Nasarel (a nasal spray) for roughly 2 months with no perceivable improvement, and abandoned it as ineffective. Jivianne Lee was a nice Korean lady doctor though, who did what she thought was best according to the symptoms that I described to her. I saw her twice, once to tell her my problems, and again to report back on the results of the antibiotic and Nasarel. She was pleased that the excess phlegm was gone (hence at that time I suppose that I did indeed have a mild bacterial infection), but the irritation in the throat and esophagus was left unchanged. I have not seen her in around 10 months or so. Thanks for your reply! :)
    mokele 2 Replies
    • December 15, 2007
    • 00:03 PM
    • 0
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  • I'm worried that the lipoma excision on the oddly called cardiac sphincter (lower end of esophagus) may have damaged it. Have you had an upper G.I. with barium? Have you tried all the mechanical aids such as rasing the head of the bed, no tight clothes, no late eating, no beer, etc. Have you been to an allergist? Do you live in the same house where all this started. Black mold in basement? Sleep apnea? Just guessing here.
    rad-skw 1,605 Replies
    • December 15, 2007
    • 00:52 PM
    • 0
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  • I'm worried that the lipoma excision on the oddly called cardiac sphincter (lower end of esophagus) may have damaged it. Have you had an upper G.I. with barium? Have you tried all the mechanical aids such as rasing the head of the bed, no tight clothes, no late eating, no beer, etc. Have you been to an allergist? Do you live in the same house where all this started. Black mold in basement? Sleep apnea? Just guessing here. I've been wondering about that lipoma for a few years. I have an excessive number of lipomas, on my arms, legs and torso, and some of them impinge on nerves enough to cause occasional local discomfort. If the lipoma at the cardiac sphincter has been causing signficant mechanical problems, interfering with closure, impingement on nerves, etc., that would go a long way to explaining a good portion of my symptoms. I have not as of yet had an upper GI with barium. That sounds like a good idea. I'll let my primary care physician know about it. A friend of mine, a gastroenterologist, already suggested various simple measures to deal with the reflux that I had a few years ago, including elevating the head of my bed, staying away from acidic or spicy foods, no caffeine, coffee, chocolate or citrus fruits, etc., but I really don't have appreciable acid reflux anymore, for close to 3 years now. I took several of the the measures he recommended back in 2002 through 2004. If the cardiac sphincter is damaged though, I am likely to suffer from chronic non-acidic reflux, which could have instigated an immune system response, including nausea, headaches, tightness in the gut, etc. I doubt that there is a sleep apnea problem. A black mold problem is possible, undetermined at the moment. Thanks much for your response! :)
    mokele 2 Replies
    • December 15, 2007
    • 08:47 PM
    • 0
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  • Hi,I have suffered the same symptoms (and reflux diagnosis) for years. Reflux treatment helps but doesn't solve the problem. I am wondering if you got a diagnosis. Also, have you had reflux testing INCLUDING a gastric emptying study? Nausea can be a sign of slow gastric emptying. Please post if you get a diagnosis or cure!Wishing you all the best!!!!!!!!!!I've been wondering about that lipoma for a few years. I have an excessive number of lipomas, on my arms, legs and torso, and some of them impinge on nerves enough to cause occasional local discomfort. If the lipoma at the cardiac sphincter has been causing signficant mechanical problems, interfering with closure, impingement on nerves, etc., that would go a long way to explaining a good portion of my symptoms. I have not as of yet had an upper GI with barium. That sounds like a good idea. I'll let my primary care physician know about it. A friend of mine, a gastroenterologist, already suggested various simple measures to deal with the reflux that I had a few years ago, including elevating the head of my bed, staying away from acidic or spicy foods, no caffeine, coffee, chocolate or citrus fruits, etc., but I really don't have appreciable acid reflux anymore, for close to 3 years now. I took several of the the measures he recommended back in 2002 through 2004. If the cardiac sphincter is damaged though, I am likely to suffer from chronic non-acidic reflux, which could have instigated an immune system response, including nausea, headaches, tightness in the gut, etc. I doubt that there is a sleep apnea problem. A black mold problem is possible, undetermined at the moment. Thanks much for your response! :)
    Anonymous 42,789 Replies
    • November 13, 2009
    • 07:46 PM
    • 0
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