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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