[29F] With severe acid reflux and dysphagia

Patient Description

A 29-year-old female reports experiencing difficulty swallowing for a couple of weeks, with a sensation of something being stuck in her throat, particularly when eating bread. This has not worsened over time but has led to a decreased appetite. She also reports severe acid reflux, occurring after every meal, with drinks, and during sleep. She has not tried any treatments for these symptoms. Additionally, she has been clearing her throat for about two weeks and has experienced heartburn, regurgitation, hoarseness, and chest discomfort after eating. There is no weight loss or changes in bowel habits. She does not smoke or consume alcohol regularly. There is no family history of gastrointestinal issues or acid reflux. Her medical history includes chronic inflammatory demyelinating polyneuropathy, Chiari malformation, intracranial hypertension, and weight loss surgery in 2017. She is allergic to iodine and is currently taking Gabapentin 650 mg three times a day.

Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash can irritate the lining of your esophagus, leading to symptoms like heartburn, regurgitation, and difficulty swallowing.
- Treatment: Lifestyle changes, such as avoiding trigger foods, eating smaller meals, and not lying down after eating, can help. Medications like antacids, H2 blockers, or proton pump inhibitors may be recommended by a doctor.
Esophageal Stricture: This is a narrowing of the esophagus that can cause swallowing difficulties. It can result from chronic acid reflux.
- Treatment: A doctor may perform a procedure to stretch the esophagus or prescribe medications to reduce acid.
Laryngopharyngeal Reflux (LPR): Similar to GERD, but the acid reaches the throat, causing symptoms like throat clearing, hoarseness, and a sensation of something stuck in the throat.
- Treatment: Similar to GERD, with a focus on dietary changes and medications.

What you can do

Dietary Changes: Avoid foods and drinks that trigger reflux, such as spicy foods, caffeine, and alcohol. Eat smaller, more frequent meals.
Lifestyle Adjustments: Elevate the head of your bed, avoid lying down after meals, and maintain a healthy weight.
Symptom Tracking: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.
Consult a Doctor: It's important to see a healthcare professional for a formal diagnosis and treatment plan.

What you should look out for

Seek Medical Attention If:
- You experience severe chest pain or difficulty breathing.
- Your symptoms worsen or do not improve with lifestyle changes.
- You have significant weight loss or difficulty swallowing persists.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a thorough evaluation and personalized treatment plan.

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3 mo ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines