[39M] With sensation of throat obstruction and gastrointestinal symptoms

Patient Description

A 39-year-old male reports a gradual onset of a sensation of something stuck in his throat since last night, which is alleviated by drinking water or hot tea. The patient denies difficulty swallowing or changes in voice. He associates the sensation with stomach acid or GERD, noting that it worsens at the end of the day or with less sleep. He experienced a burning sensation in his throat after burping, which occurred several hours after feeling the obstruction. The patient reports frequent gas, approximately 10-20 times a day, and a recent change in stool, describing it as loose, lighter in color, and greasy. He experiences occasional dull, burning, or muscle tension-like chest discomfort, possibly after eating. The patient has been experiencing a sore throat for about three weeks. He smokes 10-12 cigarettes a day and has been sober from alcohol for over three years. He has a history of autism spectrum disorder, attention deficit hyperactivity disorder, generalized anxiety disorder, and irritable bowel syndrome diagnosed two years ago. Current medications include Clonidine 0.05 mg/day, Melatonin 10 mg/day, Adderall XR 15 mg/day, Psyllium husk, and Prilosec OTC. The patient has no known allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Gastroesophageal Reflux Disease (GERD): GERD occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, leading to symptoms like the sensation of something stuck in your throat, burning in the throat, and chest discomfort. The greasy stool and gas could be related to dietary factors or other gastrointestinal issues.

    • Typical Treatments: GERD is often managed with lifestyle changes, over-the-counter medications like antacids, H2 blockers, or proton pump inhibitors (like Prilosec OTC). In some cases, prescription medications or surgery may be necessary.

  • Irritable Bowel Syndrome (IBS): Since you have a history of IBS, some of your symptoms like gas and changes in stool consistency could be related to this condition. IBS is a common disorder that affects the large intestine and can cause symptoms like cramping, abdominal pain, bloating, gas, and diarrhea or constipation.

    • Typical Treatments: Management of IBS often involves dietary changes, stress management, and sometimes medications to manage symptoms.

What you can do

  1. Dietary Adjustments: Consider keeping a food diary to identify any foods that may trigger your symptoms. Foods that are spicy, fatty, or acidic, like garlic, can exacerbate GERD symptoms. Try to avoid these and see if your symptoms improve.

  2. Lifestyle Changes: Elevate the head of your bed, avoid lying down immediately after eating, and try to eat smaller, more frequent meals. Reducing stress through relaxation techniques or exercise may also help manage both GERD and IBS symptoms.

  3. Smoking Cessation: Smoking can worsen GERD symptoms. Consider seeking support to reduce or quit smoking, which could help alleviate your symptoms.

  4. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and gain insights. This information can be valuable to share with your healthcare provider.

What you should look out for

  • Seek Medical Attention If:
    • You experience severe chest pain, especially if it radiates to your arm, neck, or jaw, or is accompanied by shortness of breath, as these could be signs of a heart condition.
    • You notice significant weight loss, difficulty swallowing, or persistent vomiting.
    • Your symptoms worsen or do not improve with over-the-counter treatments.

Remember, while these suggestions can help manage your symptoms, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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1 mo ago

People Also Ask

What are common symptoms of GERD and how can they be managed?

Common symptoms of GERD include a sensation of something stuck in the throat, burning in the throat, chest discomfort, and acid reflux. Management often involves lifestyle changes such as avoiding trigger foods, eating smaller meals, and using over-the-counter medications like antacids or proton pump inhibitors.

How does smoking affect GERD symptoms and what are the benefits of quitting?

Smoking can relax the lower esophageal sphincter, leading to increased acid reflux and worsening GERD symptoms. Quitting smoking can reduce these symptoms and improve overall health, reducing the risk of complications associated with GERD.

What dietary changes can help manage symptoms of IBS and GERD?

Dietary changes for managing IBS and GERD include avoiding spicy, fatty, or acidic foods, eating smaller and more frequent meals, and keeping a food diary to identify and eliminate trigger foods. Increasing fiber intake can also help manage IBS symptoms.

When should someone with GERD or IBS symptoms seek medical attention?

Medical attention should be sought if there is severe chest pain, especially if it radiates to the arm, neck, or jaw, or is accompanied by shortness of breath. Other concerning symptoms include significant weight loss, difficulty swallowing, persistent vomiting, or if symptoms do not improve with over-the-counter treatments.

2 Comments

Anonymous#4815

28 d ago

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Arora (Bot)#24147

28 d ago

It sounds like you're going through a lot, and it can be really challenging to manage multiple symptoms at once. It’s great that you’re reaching out for more information and support. Remember, you're not alone in this, and there are steps you can take to feel better. If you haven’t already, consider discussing these symptoms with your healthcare provider to get some clarity and tailored advice. Take care, and remember to be kind to yourself during this time! 😊

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