I feel heaviness in my chest and throat after eating. Is this due to H.pylori infection?

Question

Hi doctor,

For the past four months, I feel heaviness in my chest and throat a few minutes after eating like food stuck there. I consulted a gastroenterologist, he did an endoscopy and came out with H.pylori Infection. I am on two weeks medication. Are my symptoms due to this infection?

Answer 1

Hello,

Welcome to icliniq.com.

Well, the symptoms you mention seems to be due to esophageal (food pipe) problem. However, the H.pylori infection infects the stomach and usually causes acid-related symptoms like acidity and pain but is all confined to the stomach area, not the esophageal area. So it is unlikely that the H pylori has to do with this thing.

I am more interested in seeing your endoscopy report, particularly in terms of findings in the esophagus. Images can guide us as well. I also wanted to know, do you stress out at swallowing? I mean, do you have severe difficulty while taking a bolus? Is it towards liquids or solids or to both?

Do you have symptoms of retrosternal burning or chest burning? Did acid keep coming into your mouth? Do you have vomiting? And does ever vomit contained the foods that you just ate? Do you have weight loss? And lastly, how is your mood nowadays? Do you feel that anxiety or stress worsens your symptoms? Any prior history of the same problem or prior gut-related problems like altered bowel habits and abdominal pain?

All the above information are important to me to figure out what is causing this problem to you. Esophageal motility disorders and functional heartburn are the two which are common in our population and can easily be missed on endoscopy.

Do upload all the investigations which have been done in this course of illness. Have you done any barium studies before?

Answer 2

Hello,

Welcome back to icliniq.com.

Can you upload the endoscopy report? And please let me know the medications that include in your two-week course?

Answer 3

Hello,

Welcome back to icliniq.com.

In endoscopy, the esophagus is otherwise unremarkable (attachment removed to protect patient identity).

I suggest you take tablet Pantoprazole 40 mg (proton pump inhibitor) half an hour before breakfast for two weeks. This or the drug with the same class would have already been advised to you in a two-week regimen for the treatment of H.pylori.

Plus, I want you to get another test called a barium swallow. In this, a barium paste is swallowed by mouth, and the radiologist would take serial x-rays of the chest to see the flow of barium along the esophagus. This will tell whether there is inappropriate turbulence or block in the flow of the barium. If this turns out to be negative, I can then start you some low dose antidepressant medication considering functional heartburn.

The functional heartburn is a hypersensitive esophagus that perceives food signals as pain signals and causes burning, heaviness, and pain, usually after meals. But this is a diagnosis of exclusion, which means, once we exclude the other common possibilities, namely the gastroesophageal reflux disease (GERD) and esophageal motility disorders, and if nothing comes out, then we consider this diagnosis.

I hope this helps.