Q. Are heartburn, indigestion and frequent belching symptoms of GERD?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on May 10, 2020 and last reviewed on: May 19, 2020

Hello doctor,

Heartburn and indigestion all day. Frequent belching. Gurgling in throat/ esophagus. Throat or esophagus is making a funny noise off and on for years sporadically. Diagnosed with Gerd and Larapharyngeal reflex. Clean endoscopy in 2 years back but esophagus is slightly twisted. Had dilation during procedure. Other endoscopies were fine. Is this classic signs of GERD? Saw ENT recently for other issues, throat looked good. Just never had the gurgling as much. Taking Gas x and Protonix and tums here and there. Also deal with allergies and post nasal drip. No vomiting or fever. Just uncomfortable.

Dr. Ajeet Kumar Lohana

Medical Gastroenterology
#

Hello,

Welcome to icliniq.com.

Most of the symptoms such as burping, gurgling within esophagus and funny noise all can be encompassed in to one diagnosis, that is, GERD. But thing which make concerned, are-you have 3 endoscopies and all showling normal without signs of ulceration which is not usually a case in GERD patient unless they are on maximal acid suppressant medications and symptom free at the time of undergoing endoscopy. So endoscopy result has to be correlated with the timings and weather use of acid suppressant medication before making a diagnosis.

Given some more interesting findings like dilated esophagus, and no ulceration at the time of endoscopy, with presence of persistent symptoms, suggest some other additional problem bystanding with GERD- such as motility disorder. Some time GERD is just a menifestation of motility disorders, because two disorders almost cause similar symptoms.

Secondly for GERD, one must have PH-imepdence monitoring to confirm the diagnosis. And in case you have already gone through this, then you come in category of refractory GERD not responding to usual acid suppressant medications.

For refractory GERD, the only single test that can confirm symptoms correlation index,-acid reflux causing the symptoms or non acid reflux causing symptoms, or no acid reflux at all; is PH-impedence test while person on acid suppressant medications. I can understand it must be very exhaustive and confusing for you to understand above things, but it can be very easy while investigation all these possibilities. I urge you to upload your previous reports and keep in touch with me, as I can suggest you how it is further be approached.


The Probable causes:

Refractory GERD

Investigations to be done:

PH-impedence monitoring

Differential diagnosis:

Motility disorder
Functional heartburn

Probable diagnosis:

Refractory GERD

Treatment plan:

Suggest investigation

Regarding follow up:

You can follow up with me to discuss about how to approach this


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