
Hi- I Have An Endoscopy On Friday. The Last Endoscopy

I have an endoscopy on Friday. The last endoscopy conducted 5 years ago found mild esophagitis and GERD which was treated. I haven't noticed indigestion since, but not following a GERD diet.
For the past 6 weeks, I have noticed something strange. I have to clear my throat often (like a bubble)- when speaking voice changes. In addition, sometimes my throat feels more narrow (not to the point of not breathing) after eating certain foods. It seems like cheese or tortilla (carbs). Not sure.
Any ideas on what may be going on? The bubble in my throat, voice changes has me a bit concerned
I've been diagnosed recently with Hashimoto's (thyroid level fine, just high antibodies) and cleared with ultrasound (no goiter).
Achalasia cardia due to GERD.
Detailed Answer:
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Have gone through your details.
The feeling of narrowing or chocking sensation could be suggestive of Achalasia.It is a primary esophageal motility disorder characterized by the absence of esophageal peristalsis and impaired relaxation of the lower esophageal sphincter (LES) in response to swallowing.Esophagus is seperated from stomach by a muscular sphincter called lower esophageal sphincter.Impaired relaxation of this sphincter can also be responsible for feeling of food struck in esophagus .The degeneration of nerves due to uncontrolled GERD in esophagus often contributes to the advanced symptoms of the condition. The acid reflux Ed back into esophageal tube may cause inflammation in throat and vocal cords hence you may need to clear your throat and voice changes as a result of inflammation.
Tests suggested are-
High-resolution esophageal manometry. Using a catheter inserted down your esophagus, muscle contractions in your esophagus are measured when you swallow water.
Endoscopy- Which you are already having.
Once endoscopy is done your
gastroenterologist would start you on PPI-antacids like Rabeprazole or Esomeprazole.Esomeprazole can be used in the dosage as high as 80 mg twice daily.Trials have shown that esomeprazole is superior to other PPI's in controlling reflux symptoms. Also he would add Domperidone 30mg or Levosulpiride(both are prokinetic)slow release once daily. This will slow down the reflux of acid back.
An antacid containing local anesthetic (Mucaine gel ) should be taken 2tsf thrice daily.
Acotiamide is another wonderful new drug and is very effective in controlling symptoms of GERD and esophagitis. In trials- Acotiamide, a gastrointestinal motility modulator, at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults.
All these drugs should be considered by your gastroenterologist to provide you with symptomatic relief in your problem.All these medicine should be used initially at a time and doses should be tappered off as problem solves.
To prevent the esophageal damage from developing into Barett or acalasia cardaia I would suggest you to ask your gastroenterologist to follow aggressive treatment pattern initially. As your symptoms will improve drugs can be tappered off gradually.
Avoid-
Dairy products, which contain sugar lactose that causes gas.
Vegetables, including onions, radishes, cabbage, celery, carrots, brussel sprouts, broccoli, cauliflower and legumes.
Fruit sugar, which is especially high in prunes, raisins, bananas, apples, apricots and fruit juices from prunes, grapes and apples
Fiber.
Fatty foods and carbonated drinks.
Try Eating more fermented foods. These are rich in both good bacteria and enzymes you can try raw natto kefir or cultured veggies. This is probably one of the most important first steps.
Take a high-quality probiotic.
Take external enzyme supplements.
Exercising, to help keep food moving through your system.
Using spices that may help to prevent flatulence. These include turmeric, coriander, peppermint, fennel, sage, chamomile and ginger.
Hope i answered your query in details.
In case you have more doubts feel free to ask

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