Throat Burp, Knot in Throat – Difficulty Swallowing, Small Burps

Mrs Asked :

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For about 2 years I have a recurring excessive burping problem. They are constant, small burps that are in my throat and do not feel like a normal gassy burp. I frequently feel as if there is a knot in my throat, now and again have trouble swallowing the saliva in my mouth.

After a half hour or so of this burping, I feel exhausted and my stomach hurts, but not nausea. I have a hiatus hernia and acid reflux and have taken 5 or 6 medicines with no relief. I also have been told that I have esophageal spasm and have taken meds to relax the esophagus, also with no relief.

I always question if the hernia is the cause, but none of the docs I’ve seen think so. I cannot go on and am at the end of my rope. Please help me to get the diagnosis I need to find relief for this aggravating problem.

This question was posted under the Excessive Belching, Burping and Bloating article.

Any response by the Health Hype team does not constitute a medical consultation and the advice should be viewed purely as a guide. Always consult with your doctor before making any changes to your current treatment program. The information provided in this article is not an authoritative resource on the subject matter and solely intends to guide the reader based on the questions asked and information provided.

Dr. Chris Answered :

The feeling of a ‘knot in your throat’ with difficulty swallowing saliva is quite worrying, even if it only occurs in episodes. Firstly it is important to have an endoscopy and/or bronchoscope to identify if there is any ‘lump’ or partial obstruction in the throat which needs immediate attention. This would help you understand if the sensation of a knot in your throat is only a sensation (globus sensation) or due to some pathology. It may not be a lump inside the throat and could even be due to an enlarged thyroid gland (goiter).

Secondly, it is important to ascertain whether your ability to swallow is impaired either due to some neurological disorder or possibly a muscular disorder (since you do mention the esophageal spasms). There is a host of disorders that could affect your ability to swallow and this would need to be investigated by your doctor. Your age, past medical history, family history and current health status may bring your doctor’s attention to certain disorders specifically  and further tests and evaluation will allow your doctor to confirm a diagnosis.

It is important to remember that GERD (gastroesophageal reflux disease / acid reflux) can cause belching and it is usually small or shallow burps. The rising acid, especially when you sleep, could be reaching the throat where it is causing inflammation and therefore swelling of the back of the throat which may be the cause of this ‘knot in the throat’ sensation. Many GERD sufferers report a slight sore throat upon waking in the morning and this usually settles down during the course of the day. In some cases of GERD, the sore throat is persistent. If you can get your GERD under control, then you may find that your symptoms will settle.

Although unlikely, there is a possibility that your hiatal hernia coupled with the esophageal spasms are causing a significant obstruction and if you are swallowing air (aerophagia), this could be trapped in the food pipe (esophagus) and passed out as these shallow burps. This trapped air at the upper parts of your esophagus is what may be causing this sensation of a ‘knot in your throat’.  This is not common in a hiatal hernia and you should consult with a gastroenterologist to get more clarity on these symptoms. If you are still concerned, seek a second opinion. Only your doctor can confirm a diagnosis.

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  • Nemer Mansour

    I have simultaneously:
    1- excess in saliva (annoy me when I swallow)
    2- small burps every now and then
    3- congestion/swelling in my throat/lump
    Then it goes all alone and comes back
    What can I do to get cured. Happening since 40 days

  • Hi Nemer. These symptoms can occur with many types of gastrointestinal and non-GI conditions. You need to see a doctor who will first diagnose the underlying problem and then prescribe the appropriate medication. There is no single remedy to counteract it. Acid reflux (GERD) can cause these symptoms when the acidic stomach contents arise as high as the throat/mouth. Saliva is secreted in large amounts (known as water brash) in an attempt to neutralize the acid in the esophagus. The acid could be irritating the throat. Belching is a common symptom of GERD. However, this is just one explanation. The problem could be starting with the excessive salivation itself which
    may be a problem with your salivary glands. You may be swallowing air
    along with the excess saliva and experience belching as a result.Your doctor will be able to advise you further.

  • Peg

    I have had severe stomach cramping, excessive belching and knot in my throat sensation for the last week. It got so bad I ended up in the ER where I received an IV with meds to prevent stomach cramps and a very strong antacid. I also received meds to take home with me. They did relieve some of the pain but is still there but not so bad. How long will this last?

  • Mae Ancheta

    Here are my symptoms:
    – burping/belching esp. when waking up in the morning
    – sometimes feeeling hungry esp. at 10pm-11pm
    – discomfort on the throat/neck

  • Hi Mae. Very like it is acid reflux. It tends to worsen at night and in the morning. The hunger you are perceiving may actually be heartburn but sometimes conditions like peptic ulcer disease (PUD) presents with an insatiable hunger. Of course, it also depends when you had your last meal. Speak to your doctor but if antacids or acid-suppressing medication eases the symptoms then it is very likely GERD.

  • Harley

    After a small meal I start making noise from my throat, they sound like burps but they aren’t. They are like a burp sound forcing their way up my throat and I can’t control them. They happen nearly every day. Eventually after they’ve stopped I also begin to hiccup what could this be? And how can I stop them?