Mrs Asked :
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.