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Hello There I Have A Problem And I Have To

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Posted on Thu, 21 Jan 2021
Question: Hello there

I have a problem and I have to take some more words to describe it, because you can not examine me, I think my history and description of the problems is very important for you to be able to tell me your opinion.

In a sentance, I have severe fear I may have oesophagus cancer.

I am 51 male, never smoked, eathing moderate healthy dietary life, except some years I drank more than is considered healthy for the standards. Nothing like daily drunk, but more than 1 glass of wine a day, of course not every day.

It would be too long to tell about all my problems with health, but I will say I constantly have some problems (skin problems, muscle twitching, urinary, GA, ENT problems), mostly they change over time to return later.

I have severe health anxiety, mostly fearing the most deadly diseases like cancer, ALS, etc. They really affect my life.

If I focus on your speciality and my current problems and fear, first some background.

I've had severe GA problems in 2004. I had severe stomach pain, like acid was burning my stomach. After a bad episode I went to the gastroscopy and they say stomach is fine, a little too much acid for one antacid a day... I've also had severe colon problems with 5 times a day stool passing, diahroea, constipation, mucus, no blood. Colonoscopy revealed a small 3mm polyp, not the dangerous type. I was diagnosed functional dyspepsia and IBS. The problems took 1-2 years to subside, but I still have bad days and weeks.

Fast forward to 2013. I got severe cough without having a flu. It woke me from the middle of the night and I cough so severly I almost threw up. It was dry cough. I never went to ENT, but I went to pulmologist who said that I have chronically sore throat, signs of mucus, and LPR (laryngopharenal reflux), post nasal drip (I have a broken nose) and GERB was suspected. The symptoms with following rules of diet and PPI somehow went away, But not completely. What reamined was mucus in my nose and I use neti pot a lot for clearing it. The mucus goes to my throat and sometimes I snore and I have sore throat. I clear throat a lot of times and I had episodes of hoarse voice (a little), that would go with diagnoses, didn't scare me. Stomack was better, no burning pain and last few years I got less mucus problems in my nose, I still had throat clearing of mucus, don't remember how much, I also had some left ear pain.

Fast forward to end of october 2020. I have to say this year was very very stressful for me, as I got divorced and this corona... I mean, I have health anxiety, you can only imagine, I was living in constant fear, we can not go anywhere etc.

I am not sure if my neck pain is relevant, but it is part of my story and main fear fuel factor up to now.

End of october I got neck pain and I had right shoulder pain last six months. Both are not unusual for me, forward posture, computer work... I had left and right shoulder problem on and off for years and sometimes I got such severe stiff neck I can not even turn my head to one direction. It resolves in a few days.

This time it didn't. I have up to now (2 months) severe neck pain and both shoulders pain. Neck pain is present in the back in the middle of my collar bone and raiates to shoulders. But it is prominent on the left side, so turning neck right and down is most painfull. Sometimes is a little better, but never cures. Sometimes the pain is miserable radiating to back of my neck making me headache that is distressing to me. The pain is kind of stiff, mostly not sharp in the shoulders and in the neck it can be sharp if I turn my head. It is gnawing and stiff kind of pain. In the morning I have the most pain, I must take like 5 minutes to move around to get it together. Hot shower helps a little.

I got to orthopediacs of course thinking it has to be something bad with my spine, I admit fearing spine cancer. The X-RAY was showing some degenerative disease but nothing much and nothing explaining the pain in the neck.

About a week or 10 days ago I got some hoarse voice on and off, sometimes clearing the throat helped (we have very dry air in apartment and mostly we can not go out now in corona winter). My throat was sore few times when I was snoring because I try to sleep on my back because of by neck pain. I then started to fear because my neck is not better (but not worse also), that I may have laryngeal cancer. My voice was never strong, even years ago when I was talking loud in a caffe I got "out of my voice". And even few years back I had to clear throat when I eat peanuts. They weren't stuck in my throat, more scratched it. And now I started fearing this was somehow throat cancer, small voice changes that come and go and last week when drinking and eating my food got kind of stuck so I coughed, it happened on sipping tea 3 times in one day, like the drink would go to the lungs not in stomach (don't know English word for this, happens to everybody sometimes). That got me really alert and even more in panic mode. I can eat large pieces of food, the small ones somehow irritated my throat like coconut small flakes etc. So I was in fear of throat cancer.

Few days later both ends of my tongue got this hypersensitivity, like a little burning pain. I have some ulcers but not on the sides and back when it fiels wierd. As I have geographic tongue that burns me a lot of times, I couldn't see if tongue is ok or not, I do not differentiate geographic tongue and cancer. I got scared of tongue cancer, the next day I got some bad taste in my mouth. It is still there, the more I am concentrating on it, the more I think I have some wierd taste in mouth.

And fast forward to today, I got symptoms of oesophagus cancer. I wouldn't say I have dysphagia, although I fear it. I mean, when I swallow it is wierd. I can swallow even big pieces of food, but when the food goes down I feel like... motility is not right, like it gets stuck somewhere at the bottom and then I get spasm and a little belch no matter what I eat or even drink and then pain in the breastbone like heartburn. Today I belch so much after every drink, I never had problems with swallow, I guess that is what made me so scared.

And I googled... :-( This seem to be symptoms of the oesophagus cancer, and the more I "listen" of how I swallow there more I seem to have problems. But this happens on drinking and eating the same, I read usually it gradually progresses from big solids to liquids. I got this in few days, but I read this cancer is fast and when such symptoms arrive it is already stage IV :-( And this cancer is death sentance where it makes swallow problems.

All this scare started with the nack and then progressed to larnx and mouth and now oesophagus symptoms and problem with swallow (it is more kind of a pain when some muscle spasms when I swallow than inability to swallow, I do eat and drink).

Is this the usual presentation of oesophagus cancer? Can it be anything else at all, I have so much symptoms progressing daily (also have dry mouth few days now, my voice seems to be a little better than last week).

What I didn't find related symptom that I have for 2 months is the neck pain. First scare came from neck because it has to be something sinister, doesn't get better. But I didn't find oesophagus cancer presents itself as such stiff neck and shoulders. On X-RAY of the neck nothing is visible, the doctor said no neck spine cancer. But oesophagus cancer wouldn't start 2 months as severe stiff neck pain and then go to problems with swallowing and pain the the chest, my neck pain is on the back of the neck between shoulders.

Because of the new year and corona, no doctors here are working in a day to day basis and I will need to wait for the ENT, GI examination, not even know where to go and if it is already to late for me.

Can it be something else not so fast spreading cancer?

Thank you for reading my long letter.

Yours
XXXXXXX
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Follow up: Dr. Ramesh Kumar (0 minute later)
Hello there

I have a problem and I have to take some more words to describe it, because you can not examine me, I think my history and description of the problems is very important for you to be able to tell me your opinion.

In a sentance, I have severe fear I may have oesophagus cancer.

I am 51 male, never smoked, eathing moderate healthy dietary life, except some years I drank more than is considered healthy for the standards. Nothing like daily drunk, but more than 1 glass of wine a day, of course not every day.

It would be too long to tell about all my problems with health, but I will say I constantly have some problems (skin problems, muscle twitching, urinary, GA, ENT problems), mostly they change over time to return later.

I have severe health anxiety, mostly fearing the most deadly diseases like cancer, ALS, etc. They really affect my life.

If I focus on your speciality and my current problems and fear, first some background.

I've had severe GA problems in 2004. I had severe stomach pain, like acid was burning my stomach. After a bad episode I went to the gastroscopy and they say stomach is fine, a little too much acid for one antacid a day... I've also had severe colon problems with 5 times a day stool passing, diahroea, constipation, mucus, no blood. Colonoscopy revealed a small 3mm polyp, not the dangerous type. I was diagnosed functional dyspepsia and IBS. The problems took 1-2 years to subside, but I still have bad days and weeks.

Fast forward to 2013. I got severe cough without having a flu. It woke me from the middle of the night and I cough so severly I almost threw up. It was dry cough. I never went to ENT, but I went to pulmologist who said that I have chronically sore throat, signs of mucus, and LPR (laryngopharenal reflux), post nasal drip (I have a broken nose) and GERB was suspected. The symptoms with following rules of diet and PPI somehow went away, But not completely. What reamined was mucus in my nose and I use neti pot a lot for clearing it. The mucus goes to my throat and sometimes I snore and I have sore throat. I clear throat a lot of times and I had episodes of hoarse voice (a little), that would go with diagnoses, didn't scare me. Stomack was better, no burning pain and last few years I got less mucus problems in my nose, I still had throat clearing of mucus, don't remember how much, I also had some left ear pain.

Fast forward to end of october 2020. I have to say this year was very very stressful for me, as I got divorced and this corona... I mean, I have health anxiety, you can only imagine, I was living in constant fear, we can not go anywhere etc.

I am not sure if my neck pain is relevant, but it is part of my story and main fear fuel factor up to now.

End of october I got neck pain and I had right shoulder pain last six months. Both are not unusual for me, forward posture, computer work... I had left and right shoulder problem on and off for years and sometimes I got such severe stiff neck I can not even turn my head to one direction. It resolves in a few days.

This time it didn't. I have up to now (2 months) severe neck pain and both shoulders pain. Neck pain is present in the back in the middle of my collar bone and raiates to shoulders. But it is prominent on the left side, so turning neck right and down is most painfull. Sometimes is a little better, but never cures. Sometimes the pain is miserable radiating to back of my neck making me headache that is distressing to me. The pain is kind of stiff, mostly not sharp in the shoulders and in the neck it can be sharp if I turn my head. It is gnawing and stiff kind of pain. In the morning I have the most pain, I must take like 5 minutes to move around to get it together. Hot shower helps a little.

I got to orthopediacs of course thinking it has to be something bad with my spine, I admit fearing spine cancer. The X-RAY was showing some degenerative disease but nothing much and nothing explaining the pain in the neck.

About a week or 10 days ago I got some hoarse voice on and off, sometimes clearing the throat helped (we have very dry air in apartment and mostly we can not go out now in corona winter). My throat was sore few times when I was snoring because I try to sleep on my back because of by neck pain. I then started to fear because my neck is not better (but not worse also), that I may have laryngeal cancer. My voice was never strong, even years ago when I was talking loud in a caffe I got "out of my voice". And even few years back I had to clear throat when I eat peanuts. They weren't stuck in my throat, more scratched it. And now I started fearing this was somehow throat cancer, small voice changes that come and go and last week when drinking and eating my food got kind of stuck so I coughed, it happened on sipping tea 3 times in one day, like the drink would go to the lungs not in stomach (don't know English word for this, happens to everybody sometimes). That got me really alert and even more in panic mode. I can eat large pieces of food, the small ones somehow irritated my throat like coconut small flakes etc. So I was in fear of throat cancer.

Few days later both ends of my tongue got this hypersensitivity, like a little burning pain. I have some ulcers but not on the sides and back when it fiels wierd. As I have geographic tongue that burns me a lot of times, I couldn't see if tongue is ok or not, I do not differentiate geographic tongue and cancer. I got scared of tongue cancer, the next day I got some bad taste in my mouth. It is still there, the more I am concentrating on it, the more I think I have some wierd taste in mouth.

And fast forward to today, I got symptoms of oesophagus cancer. I wouldn't say I have dysphagia, although I fear it. I mean, when I swallow it is wierd. I can swallow even big pieces of food, but when the food goes down I feel like... motility is not right, like it gets stuck somewhere at the bottom and then I get spasm and a little belch no matter what I eat or even drink and then pain in the breastbone like heartburn. Today I belch so much after every drink, I never had problems with swallow, I guess that is what made me so scared.

And I googled... :-( This seem to be symptoms of the oesophagus cancer, and the more I "listen" of how I swallow there more I seem to have problems. But this happens on drinking and eating the same, I read usually it gradually progresses from big solids to liquids. I got this in few days, but I read this cancer is fast and when such symptoms arrive it is already stage IV :-( And this cancer is death sentance where it makes swallow problems.

All this scare started with the nack and then progressed to larnx and mouth and now oesophagus symptoms and problem with swallow (it is more kind of a pain when some muscle spasms when I swallow than inability to swallow, I do eat and drink).

Is this the usual presentation of oesophagus cancer? Can it be anything else at all, I have so much symptoms progressing daily (also have dry mouth few days now, my voice seems to be a little better than last week).

What I didn't find related symptom that I have for 2 months is the neck pain. First scare came from neck because it has to be something sinister, doesn't get better. But I didn't find oesophagus cancer presents itself as such stiff neck and shoulders. On X-RAY of the neck nothing is visible, the doctor said no neck spine cancer. But oesophagus cancer wouldn't start 2 months as severe stiff neck pain and then go to problems with swallowing and pain the the chest, my neck pain is on the back of the neck between shoulders.

Because of the new year and corona, no doctors here are working in a day to day basis and I will need to wait for the ENT, GI examination, not even know where to go and if it is already to late for me.

Can it be something else not so fast spreading cancer?

Thank you for reading my long letter.

Yours
XXXXXXX
doctor
Answered by Dr. Ramesh Kumar (16 hours later)
Brief Answer:
Please go through detailed answer dear.

Detailed Answer:
Hello and thank you for choosing "Ask a Doctor " service for your query,
Have seen your details and from your history it's evident that your body is under lots and lots of stress(mental) from years.
See most of the organs of our body are controlled by parasympathetic or sympathetic nervous system...The work of parasympathetic nervous system is to calm down your body while sympathetic is a flight and fight type of system...Now when they are not in balance with each other(most likely anxiety is the cause) one overrides other.
No you don't have esophageal cancer.
Neither do you have GERD(rather the gross anxiety is the root cause of all your problems e.g GERD).
GERD is usually caused due to over stimulation of vagus nerves.

Constant anxiety cause severe spasm in all muscles of body and in long runs may cause pain also.
Have you ever been to a musculo skeletal physiotherapist.If not I would suggest you to consult a musculo skeletal physiotherapist asap and get the complete course of therapy done.
Secondly we need to address your anxiety issues before they make things more worse(You are not suffering from health anxiety rather it's an obsession and compulsion).
Strong recommendations-
Meet a musculoskeletal physiotherapist.
A psychological counselling /Medication should be taken to calm down anxiety issue and overstimulated sympathetic nerves.
Thank you!

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ramesh Kumar (0 minute later)
Brief Answer:
Please go through detailed answer dear.

Detailed Answer:
Hello and thank you for choosing "Ask a Doctor " service for your query,
Have seen your details and from your history it's evident that your body is under lots and lots of stress(mental) from years.
See most of the organs of our body are controlled by parasympathetic or sympathetic nervous system...The work of parasympathetic nervous system is to calm down your body while sympathetic is a flight and fight type of system...Now when they are not in balance with each other(most likely anxiety is the cause) one overrides other.
No you don't have esophageal cancer.
Neither do you have GERD(rather the gross anxiety is the root cause of all your problems e.g GERD).
GERD is usually caused due to over stimulation of vagus nerves.

Constant anxiety cause severe spasm in all muscles of body and in long runs may cause pain also.
Have you ever been to a musculo skeletal physiotherapist.If not I would suggest you to consult a musculo skeletal physiotherapist asap and get the complete course of therapy done.
Secondly we need to address your anxiety issues before they make things more worse(You are not suffering from health anxiety rather it's an obsession and compulsion).
Strong recommendations-
Meet a musculoskeletal physiotherapist.
A psychological counselling /Medication should be taken to calm down anxiety issue and overstimulated sympathetic nerves.
Thank you!

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar (2 hours later)
Thank you for you kind and reassuring answer?

So even my latest symptoms regarding swallowing are not stage IV cancer? I had problems with mucus in throat and nose before (mostly clear mucus, never bloody), but I never had difficulty swallowing. I mean I have the same difficulty with swollowing a piece of bread or drinking water and this happened recently (1 week ago) when I got drink into lungs few times in same day and I eat nuts and using antiacid pills, this small particles of food seem to sometimes (more often than normal) find a way to my airways or they just seem they don't go down the throat and iritate me so I have to clean the throat. So I thought maybe there is a mass preventing me to swallow normally.

It is a feeling when I swallow this last 2 days that the motility is not ok, the food goes down harder and when it goes down to the chest like the LEF would constrick and open wrongly and it makes me pain after eating right above the stomach and I also notice I need to have a small burp to pass the air out after I drink anything or eat anything. And I am so concentrating of how I swallow that I can not swallow right and immediately after swallow I have some gas I haveto let out.

And the more worrying is the fact I am on omeprazole since last week and it does nothing, I have new sysptom with swallow now.

And I was on gastroscopy 15 years ago, since then I could developed something, as I read most people who drank too much develop this cancer and I did drink too much a few years (don't drink at all now).

So my question is, is it really possible, in your opinion, this could all be "only" stress related? I can understand stress on my neck stiffness and some diahhroea and stomach pain, but dysphagia is considered a red flag, isn't it? I am not sure if this is real dysphagia, but I have some problem when I swallow and then I feel muscles in my chest contracting like they couldn't get food down and then some pain at the top of the stomach.

I am sure you examined many patients in your profession, it is still possible endoscopic evaluation of everything would see nothing much? I feel like my eosophages is inflamed somehow, eathing aggrivates the pain there. I do feel sometimes that observing how you swallow makes things worse, but I started because I had problems not vice versa.

I do also have again a lot of muscle twitching, but this is I guess unrelated, I don't scare of ALS any more after this years.

So you still think this is not cancer? What can it be to have burning pain down the chest and have to belch (because the water seems to go down irritating the LES) after every sip of water this last 2 days? I still have a lot of times tiny food get's stuck and I have to clear my throat. I was going for a run 4 km today and I need to clear my throat all the time. Can all this be my concentration and fear making me this symptoms or some minor problem with indigestion?

I will go to muscoloskeletal therapist, you think my neck 2 months pain is not related to my oesophages at all?
I will also go to counceling. I just need to know it is possible this is not terminal cancer.

Thank you for all your patience.
XXXXXXX
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Follow up: Dr. Ramesh Kumar (0 minute later)
Thank you for you kind and reassuring answer?

So even my latest symptoms regarding swallowing are not stage IV cancer? I had problems with mucus in throat and nose before (mostly clear mucus, never bloody), but I never had difficulty swallowing. I mean I have the same difficulty with swollowing a piece of bread or drinking water and this happened recently (1 week ago) when I got drink into lungs few times in same day and I eat nuts and using antiacid pills, this small particles of food seem to sometimes (more often than normal) find a way to my airways or they just seem they don't go down the throat and iritate me so I have to clean the throat. So I thought maybe there is a mass preventing me to swallow normally.

It is a feeling when I swallow this last 2 days that the motility is not ok, the food goes down harder and when it goes down to the chest like the LEF would constrick and open wrongly and it makes me pain after eating right above the stomach and I also notice I need to have a small burp to pass the air out after I drink anything or eat anything. And I am so concentrating of how I swallow that I can not swallow right and immediately after swallow I have some gas I haveto let out.

And the more worrying is the fact I am on omeprazole since last week and it does nothing, I have new sysptom with swallow now.

And I was on gastroscopy 15 years ago, since then I could developed something, as I read most people who drank too much develop this cancer and I did drink too much a few years (don't drink at all now).

So my question is, is it really possible, in your opinion, this could all be "only" stress related? I can understand stress on my neck stiffness and some diahhroea and stomach pain, but dysphagia is considered a red flag, isn't it? I am not sure if this is real dysphagia, but I have some problem when I swallow and then I feel muscles in my chest contracting like they couldn't get food down and then some pain at the top of the stomach.

I am sure you examined many patients in your profession, it is still possible endoscopic evaluation of everything would see nothing much? I feel like my eosophages is inflamed somehow, eathing aggrivates the pain there. I do feel sometimes that observing how you swallow makes things worse, but I started because I had problems not vice versa.

I do also have again a lot of muscle twitching, but this is I guess unrelated, I don't scare of ALS any more after this years.

So you still think this is not cancer? What can it be to have burning pain down the chest and have to belch (because the water seems to go down irritating the LES) after every sip of water this last 2 days? I still have a lot of times tiny food get's stuck and I have to clear my throat. I was going for a run 4 km today and I need to clear my throat all the time. Can all this be my concentration and fear making me this symptoms or some minor problem with indigestion?

I will go to muscoloskeletal therapist, you think my neck 2 months pain is not related to my oesophages at all?
I will also go to counceling. I just need to know it is possible this is not terminal cancer.

Thank you for all your patience.
XXXXXXX
doctor
Answered by Dr. Ramesh Kumar (15 hours later)
Brief Answer:
An endoscopy should be done.

Detailed Answer:
Hello my dear patient,
Firstly no it's not stage 4 cancer.
Cancer leads to a stage called cachexia in which a person loses drastic weight for e.g 10 kgs in 20 days.
Your problems could either be related to hyperstimulated nerves(causing spasm in esophageal muscles) or a condition called achalasia cardia could be there in which esophagus is blocked.
Recommendations-
Fresh endoscopy.
If endoscopy is normal just get a physio and pyschological consultation done.
Thank you!
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Ramesh Kumar (0 minute later)
Brief Answer:
An endoscopy should be done.

Detailed Answer:
Hello my dear patient,
Firstly no it's not stage 4 cancer.
Cancer leads to a stage called cachexia in which a person loses drastic weight for e.g 10 kgs in 20 days.
Your problems could either be related to hyperstimulated nerves(causing spasm in esophageal muscles) or a condition called achalasia cardia could be there in which esophagus is blocked.
Recommendations-
Fresh endoscopy.
If endoscopy is normal just get a physio and pyschological consultation done.
Thank you!
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar (12 hours later)
Well, I try to believe this is no cancer, stage I or IV.

I have my final consultation I have some questions.

1. I can not take endoscopy because of the holidays and corona longer lines, I can take it in 1 month, would I miss something (this is always a scare for hypohondriacs).

2. This achalasia cardia seems to be rare disorder. I believe you wrote spasms, this is exactly how I wanted to describe it today. I feel like food is going down (sometimes I belch and go up again but rarely, mostly it is just air). Is it possible this are all wrong spasms of esophagus and stomach. Stomach problem I have now (extended from my throat problems) is that after I eat there is a lot of rumbling, a lot of belching and pain that feels like XXXXXXX and upper stomach just spasms at the wrong time. Is this possible? Does this exist? Because 15 years ago I had such spasmatic feeling that go to belching and to pain that radiates behind chest also, but it comes and goes, develops after eating or drinking. As I had severe pain a day before gastroscopy and gastroscopy found nothing at all in 2005, could it be motility disorder that is also happening now?

3. Does it make sense, I can eat better I think if I can get my mind out of how I swallow...? That is a problem bacause I feel like motility problem in esophagus and stomach. But as you told me, cancer in esophagus would present different and wouldn't start with same symptoms for liquid and solid food and have this voice problems and throat problems...

4. Today my symptoms went also lower, as I said I now have like esophagus and stomach cramps when swallowing, I have stomach pain like burning acid (but in 2005 they found nothing of this similar symptom) and now I have some colon problems (it started with neck, stomach and colon in october, but the nausea and mucus in stool went away after 14 days). By colon problems now I mean I have so much flatulence everything hurts me. Can this be from omeprazole and antiacids?

5. Do you think I have GERD at all, or this tablets are making it worse for my digestion? I mean they diagnosed me with LFR (but not by ENT examination, just by symptoms) 7 years back. It seems tablets don't help and what I eat also makes no difference, because I eas only non acidic food now, no chocolate, no tomato, nothing, and it is not making me better, but worse (flatulence). That is why my cancer fears trigger. If medication doesn't work it is usually either cancer or... "nothing".

6. Clean or white mucus from throat clearing and sometimes hoarse voice can be from LFR or should I also do ENT endoscopy? :-(

7. So you think there is no late stage cancer in me at this moment? Too much symptoms that even migrate? Cancer in GI tract doesn't make your neck stiff and painfull? People with so much health problems are a problem because we never know if it is "real" or "fake"...

That is all I would bother you...

Thank you very much for all your kind answers and a lot of patience with me

Stay healthy and Merry Christmas to you. May the 2021 be a better year for all of us.

Yours
XXXXXXX
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Follow up: Dr. Ramesh Kumar (0 minute later)
Well, I try to believe this is no cancer, stage I or IV.

I have my final consultation I have some questions.

1. I can not take endoscopy because of the holidays and corona longer lines, I can take it in 1 month, would I miss something (this is always a scare for hypohondriacs).

2. This achalasia cardia seems to be rare disorder. I believe you wrote spasms, this is exactly how I wanted to describe it today. I feel like food is going down (sometimes I belch and go up again but rarely, mostly it is just air). Is it possible this are all wrong spasms of esophagus and stomach. Stomach problem I have now (extended from my throat problems) is that after I eat there is a lot of rumbling, a lot of belching and pain that feels like XXXXXXX and upper stomach just spasms at the wrong time. Is this possible? Does this exist? Because 15 years ago I had such spasmatic feeling that go to belching and to pain that radiates behind chest also, but it comes and goes, develops after eating or drinking. As I had severe pain a day before gastroscopy and gastroscopy found nothing at all in 2005, could it be motility disorder that is also happening now?

3. Does it make sense, I can eat better I think if I can get my mind out of how I swallow...? That is a problem bacause I feel like motility problem in esophagus and stomach. But as you told me, cancer in esophagus would present different and wouldn't start with same symptoms for liquid and solid food and have this voice problems and throat problems...

4. Today my symptoms went also lower, as I said I now have like esophagus and stomach cramps when swallowing, I have stomach pain like burning acid (but in 2005 they found nothing of this similar symptom) and now I have some colon problems (it started with neck, stomach and colon in october, but the nausea and mucus in stool went away after 14 days). By colon problems now I mean I have so much flatulence everything hurts me. Can this be from omeprazole and antiacids?

5. Do you think I have GERD at all, or this tablets are making it worse for my digestion? I mean they diagnosed me with LFR (but not by ENT examination, just by symptoms) 7 years back. It seems tablets don't help and what I eat also makes no difference, because I eas only non acidic food now, no chocolate, no tomato, nothing, and it is not making me better, but worse (flatulence). That is why my cancer fears trigger. If medication doesn't work it is usually either cancer or... "nothing".

6. Clean or white mucus from throat clearing and sometimes hoarse voice can be from LFR or should I also do ENT endoscopy? :-(

7. So you think there is no late stage cancer in me at this moment? Too much symptoms that even migrate? Cancer in GI tract doesn't make your neck stiff and painfull? People with so much health problems are a problem because we never know if it is "real" or "fake"...

That is all I would bother you...

Thank you very much for all your kind answers and a lot of patience with me

Stay healthy and Merry Christmas to you. May the 2021 be a better year for all of us.

Yours
XXXXXXX
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Follow up: Dr. Ramesh Kumar (12 minutes later)
PS - When I swallow it feels like I have a lump in my throat, but I guess it can be that there is no lump, just a feeling of it?

PS2 - Don't dare to ask, the swallow problem can not be bulbar ALS?
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Follow up: Dr. Ramesh Kumar (0 minute later)
PS - When I swallow it feels like I have a lump in my throat, but I guess it can be that there is no lump, just a feeling of it?

PS2 - Don't dare to ask, the swallow problem can not be bulbar ALS?
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Follow up: Dr. Ramesh Kumar (3 minutes later)
PS3 - Could it be Barrett’s esophagus with my throat problems? I have all symptoms of it :-( How long does it develop? 15 years is enough time? I have to wait 1 month for Gastroscopy.
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Follow up: Dr. Ramesh Kumar (0 minute later)
PS3 - Could it be Barrett’s esophagus with my throat problems? I have all symptoms of it :-( How long does it develop? 15 years is enough time? I have to wait 1 month for Gastroscopy.
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Follow up: Dr. Ramesh Kumar (12 hours later)
This is really wierd, my symtoms are changing somehow. They started with hoarse voice, it is ok at the moment, small food something going to the lungs, like I can not swallow. Now I have pain in chest where eosophagus and upper abdomen are and feeling of lump in my throat when I swallow even salvia. I don't believe the lump can grow so large in few days so even salvia would bother me, it is like I have inflamed eosophagus and stomach, I am constantly having burning pain.

And then I don't eat much because it is even worse and flatulence, and stomach burping and sounds, and I am not hungry because I am worried. And then I will loose weight because of that, I already lost 1 kilo in a week, but yesterday it was the worst pain and cramps in stomach ;-( What could be so wrong with me :-/ Nothing I do, seem to help. This is now worse than neck pain itself.
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Follow up: Dr. Ramesh Kumar (0 minute later)
This is really wierd, my symtoms are changing somehow. They started with hoarse voice, it is ok at the moment, small food something going to the lungs, like I can not swallow. Now I have pain in chest where eosophagus and upper abdomen are and feeling of lump in my throat when I swallow even salvia. I don't believe the lump can grow so large in few days so even salvia would bother me, it is like I have inflamed eosophagus and stomach, I am constantly having burning pain.

And then I don't eat much because it is even worse and flatulence, and stomach burping and sounds, and I am not hungry because I am worried. And then I will loose weight because of that, I already lost 1 kilo in a week, but yesterday it was the worst pain and cramps in stomach ;-( What could be so wrong with me :-/ Nothing I do, seem to help. This is now worse than neck pain itself.
doctor
Answered by Dr. Ramesh Kumar (4 days later)
Brief Answer:
Follow up.

Detailed Answer:
Hello and sorry for a delayed reply,
Unfortunately was in ICU due to COVID infection,
See achalasia is a rare situation and so is esophageal carcinoma.
As you feel that symptoms are like spasm a trial dose of nitrocontin 2.6mg can be taken after consultation(relieves spasm esophageal).
But I would suggest you to meet a physiotherapist and pyschologist asap...Once your anxiety is controlled things would be in control.
Thank you!
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ramesh Kumar (0 minute later)
Brief Answer:
Follow up.

Detailed Answer:
Hello and sorry for a delayed reply,
Unfortunately was in ICU due to COVID infection,
See achalasia is a rare situation and so is esophageal carcinoma.
As you feel that symptoms are like spasm a trial dose of nitrocontin 2.6mg can be taken after consultation(relieves spasm esophageal).
But I would suggest you to meet a physiotherapist and pyschologist asap...Once your anxiety is controlled things would be in control.
Thank you!
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2912 Questions

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Hello There I Have A Problem And I Have To

Hello there I have a problem and I have to take some more words to describe it, because you can not examine me, I think my history and description of the problems is very important for you to be able to tell me your opinion. In a sentance, I have severe fear I may have oesophagus cancer. I am 51 male, never smoked, eathing moderate healthy dietary life, except some years I drank more than is considered healthy for the standards. Nothing like daily drunk, but more than 1 glass of wine a day, of course not every day. It would be too long to tell about all my problems with health, but I will say I constantly have some problems (skin problems, muscle twitching, urinary, GA, ENT problems), mostly they change over time to return later. I have severe health anxiety, mostly fearing the most deadly diseases like cancer, ALS, etc. They really affect my life. If I focus on your speciality and my current problems and fear, first some background. I've had severe GA problems in 2004. I had severe stomach pain, like acid was burning my stomach. After a bad episode I went to the gastroscopy and they say stomach is fine, a little too much acid for one antacid a day... I've also had severe colon problems with 5 times a day stool passing, diahroea, constipation, mucus, no blood. Colonoscopy revealed a small 3mm polyp, not the dangerous type. I was diagnosed functional dyspepsia and IBS. The problems took 1-2 years to subside, but I still have bad days and weeks. Fast forward to 2013. I got severe cough without having a flu. It woke me from the middle of the night and I cough so severly I almost threw up. It was dry cough. I never went to ENT, but I went to pulmologist who said that I have chronically sore throat, signs of mucus, and LPR (laryngopharenal reflux), post nasal drip (I have a broken nose) and GERB was suspected. The symptoms with following rules of diet and PPI somehow went away, But not completely. What reamined was mucus in my nose and I use neti pot a lot for clearing it. The mucus goes to my throat and sometimes I snore and I have sore throat. I clear throat a lot of times and I had episodes of hoarse voice (a little), that would go with diagnoses, didn't scare me. Stomack was better, no burning pain and last few years I got less mucus problems in my nose, I still had throat clearing of mucus, don't remember how much, I also had some left ear pain. Fast forward to end of october 2020. I have to say this year was very very stressful for me, as I got divorced and this corona... I mean, I have health anxiety, you can only imagine, I was living in constant fear, we can not go anywhere etc. I am not sure if my neck pain is relevant, but it is part of my story and main fear fuel factor up to now. End of october I got neck pain and I had right shoulder pain last six months. Both are not unusual for me, forward posture, computer work... I had left and right shoulder problem on and off for years and sometimes I got such severe stiff neck I can not even turn my head to one direction. It resolves in a few days. This time it didn't. I have up to now (2 months) severe neck pain and both shoulders pain. Neck pain is present in the back in the middle of my collar bone and raiates to shoulders. But it is prominent on the left side, so turning neck right and down is most painfull. Sometimes is a little better, but never cures. Sometimes the pain is miserable radiating to back of my neck making me headache that is distressing to me. The pain is kind of stiff, mostly not sharp in the shoulders and in the neck it can be sharp if I turn my head. It is gnawing and stiff kind of pain. In the morning I have the most pain, I must take like 5 minutes to move around to get it together. Hot shower helps a little. I got to orthopediacs of course thinking it has to be something bad with my spine, I admit fearing spine cancer. The X-RAY was showing some degenerative disease but nothing much and nothing explaining the pain in the neck. About a week or 10 days ago I got some hoarse voice on and off, sometimes clearing the throat helped (we have very dry air in apartment and mostly we can not go out now in corona winter). My throat was sore few times when I was snoring because I try to sleep on my back because of by neck pain. I then started to fear because my neck is not better (but not worse also), that I may have laryngeal cancer. My voice was never strong, even years ago when I was talking loud in a caffe I got "out of my voice". And even few years back I had to clear throat when I eat peanuts. They weren't stuck in my throat, more scratched it. And now I started fearing this was somehow throat cancer, small voice changes that come and go and last week when drinking and eating my food got kind of stuck so I coughed, it happened on sipping tea 3 times in one day, like the drink would go to the lungs not in stomach (don't know English word for this, happens to everybody sometimes). That got me really alert and even more in panic mode. I can eat large pieces of food, the small ones somehow irritated my throat like coconut small flakes etc. So I was in fear of throat cancer. Few days later both ends of my tongue got this hypersensitivity, like a little burning pain. I have some ulcers but not on the sides and back when it fiels wierd. As I have geographic tongue that burns me a lot of times, I couldn't see if tongue is ok or not, I do not differentiate geographic tongue and cancer. I got scared of tongue cancer, the next day I got some bad taste in my mouth. It is still there, the more I am concentrating on it, the more I think I have some wierd taste in mouth. And fast forward to today, I got symptoms of oesophagus cancer. I wouldn't say I have dysphagia, although I fear it. I mean, when I swallow it is wierd. I can swallow even big pieces of food, but when the food goes down I feel like... motility is not right, like it gets stuck somewhere at the bottom and then I get spasm and a little belch no matter what I eat or even drink and then pain in the breastbone like heartburn. Today I belch so much after every drink, I never had problems with swallow, I guess that is what made me so scared. And I googled... :-( This seem to be symptoms of the oesophagus cancer, and the more I "listen" of how I swallow there more I seem to have problems. But this happens on drinking and eating the same, I read usually it gradually progresses from big solids to liquids. I got this in few days, but I read this cancer is fast and when such symptoms arrive it is already stage IV :-( And this cancer is death sentance where it makes swallow problems. All this scare started with the nack and then progressed to larnx and mouth and now oesophagus symptoms and problem with swallow (it is more kind of a pain when some muscle spasms when I swallow than inability to swallow, I do eat and drink). Is this the usual presentation of oesophagus cancer? Can it be anything else at all, I have so much symptoms progressing daily (also have dry mouth few days now, my voice seems to be a little better than last week). What I didn't find related symptom that I have for 2 months is the neck pain. First scare came from neck because it has to be something sinister, doesn't get better. But I didn't find oesophagus cancer presents itself as such stiff neck and shoulders. On X-RAY of the neck nothing is visible, the doctor said no neck spine cancer. But oesophagus cancer wouldn't start 2 months as severe stiff neck pain and then go to problems with swallowing and pain the the chest, my neck pain is on the back of the neck between shoulders. Because of the new year and corona, no doctors here are working in a day to day basis and I will need to wait for the ENT, GI examination, not even know where to go and if it is already to late for me. Can it be something else not so fast spreading cancer? Thank you for reading my long letter. Yours XXXXXXX