Brief Answer:
As below:
Detailed Answer:
Hi,
Thank you for your query.
1. The symptoms that you describe are common. They result usually from conditions such as LPR (
LaryngoPharyngeal reflux) which does worsen with stress. In LPR, the chest symptoms seen in GERD (
GastroEsophageal Reflux Disease) are usually absent. It is likely that a Gastroscopy may miss the subtle changes in the throat and larynx. Get a Videolaryngosocpy done.
2. Since burping requires pulling at the skin overlying the trachea and throat, there may be mild
cricopharyngeal spasm. The source of the air may be eating too quickly, certain gas forming foods (
Food Intolerance) or excessive gas forming bacteria. If you have abdominal symptoms or
diarrhea, rule out SIBO (Small Intestinal Bacterial Overgrowth) syndrome.
3. Additional tests such as Esophageal Mannometry, Tests for H.pylori Infection, Abdominal USG (
Ultrasound) to rule out hiatal (sliding) hernia, Stool examination as well as a follow up with the tests already under process are required.
4. In the meanwhile, you may double the dose of Nexium. If this trial does not help, add
domperidone. Take the morning dose of Nexium half an hour before breakfast on an empty stomach.
I must emphasize that such symptoms are very common and not a cause for worry.
If you have any further questions, I will be available to answer them.
Regards.