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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Discomfort In The Stomach And Esophagus While Eating?

Hi, My 88 year old father is having trouble with his stomach/esophagus? He has the feeling of when you eat something it doesn t go all the way down. He cannot eat anything it will not go down he spits it up. He says it feels like a ball at the top of his stomach. Not painful, but a lot of discomfort. Any ideas? He called the nurse hot line and she thought that it might be gas, but he has felt this way since Saturday night.
Tue, 20 Dec 2016
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General & Family Physician 's  Response
hi and thank you
Esophagitis refers to a chronic inflammatory lesion of the esophagus secondary to irritation, most often by acid digestive secretions (gastric acid, etc.) which rise abnormally during untreated gastroesophageal reflux GERD, but also by Absorption of caustic products (poisoning); Or by opportunistic infections (herpes, cytomegalovirus, candida, in the case of immunosuppression); Or by the ingestion of certain medicinal products, finally by ionizing radiation.

The symptoms of gastroesophageal reflux persist and the patient gets worse when he swallows and swallows harder and harder (painful dysphagia). Bloody vomiting sometimes occurs. Acid ascents to the mouth, irritation of the upper or buccal mucosa are possible as well as its respiratory symptoms like cough ++ (aspiration of small amounts of acid).

The causes are therefore often those of gastro-oesophageal reflux. In the beginning, the acid attack of the mucosa causes diffuse superficial esophagitis. Little by little, in the absence of treatment, the altered mucosa will ulcerate and progressive inflammatory sclerosis will result in a narrowing of the esophagus causing the symptoms that your father reports.

So to stop the unfavorable course of the disease an emergency gastric fibroscopy with multiple biopsies by a gastroenterologist is indisputable.

In 90 per cent of cases the gastroenterologist prescribe PPIs and metoclopramid for a fairly long time, but the symptoms disappear after 48 hours.
If irreversible lesions are found, surgical procedures are possible depending on the results found on fibroscopy.
But in case of irreversible lesions, the patient always reports an impossibility of swallowing food, which your father does not have.
best wishes
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What Causes Discomfort In The Stomach And Esophagus While Eating?

hi and thank you Esophagitis refers to a chronic inflammatory lesion of the esophagus secondary to irritation, most often by acid digestive secretions (gastric acid, etc.) which rise abnormally during untreated gastroesophageal reflux GERD, but also by Absorption of caustic products (poisoning); Or by opportunistic infections (herpes, cytomegalovirus, candida, in the case of immunosuppression); Or by the ingestion of certain medicinal products, finally by ionizing radiation. The symptoms of gastroesophageal reflux persist and the patient gets worse when he swallows and swallows harder and harder (painful dysphagia). Bloody vomiting sometimes occurs. Acid ascents to the mouth, irritation of the upper or buccal mucosa are possible as well as its respiratory symptoms like cough ++ (aspiration of small amounts of acid). The causes are therefore often those of gastro-oesophageal reflux. In the beginning, the acid attack of the mucosa causes diffuse superficial esophagitis. Little by little, in the absence of treatment, the altered mucosa will ulcerate and progressive inflammatory sclerosis will result in a narrowing of the esophagus causing the symptoms that your father reports. So to stop the unfavorable course of the disease an emergency gastric fibroscopy with multiple biopsies by a gastroenterologist is indisputable. In 90 per cent of cases the gastroenterologist prescribe PPIs and metoclopramid for a fairly long time, but the symptoms disappear after 48 hours. If irreversible lesions are found, surgical procedures are possible depending on the results found on fibroscopy. But in case of irreversible lesions, the patient always reports an impossibility of swallowing food, which your father does not have. best wishes