Acute onset GERD... diagnosis help?

[joropo]

I have been experiencing persistent and debilitating chest discomfort and excessive throat clearing for the past 9 months, which I believe to be caused by acid reflux.

My symptoms usually present immediately following meals and progressively worsen over the course of the day. I have completely transformed my diet however this has had minimal impact. I experience symptoms regardless of what I eat. I am losing weight as a result of the discomfort associated with meals.

Antacids generally help however based on how persistent my symptoms are I try to avoid over-usage. Once-daily omeprazole also reduced my symptoms however I stopped this medication based on concerns about the long term health effects and a desire to identify and address the underlying root cause of this issue.

I do not experience upset stomach, indigestion, bloating, belching, diarrhea or other common stomach and lower GI symptoms at all. My symptoms are localized to the lower esophagus. I also do not experience the burning sensation commonly associated with heartburn. I have lost my voice on occasion during more severe symptomatic episodes.

A barium swallow x-ray in May suggested a minimal sliding hiatal hernia. A repeat upper endoscopy is scheduled for July 15th. My first endoscopy was terminated early due to residual food in stomach however the doctor noted in his report "normal appearing esophagus and eg junction."

I had no history of these symptoms prior to November 2021. Symptoms presented immediately after a three week hacking cough followed by symptomatic COVID. During COVID I was prescribed Tessalon (benzonatate) by my doctor which I took on several occasions. After taking benzonatate for the first time I was extremely bothered by the sensation of something being stuck in my throat, which I attempted to address with hot liquids and repeated throat clearing.

I am seeking a referral to an appropriate specialist, most likely a gastroenterologist or gastrointestinal surgeon. Based on the (i) acute onset, (ii) persistence and (iii) severity of my symptoms, (iv) the absence of associated stomach and lower GI problems, and (v) the failure of significant diet-based interventions to address my symptoms, I believe that my case requires more intensive evaluation. However this has been slow going as I work my way through Kaiser's systems.

Potential diagnoses, in my opinion and in order of likelihood, I currently consider as follows:

1. Symptomatic hiatal hernia (potentially a result of hacking cough and/or benzonatate)
2. Esophageal dysmotility (potentially a result of benzonatate)
3. Esophageal cancer (unlikely but would still like to rule this out)

I'd love any insights from this community as I am often discouraged as a result of feeling awful every day and still having no clear understanding after 9 months.