Regurgitation and Migraines

[MedTechAsh84]

About four years ago I begin having issues with regurgitation what I had eaten so my doctor put me on Reglan and the symptoms seemed to be ok as long as I didn't miss a does of my meds. Being concerned about the FDA black box warning on the drug I switched to Prilosec and did fine on it for about a year. In May of 2012 I had a new symptom come on after I swallowed a pill the wrong way. I constantly had a feeling that a lump was in the back of my throat. I had previously been diagnosed with GERD but when I went to a new GI doctor they said this diagnosis couldn't be confirmed without the upper EGD test so I was scheduled this and an Esophageal Motility Study. Everything game back completely normal so they sent off some biopsies for eosinophilic esophagitis which were also normal.  I was fine for about a month after the EGD but then my symtoms showed up again. Oh I forgot to mention during this time I was placed on Prevacid.  In Novemeber I had a spell where on top of the regurgitation I got a massive migraine so I had to go to the ER. It got so bad that I was dry heaving. The Dr. gave me an IV of Demorol and Phenagrain. I told him about my history and he suggested it was either Galbladder or Gastroperesis. He gave me an IV of Reglan and I got better and begin once again taking the Reglan. I was Ok till about the first of January and a week ago I had to go to the afterhours walk in clinic because I had another migraine/regurgitation spell. I switched my meds to Zegrid because I've noticed when I switch brands I seem to get some relief.  Everytime I eat I feel a lump in my throat and within a couple of weeks I have a real bad regurgitation/migraine spell. I have tested my galbladder, which is fine. I do not have Hpylori. I have spent so much on medical bills already that I am hesititant to have the gastric emptying study done.  I can't tolerate ice cream or milk or popcorn or even water. I can drink sprite, ginger ale, mountain dew, gatorade, fruit juice ( although not too much apple and no orange juice) and no dark beverages. I also recently tried sparkling water and that seems to be ok.  I am going on a gluten-free/soy free diet just to see if I have a food sensitivity. Any suggestions on what my next step should be would be greatly appreciated.  Also I don't know if I should see a GI or an ENT.  I'm so frustrated on not being able to eat and getting full so quickly after I eat that I'm losing hope that I will ever find a solution for this.

[CalGal]

Most allergy testing is, I believe, IgE-based and will show you if something will produce an immediate reaction (minutes to hours). Food allergy uses IgG and IgA reactions and are designed to show reactions that will show up in a couple of days to several weeks. With food intolerance, the reactions might only show up days later, so it makes it difficult to pin down.

You might want to consider checking with a functional medicine doctor who has experience in food intolerance issues - not all do so check them out thoroughly.

Food intolerance can produce a number of symptoms similar to those you've mentioned - including the migraines. Migraines are very common in those with IgA-based issues with gluten.

[MedTechAsh84]

It seemed to help the first couple of weeks but then things went back to normal. I have had an allergy test done before and found out I am not allergic to anything. Would the food intolerance test be something different? I have also found out that while I can't tolerate water I am able to drink sparkling water.

[CalGal]

What happened when you went on the exclusion diet? Did it help? Considering you said you can't handle ice cream or milk, did you ever exclude all forms of dairy from your diet?

Have you considered food intolerance testing?

[MedTechAsh84]

I went to an ENT and he placed a tube down my throat but all was normal.  I have noticed that almost every time I have a regurgitation episode I almost always get a migrain headache over my right eye and have to have a bowel movement. I take Prilosec once a day and Reglan about every 4 days. Any more suggestions on what I should do next?

[S. Kaul, MD]

Hi there!

Well, without a clinical evaluation it would be difficult to comment specifically on the situation. While the GERD is best managed by a gastroenterologist and migraines by a neurologist, depending on the severity of the condition and the medication side effect profile; the ‘lump sensation’ in your throat is called globus in medical terms. The feeling of a lump indicates that one of the muscles along the way is tightened. Although globus usually doesn't represent a serious problem, when present steadily for more than two weeks or intermittently for two or three months, a thorough examination of the oral cavity and throat is in order, especially in smokers. The most common cause for this symptom is infection, usually viral. Masses and tumors and incoordinated contraction in the upper oesophagus and psychological stress could also cause the sensation. It would be best to have this evaluated by an ENT specialist for an accurate diagnosis and appropriate management.
Hope this helps.

Take care!