Hello XXXXXXX
I am very proud of you that you are taking care of yourself
very well, excercing regularly, not smoking or drinking.
You were told by your doctor that you had GERD. The
symptoms of GERD are varied. Most common is heartburn,
others could be night time cough, sore throat , hoarseness,
sleep disturbance and sometimes Asthma like syptoms.
You have had good work up including endoscopy which has
ruled out ulcers etc. Normal ultrasound rules out gallstones
although there is a condition called "Acalculous Cholecystitis"
which is rare, but a person would have an acute attack
with fever,chills,nausea,vomiting and acute right sided
abdominal pain. I don't think you have that especially with
normal liver tests. If you were getting significant relief when
you were on Nexapro , I would agree the burning was related
to acid. The only other thing I can think of is condition called
"Costochondritis", inflammation of the rib cage and irritated
nerve ending causing burning pain. I would try applying some
local anagesic cream such as Mentholatum or aspirin containing
ones.
Wish you good health.

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Hello, XXXXXXX
Glad that you were able to see my note.
Bloating is caused by excessive gas build up
and a slower contraction of the intestines.
We swallow air everytime we eat or drink
and also during digetive process fermentation
produces gas as well. Lentils such as Urad dhal,
Chana Dhal contribute more for gas. Also excess
carbohydrates. Some people have lactose intolerance.
They are deficient in lactase enzyme. There is a simple
breath test that can detect this.
These are some of my thoughts.
Small amount of peppermint oil two or three times a day
may reduce the gas bloat. Also Fenugreek is known to help.
Wish you well.

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