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Hello, I Am 32 Year Old Man, About 220 Pounds,.

Posted on Thu, 17 Jan 2019

Question: Hello,

I am 32 year old man, about 220 pounds,. 5 foot 11. No real history of anything other than poorly controlled GERD.

My question is for the last 3 or so weeks I've had pain when I swallow anything including just Saliva. Also pain when I burp or hiccup. Over these 3 weeks I have had several bouts of bad heartburn, and due to some poor choices with alcohol, have vomited maybe once a week in the last 3 weeks. Pain increased as of this last weekend after vomiting Friday.

I had an endoscopy and a CT of my thorax about a year ago that showed nothing but GERD but I haven't really followed much of a protocol since then, but regardless I'm quite worried about esophageal cancer. Also have been losing weight, about 8-10 pounds over the past month or so, but could be due to irregular eating habits. The pain is about in line with my nipple, on the right side, and also hurts when I belch.

What could this be? Is it possible that cancer could develop from basically nothing other than GERD in a year? Could something else cause this kind of pain when swallowing? I'm very worried...

Answered by Dr. Deepak Sundriyal (1 hour later)

Brief Answer:
It can be esophagitis also

Detailed Answer:
Hello dear.
I have gone through the details.

So the likely possibility in your case can be:
-reflux esophagitis,
-esophageal candidiasis,
or uncommonly, dysmotility disorder of esophagus.

The possibility of cancer is remote as it presents first with dysphagia. Pain is a symptom that comes in later.

Thanks and regards
Feel free to ask further

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Deepak Sundriyal (19 minutes later)

So even with being on Prilosec for 3 weeks, and the fact that the pain has been ongoing for 1 month the chances of cancer are remote? My understanding is that pain when swallowing can be an alarm symptom.

Answered by Dr. Deepak Sundriyal (1 hour later)

Brief Answer:
Hello. Yes, it seems remote

Detailed Answer:
Hello again.

So, the possibility seems remote as cancer presents with typical symptoms of obstruction of food bolus which you don't have. Pain is also slightly away from the midline.

I will advise you to undergo an esophagoscopy for evaluation, but again, please relax. It doesn't look like cancer.

Thanks and regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Deepak Sundriyal (1 hour later)

Do you mean pain away from the midline is more likely to be cancer? Because my pain is definitely to the right side not straight down the middle. So because the pain is off midline it could be a cancer symptom, however because there has been no dysphagia it isn't likely? I think I am more worried now due to the location of the pain. Please let me know.

Answered by Dr. Deepak Sundriyal (34 minutes later)

Brief Answer:
Hello. I mean, it is unlikely to be cancer

Detailed Answer:
Hello. So pain in away from midline and highly unlikely to be cancer. There is nothing to worry.
Relax.
Thanks and regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Deepak Sundriyal (3 hours later)

Now I am a bit confused because you said pain away from the midline is one symptom of esophageal cancer. I guess at this point I will just need to wait and get a scope, but could those things you've suggested above last for a month, even while taking PPIs for 3 weeks? I guess it's the fact that it's on one side, and the length of time I've had the symptoms that worry me the most.

Answered by Dr. Deepak Sundriyal (9 minutes later)

Brief Answer:
Hello. reflux esophagitis can persist for long

Detailed Answer:
Hello again. So , there is no confusion. Pain away from midline cannot be due to cancer of esophagus.
Symptoms of reflux esophagitis can persist for long and similarly dysmotility disorder can persist. You require a repeat esophagoscopy to look for the cause.
Thanks and regards

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Above answer was peer-reviewed by : Dr. Kampana