FBN

I eat and usually go straight tothe "john" after.....if its spicy like really spicy.....it will be straight away if not so spicy longer ....when i was younger used to use the lav straight after sports when relaxed,......I reckon everyone is different timing so i don't worry...but check what water supply its almost impossible not to have the runs in thailand unless you control everything you eat by yourself.....

It's called "gastro-colic reflex" (anything goes into the stomach and it stimulates peristalses in the lower gut..)and normally present in babies. Adults by and large lose this reflex but may be normal for many.. In amebiasis, it becomes very prominent again...

Does anyone know and recommend a hospital where I can have an Esophagogastroduodenoscopy (EGD) done. The doctor suggested I go for an EGD but at Bangkok Hospital the cost is 8000 Baht. A bit pricy I thought. Anyone recommend another good hospital for this that charges less.

Thanks

It is the guy behind the scope that's important. Select that first, then the price..

As my teachers used to say, the most important part of a stethoscope... is the one that fits between the earpieces..

Hi All

Which strong pain killers pills can anyone of you recommend me which is available in Thai pharmacy ?

For Knee and sholder joints for playing sports before games.

cheers

Tytus

You won't get "strong" pain killers from a Thai pharmacy.. Most of that stuff (Codein etc) can only be kept (by law) in a registered hospital.

Ibuprofen (Advil/Brufen) is the most common drug used in these circumstances but can cause real damage to stomach and kidneys (in cases of dehydration) if taken before playing any games.. NOT a good idea.

Causes gastric irritation any time in susceptible people.

Serious medication should always be taken under guidance of a qualified physician..

Ive been in Thailand quite a few years now. Never really had a problem with the food, sometimes had something that didnt agree with but nothing major....always eaten a bit of spicy food, nothing crazy just avergae spicy and usually been ok.

But over the past year or so (Ive only started to think about this now) Ive had to go to the bathroom quite a lot, always after Ive eaten and usually after lunch (but sometimes after dinner too). Sometimes I have diarhrea and sometimes I dont but nearly as soon as I finish lunch then Im off to the bathroom, and sometimes I need to go again 5 mins later!! Often I start to feel hungry again say 30-60 mins later so im worried that my food isnt being digested correctly. At first I thought its thai food but Ive been eating thai food for a while and never really had this problem,but also I get this after eating regular western food such as a couple of sandwiches....

I want to go tho see the doc but I dont knwo what to tell him...what the hells wrong with me???

Your syptoms are consistent with chronic amebiasis.

Most common of the parastic gut infections in tropical areas. Loose stools with some mucus, foam and lots of gas... Urgency to go after eating... Episodes of diarrhoea follows a carbohydrate load... No fevers, no cramps..

Difficult to confirm by lab tests. Usually a large fresh stool sample is needed; microscopy may find the small "cysts" you secrete but they are small and not easy to detect. Actual visualisation of live amoeba is the best diagnosis. Blood tests no help really.

Final solution may just be to take the required medication. (Fasigen, over three days in divided doses..).

Re-infection occurs easily from eating fresh, raw salads and other vegs.

Useful info are available on the internet by searching both amebiasis and Fasigen..

Its only my "gut" feeling

Good Luck..

Received a reply from my Doctor at Bumrungrad, as below...

"Dear Mr. Martin Richard Wickham,

According to your previous message to us, please see our doctor's reply below;

I did not see anything wrong in your throat. Base of your history that you ever did barium swallow before seeing me.

I believe you have no tumor on your throat."

Is that what medical records look like?? (as I had asked for them).

What about my original email question of..."I would also like to know if he saw any redness or inflammation consistent with gastric reflux?"

Anyway, for the simple reason that I do feel better after stopping all medication prescribed, I am going to leave it there unless anyone thinks better of that decision?

Medical Records:

Will not, and should not be sent by e-mail for legal medical confidentiality reasons. You will have to go to the hospital; same clinic where the doctor saw you, present your hospital number to the admin person at the nursing station and then make a formal request to have copies. The hospital may, and should, ask you to provide an ID as well as ask you to sign a form. The doctor will also have to sign on the same document before records are handed over. You have legal right to them but the hospital also has a legal obligation not to release confidential medical information to other than the patient unless you have authorised them to do so.

Do not try and engage the hospital in e-mail communications other than getting quotes or making appointments; these departments are not set up do accommodate this.

Redness/inflammation:

Did the doctor do a formal gastrocopy or just and upper respiratory tract inspection? I think the latter as you would have had to be fasting for a gastroscopy. There would be no redness in the upper throat area only in the lower esofagus/upper stomach. (only seen at gastroscopy..)

Your symptoms of GERD/hiatus hernia (the same thing; the first is the formal diagnosis, the second term describes the underlying anatomical defect or reason), will respond to this treatment; the improvement may last a few weeks or less but will probably return as you did not take the medication long enough for significant healing to occur.

In my humble opinion; you have not progressed much further than square one when this thread was started apart from confirming that there was nothing wrong with the "upper throat" area. Even this is not clear.

You have, in my opinion, only 2 choices:

1. Stay off treatment as you do feel better at the moment and implement all the other good measures advised in this forum. You may need to do it all over again in a few months.
   
2. See a good gastro-enterologist and have a gastrocscopy done or other investigation as directed by the physician. Don't be agressive and prescriptive in you communications with Thai docs; they shut down and you will not get the full benefit of your consultation. Be gentle and polite but insistent.
   

Good Luck...

No more!! PLEASE NO More!!

Great actually!!!

Would it be okay to go diving to Similan around mid of Septmber ? How's the weather at that time?

If not, any suggestions?

Also, any liveboard trips coming up that can do rescue diving course?

Did the liveaboard around the Similans in January; poor vis, very strong currents, It may have been an exception but best definitely would be Nov/Dec..

The attached photos in this thread are really good; for someone who also dabbles in this hobby too, would the posters please state the equipment/films etc. used as well as the sea conditions and dates...

I found this picture the other day and it cracked me up.

In the same theme...

AN ATHEIST IN THE WOODS

An atheist was walking through the woods.

"What majestic trees"!

"What powerful rivers"!

"What beautiful animals"!

He said to himself.

As he was walking alongside the river, he heard a

rustling in the bushes behind him. He turned to look.

He saw a 7-foot grizzly charge towards him. He ran as

fast as he could up the path. He looked over his

shoulder & saw that the bear was closing

In on him.

He looked over his shoulder again, &the bear was even

closer. He tripped &fell on the ground. He rolled over

to pick himself up but saw that the bear was right on

top of him, reaching for him with his left paw

&raising his right paw to strike him. At that instant

the Atheist cried out, "Oh my God!"

Time Stopped.

The bear froze.

The forest was silent.

As a bright light shone upon the man, a voice came out

of the sky. "You deny my existence for all these

years, teach others I don't exist and even credit

creation to cosmic accident." "Do you expect me to

help you out of this predicament? Am I to count you as

a believer"?

The atheist looked directly into the light, "It would

be hypocritical of me to suddenly ask You to treat me

as a Christian now, but perhaps You could make the

BEAR a Christian"?

"Very Well," said the voice.

The light went out. The sounds of the forest resumed.

And the bear dropped his right paw, brought both paws

together, bowed his head &spoke:

"Lord bless this food, which I am about to receive

from thy bounty through Christ our Lord, Amen."

Alcohol has a vasoldilator effect which could account for this. The feeling will be more pronounced if you have any cardiovascular problems, are at all dehydrated, or are deficient in one of the B vitamins. It will also of course be more pronounced if you are in general hyoper aware of boidy sensations.

Do you have any history of cardiovascular problems? Do your feet or ankles swell at all by the end of the day? Any loss of sensation in the feet or toes?

If answer to any of the above is yes you m ight do well to see a doctor. If answer to asll is no, I'd recommend:

(1) Increasing your fluid intake (non-alcoholic fluid intake). Fruit juices, sports drinks or plain water OK. A simple guide to fluid balance is the color of your urine, should be very light in color, if dark yellow or tea-colored you are dehydrated.

(2) Anytime that you have been sweating significantly be sure to replace the lost electrolytes. The widely sold Thai lemonades and fresh orange juice which come with a dash of added salt are ideal for this, so are green coconuts, or if you oprefer can go the electrolyte/sports drink route.

(3) Take a good B-comnplex supplement or multivit with all the B vits in it.

(4) Take a small amount of food before or with the beer.

Good advice..

In general the blood vessel dilating effect of alcohol will primarily affect the "blush" area; in other words, the face, upper chest and neck, not the lower limbs.

However, if there may be an underlying condition predisposing you to vasodilatation, such as estrogen deficiency during menopause; alcohol, even in minute amounts, can precipitate this under these circumstances.

Estrogen deficiency can have a myriad of effects on the body; all seemingly unrelated, including heart palpitations etc...

The test is obvious; avoid beer on a few evenings and see what happens..

Above all be reminded of the following advice from a great statesman:

"Beer is proof that God loves us and wants us to be happy."

~ Benjamin Franklin

Thanks for the reply. The reason I haven't been to see the doctor is because this last month it seems to have improved slightly, I was hoping it would go away itself. I suppose a trip to the doctor wouldn't hurt though if the health insurance is covering all costs

An occasion of imbibing excessive amounts of alcohol at one sitting actually damages three organs; the liver, the pancreas and the stomach itself. First through direct toxic effects of ethanol and the second through "overuse"; enzymes supposed to "detoxify" alcohol gets used up and then the sustained higer blood alcohol level damages organs. The evidence of which we casually refer to as a "hangover".

Severe pancreatitis can be a very serious and potentially fatal condition.

Sustained or frequent vomiting after such an episode is due to an acute inflammation of the stomach which makes it really sensitive to any acid secreted after eating any food. It revolts and ejects the unwanted irritant. This can lead to vomiting blood, called the "Mallory Weiss syndrome" if not contained; caused by rupture of blood vessels in the lower end of the esofagus. Also potentially serious. The damage to the pancreas and the liver will result in nausea too.

These conditions take a while to resolve but usually leaves no permanent scars or tissue damage. (unless exposed to this kind of insult frequently..) More frequent in "binge" drinking than chronic alcoholism. (the liver gets better at managing alcohol; to a point...)

Unlikely that the doc will find anything abnormal in your case. Blood tests for acute pancreatitis and liver damage reverts to normal roughly at the same time as your nausea and other symptoms disappear.

If the symptoms persist beyond a week or two, it would be good to see a doc and get an "informed" opinion (or an educated guess, depends on who you see!!).

The treatment in the acute phase is usually a hospital admission, nothing by mouth, IV fluids, a nasty stomach tube and some symptomatic medication...

Hope the cause was worth the outcome...

Dark stuff...

The song and the face of the stripper... Same time as the inquest jury visit to Paris...

A few more...

A fanatic is one who can't change his mind and won't change the subject.

Winston Churchill

A man has one hundred dollars and you leave him with two dollars, that's subtraction.

Mae West

Between two evils, I always pick the one I never tried before.

Mae West

Give a man a free hand and he'll run it all over you.

Mae West

It takes two to get one in trouble.

Mae West

Sex is emotion in motion.

Mae West

America is the only country that went from barbarism to decadence without civilization in between.

Oscar Wilde

I am so clever that sometimes I don't understand a single word of what I am saying.

Oscar Wilde

Men marry because they are tired; women, because they are curious; both are disappointed.

Oscar Wilde

If women ran the world we wouldn't have wars, just intense negotiations every 28 days.

Robin Williams

Never pick a fight with an ugly person; they've got nothing to lose.

Robin Williams

We had gay burglars the other night. They broke in and rearranged the furniture.

Robin Williams

A black cat crossing your path signifies that the animal is going somewhere.

Groucho Marx

Alimony is like buying hay for a dead horse.

Groucho Marx

Humor is reason gone mad.

Groucho Marx

I remember the first time I had sex - I kept the receipt.

Groucho Marx

Always carry a flagon of whiskey in case of snakebite and furthermore always carry a small snake.

W. C. Fields

I am free of all prejudices. I hate every one equally.

W. C. Fields

Recently, I've been getting weird feeling when going to sleep. Feelings like I'm having a heart attack.

Also, when eating I get food stuck in my throat. It's difficult to eat, especially in places like KFC. This seems to trigger some sort of visious cycle and anxiety comes.

I had some anxiety problems when I was 18 but managed to cope with lots of alcohol and drugs for the next 20 years.

I gave up alcohol 7 years ago, then a very high diazepam addiction was ended. Smoking was quit about 4 months ago.

I have started a new part-time job which keeps me on the computer to strange hours.

Any advice?

Thanks

N N

Keep the caffeine intake down.

Cheers

... and KFC!!

More seriously though: Avoid any food with MSG (monosodium glutamate)...

Why? its a natural substance, your body even produces 5 grams of it a day - There has never been any medical study that has managed to prove this myth that MSG is any more dangerous than say salt.

There is a lot of info out there; true, mostly anecdotal but also from personal experience, assisting someone with this sensitivity. Keep in mind though, it may be primarily a sensitivity issue for specific individuals, rather than a general occurrence.

When dealing with something like anxiety, diet should never be excluded with regards to therapy. Avoid junk food, stay with the healthy stuff; definitely worth a test...

Copied from the FDA commissioned report:

A 1995 FDA-commissioned report acknowledged that "An unknown percentage of the population may react to MSG and develop MSG symptom complex, a condition characterized by one or more of the following symptoms:

• burning sensation in the back of the neck, forearms and chest
  
• numbness in the back of the neck, radiating to the arms and back
  
• tingling, warmth and weakness in the face, temples, upper back, neck and arms
  
• facial pressure or tightness
  
• chest pain
  
• headache
  
• nausea
  
• rapid heartbeat
  
• bronchospasm (difficulty breathing)
  
• drowsiness
  
• weakness."^[6]
  

Recently, I've been getting weird feeling when going to sleep. Feelings like I'm having a heart attack.

Also, when eating I get food stuck in my throat. It's difficult to eat, especially in places like KFC. This seems to trigger some sort of visious cycle and anxiety comes.

I had some anxiety problems when I was 18 but managed to cope with lots of alcohol and drugs for the next 20 years.

I gave up alcohol 7 years ago, then a very high diazepam addiction was ended. Smoking was quit about 4 months ago.

I have started a new part-time job which keeps me on the computer to strange hours.

Any advice?

Thanks

N N

Keep the caffeine intake down.

Cheers

... and KFC!!

More seriously though: Avoid any food with MSG (monosodium glutamate)...

Recently, I've been getting weird feeling when going to sleep. Feelings like I'm having a heart attack.

Also, when eating I get food stuck in my throat. It's difficult to eat, especially in places like KFC. This seems to trigger some sort of visious cycle and anxiety comes.

I had some anxiety problems when I was 18 but managed to cope with lots of alcohol and drugs for the next 20 years.

I gave up alcohol 7 years ago, then a very high diazepam addiction was ended. Smoking was quit about 4 months ago.

I have started a new part-time job which keeps me on the computer to strange hours.

Any advice?

Thanks

N N

Keep the caffeine intake down.

Cheers

... and KFC!!

My Doctor in UK was going to refer me and expected wait was around 1 month on NHS. That would have been fine and cost, of course, zero to me on the NHS.

I would have prefered that frankly to sorting it out here in light of the Hospital's email responses to date and the uncertainty that I would not have felt I needed to look into back home.

Unfortunately I had already cancelled my flight once and rebooked it and felt I did not want to cancel again to stay to wait for treatment, but on balance I now think it would have been easier and as free, also much more financially sensible than the cost being suggested in Thailand so far for an acceptable standard.

Question 1.

I realise Omeprazole should only be taken for a limited time, up to about 4 weeks. What I don't understand, as another poster here had worse symptoms than me, is what happens when I stop taking these tablets. Do I just go back to the same problem getting worse?

As for Bronchoscopy or Gastroscopy. It certainly sounds like my first email response from Bumrungrad falls below a high standard, as I clearly detailed my swallowing symptoms to them and I would agree that it most likely clearly has nothing to do with the lungs and airways. I have emailed asking for the cost of a Gastroscopy.

Meanwhile I will await responses for a day or 2 as my Omeprazole seems to be making my life normal again and I plan to chase up by phone midweek if not heard again from Phyathai and Bumrungrad, to book an appointment to see Doctor for next week.

Question 2.

Is there a chance that my Omeprazole tablets that are alleviating my problem could mask it when I see a Doctor??

Thanks to all

Q1: Duration of treatment will depend on the diagnosis and follow-up. Hiatus hernia with resultant GERD is based on a mechanical defect in the diaphragm and symptoms tend to be recurrent. If very severe, surgical repair is sometimes done but likely that treatment will have to be repeated intermittently; depending on diet, weight management and other associated measures in the course of management.

Q2: If taken for longer than a week or two, it will mask signs at gastroscopy (reduced inflammation etc); be sure that the attending physician is fully aware of whatever medications have been taken and how long.

looking like Bumrungrad, although a bit expensive from what I had previously been given to expect.

They replied to my email stating:

"Due to limited information, we can provide on the the cost of possible procedure. If Bronchoscopy is suggested by our doctor, the cost is ranged from 35,000-65,000 Baht** (outpatient basis)"

I had told them the details of my swallowing problems and hoped for rather less cost, going on previous posts here. Assuming I need this as I am not sure? The mere term Broncho, seems to infer lungs etc and my problem is only as far as my Throat/oesophagus/larynx/farynx area, as far as I know. Surely my swallowing problem does not get into the realms of lungs or is Bronchoscopy just a technical term for a look down my throat??

The Phyathai Hospital are to reply tomorrow, although the initial email received from Phyathai 2 Hospital in Bangkok has been forwarded to the Phyathai Sriracha hospital, presumably as I mentioned I am living near Pattaya. However, on their website it states clearly that Phyathai 2 is their ENT designated Hospital and I would rather go to the best rather than be directed to the nearest, if it does turn out to be the main reason for the selection of Phyathai at Sriracha.

All in all, looking like spending up to 65,000 Baht plus medication and sundry charges no doubt at Bumrungrad, but I am going to find out a little more from these 2 Hospitals in the next day or so before I book in for next week.

I am now starting to think I would have been better just delaying my flight and getting it done on the NHS. Treatment would have been acceptable to me without feeling that I needed to ensure the standards and Doctor first and costs zero.

Maybe tomorrow I will feel better.

Bronchoscopy is quite a different procedure; this involves putting a scope down the airways into the lungs and is much more complicated and invasive than a gastroscopy, hence the increased cost. Your problem seems to involve the upper throat area and it does seem unlikely that you will need this procedure.

First things first; see an ENT or Gastro-enterologist first and take it from there; we are merely speculating here at this point in time with the available information. Discuss further investigations with the physician and costs involved; obviously, urgency of any indicated investigations will determine further decisions..

Understanding lower backache goes a long way towards treating it..

Mechanical backache arises from the small joints at the back of the vertebra (paravertebral joints). These are angled upwards and slightly inwards normally and their function is to stabilise the rotational movement of the back in the lower back area (lumbar region). The chest or thoracic part of the spine rotates as a unit as this section is "splinted" by the ribs.

A large percentage of people has a slight abnormality in this area; the paravertebral joints are angled slightly more horisontally sometimes, allowing for more movement at that particular level. The back muscles will go into spasm when "over rotation" is precipitated by overuse or excess stress through bending inappropriately or lifting heavy items the wrong way.

Bending down straight from the waist with straight legs has a leverage disadvantage of about 30:1 on the lower back. (picking up one kg of wight from this position will put a strain of roughly 30kg on the lumbar spine...)

The pain occurs when the back muscles go into spasm due to pain from overstraining a paravertebral joint.

Treatment, therefore, should be aimed at relieving the muscle spasm. Taking weight off the back by lying down with pillows behind the knees helps. Then massage or physiotherapy to try and reduce the spasm should also be done.

A good masseuse (Swedish massage NOT Thai traditional) should be able to do this. Admittedly, finding an individual with good skills is not easy but works wonders if the proper technique is applied.

Swimming in the acute phase will either not be possible and is not really indicated; it is excellent long term therapy though.

Strengthening abdominal muscles is absolutely imperative as a long term preventative measure. Avoid sit-ups from full supine position; only attempt to lift shoulders a few inches to achieve abdominal muscle work without putting further strain on the lower back.

Back pain due to disc problems are usually associated with pain or numbness down a leg. This is due to nerve root irritation by the bulging disc and should be treated with more caution and it is advised to have a expert opinion and investigations (such as MRI) done before "self-treating"...

90% of people will have lower backache at some point in time. 90% of these will clear up without any treatment given enough time. Less than 3% of all backaches may require surgery.

Interesting research on the Thai middle class..

Mr___Mrs_Thailand__Asia_s_midd_40443760_.pdf

The Expat,

Thanks very much.

Do you have any details on that medicine as a google search does not return much of note (even for peptazole) and your symptoms sound worse than mine. Not sure, but another poster said it is the same as OMEPRAZOLE.

Did you not have any other corrective action and the symptoms dissapeared just from taking this medication?

My sypotoms were.....well how do I say it......god awful! Horrible and I thought I was going to choke to death! I got to a point where I did not look foward to meal times. All I did was take the medicine. The problem decrease slowly over 30 to 45 days. I used to choke and vomit almost everytime I ate. Now it has not ahppened in a long time. Thougt I was going to have an episode the other day, but did not. I think I had not cheweed my food enough! The tissue that the acid destroyed seems to have healed and everything is working fine. To be honest I am off the meds no and want to see what is going o happen. I cut out the greasy foods and do not have heartburn anymore either.

Another thing that seemed to be a factor for me was stress. I have so much less stress now that I am retired and living here in Thailand.

Good luck Twix!

Try searching "Losec" ; this was the original commercial name of Omeprazole; most of the other drugs mentioned above are generic copies of the same. The Losec search will get you lots of info.

Suggest to get a final diagnosis before taking this medication...

It was a dark and stormy night..

They were alone in the house...

They_were_together_in_the_House.doc

--Mark Twain

Evolution spent an awful long time optimising your insides. I suggest you think twice.

My philisophy in life is: Say nothing if you can't say anything positive..

So here goes: The only people benifitting from this "procedure" are the ones collecting 3000 baht to do it...

There is a huge difference between clinical depression and so called expat depression. One a chemical issue with the brain and the other a lifestyle change brought on by issues in life.

I have clinical depression. Have had it for 20 odd years. For a few years, I was not medicated. Mid 90s I was. Paxil brought on suicide thoughts. Zoloft did not help and never took Prozac. At the end, I stopped the medication. It was not helping and it made matters worse.

So I moved to Thailand. It did not make it worse, but it did not make it better.

I found that having funny friends helps a lot. And watching the strange things that Thais do in their lives and lack of complete common sense, makes me laugh.

The downside is that for the most part, changes in lifestyle does not really help the clinically depressed. It helps, but it is not a cure-all.

After 6 odd years here, I was enjoying life more. I had a good friend who backstabbed me and accused of me something I did not do, and it brought the depression on, or made it worse. It takes a long time to recover again. Thank you, my German "friend".

I have a wife and a lovely son, 17 months old. They make me happy. Short term, for me, as they go to bed or I do not see them, the worries of life come back again. But having a family helps a great deal.

With schooling coming up in a year or two, I may have to move back to the UK. That will make my depression worse.

But my only advise to a clinical depressed person: have happy friends. It really makes a difference. You can draw from that and laugh and it makes you look forward to life again. The laughter of a toddler is incredibly happy for me. Have those friends understand you, also helps.

The spectrum of depressive illness is quite wide; we did not attempt to discuss endogenous depression or the bi-polar disease (which requires really expert management and treatment) here but just a variation that seems to be common in expats.

http://www.hbcprotocols.com/9types.html

The link is to an article which I feel is fairly well written and comprehensive without being too "medical". St Jon's Wort is also a widely used remedy but one which I have no experience with.

5% of the world's population is estimated to suffer from depression...

Depressing, isn't it?

My earlier reply has been swallowed by the cyber-ghost...

Without a detailed history it is difficult to give more than just general advice. Obstruction in the esofagus can come from something inside the tube itself or something outside pressing on it. The esofagus is not a rigid structure like the trachea (wind pipe) and will normally be closed or collapsed but it lies against the trachea and anything associated with this structure or their path through the chest (mediastinum) may cause symptoms of difficulty in swallowing. Trying to find a common cause for the whistling sound when you breathe and the discomfort when swallowing....

Asthmatic breathing (wheezing) is easy to diagnose and should not have been a problem for your doc in the UK to establish. So there may be more to this and should be thoroughly investigated.

Narrowing of the esofagus due to scar tissue formed in the healing process after acid damage from GERD, can only be treated by physically dilating or stretching the tube; done in a similar fashion as a gastroscopy. This is usually only reserved for most severe cases where there is either a very severe or total obstruction.

Other management is just symptomatic; chew food well and eating slowly.

An associated condition known as esofageal spasm can also occur in this situation; it basically just means a discoordinated contraction of the muscles of the esofagus (the are circular, oblique and longitudinal layers) that may cause a temporary obstruction. This may even happen with fluids and is usually not there every time you swallow. Mechanical obstruction will cause discomfort every time..

Simple medication like Motilium to regulate the muscle coordination may help.

Finally, I would suggest a consult with a Gastro-enterologist first based on your previous history of GERD. You may need further referral to either an ENT doc or even a chest physician.

Good Luck!