My symptoms are:
1.- Difficulty or an inability to belch; this can occur while fasting, but it is more noticeable after eating. When I do manage to belch, I feel some relief or a sense of pressure being released.
My belches often smell strongly of the food I last ate—sometimes for hours—and occasionally, when I force a belch, small bits of food or liquid come back up, which may or may not cause a burning sensation in my throat. In the last month, on two occasions, a small amount of acid has come all the way up to my mouth when belching, which has caused me a great deal of distress.
2.- Constant nausea—a persistent feeling of revulsion or disgust, though without actual vomiting.
3.- A sensation of regurgitation; I feel as though what I have eaten is coming back up, though without any burning sensation or actual food particles.
4.- A feeling of heaviness and mild discomfort or pain in the epigastric region or around the abdomen, accompanied by a sense of being overly full or bloated. When I try to induce or force a belch, the pressure actually increases, causing further discomfort and resulting in sounds from my throat that resemble belching. This almost always occurs after eating.
5.- A sensation that food gets somewhat stuck in my throat—particularly with more solid foods, or with pills if I don’t take them with enough water—though I do not actually choke or gag.
Constant bloating/gas, which is more pronounced at night; throughout the day, I also notice that I am continuously passing small amounts of gas.
When I feel unable to belch, it triggers significant anxiety, and the nausea intensifies.
6.- Episodes of hiccups are painful; I experience chest pain, and it becomes even more difficult and painful to belch.
7.- At times, I also feel as though I am swallowing a large amount of air. 8.- Although it is not very common, I have noticed that sometimes—after eating spicy foods, items with a lot of chocolate, or somewhat fatty meals—my throat begins to burn. The burning intensifies when I belch and can persist for one to two days before subsiding.
I have been experiencing this for four years. My diagnosis has almost always been functional dyspepsia or gastritis. I have taken various medications, such as levosulpiride, itopride, famotidine, and even sucralfate. While drugs like amitriptyline or mirtazapine help modulate my response to nausea or the inability to belch—making me feel less anxious, though no less uncomfortable—they do not eliminate the symptoms. This has significantly diminished my quality of life, as it prevents me from living normally. I have undergone an endoscopy, during which specialists ruled out any physical damage or hernias.
The last neurogastroenterologist I consulted advised against seeing an ENT specialist, maintaining that the issue is simply functional dyspepsia—a chronic, incurable condition that can only be managed. He described it as benign and suggested cognitive-behavioral therapy to help me cope with the persistent discomfort in my daily life. He noted that there could be other factors, likely involving the lower esophageal sphincter (LES) rather than the upper esophageal sphincter (UES), that make it difficult for me to belch and may also lead to increased gas production. To make matters worse, my family does not believe that I am truly unwell, which adds to the difficulty.
I have been taking mirtazapine for three weeks. I have noticed a significant reduction in the sensation of being unable to belch, though the problem has not disappeared entirely; after finishing a meal, I feel extremely bloated. When I try to belch, it feels as though I am completely filled with air—yet instead of belching, I experience increased nausea, abdominal distension, and excessive gas, and I still struggle to expel the air that I am unable to release through belching. Is it worth seeing an otolaryngologist?