Bulbar vs GERD?

[Jennie0813]

I’m a 45yo woman currently dealing with some troubling throat issues. It’s probably GERD, though I haven’t experienced any of the heartburn typically associated with GERD and don’t have a history of GERD to date. Basically I have a strong “globus” sensation, sometimes food gets stuck or occasionally comes back up. My voice seems a bit more raspy or hoarse.

My question is - I was looking up my symptoms and Dr. Google is of course evil and suggests ALS among other things. Early ALS symptoms include “trouble swallowing”. This is vague - for instance, I CAN swallow but clearly I’m having issues. I’m not choking on food or water to be clear.

I’m clear with limb onset ALS that it’s more about the absence of feeling weird, pain etc. Is this also true with bulbar onset? I acknowledge I have some health anxiety but I’ve done pretty well with it when I’ve either been able to get testing or speak with people including doctors to rule out the scariest of possibilities. Here I had a trip to the ER because my throat issues made me feel like I couldn’t take as deep breaths as normal and I had some chest pain which seems to have resolved. Also had an endoscopy that seemed to be clear although pathology said “squamous mucosa with reactive changes,” don’t know what that is yet.

I’m not usually the type to keep looking for reasons to have the horrible disease but I’d like to understand the difference between early bulbar onset and GERD as it relates to swallowing/throat. Anything to keep me from going down this rabbit hole will be helpful. It will be a while before I see a GI doc and I’m awaiting an appt to get my Ativan refilled. Thank you in advance for all that you do.

Previous threads:
Heavy shoulders - als? Also please suggestions for anxiety
Bulbar symptoms related to throat
Continued bulbar/swallowing/voice concerns - please help

 

[lgelb]

A gastroenterologist should be consulted to follow up the reactive changes, which may be GERD despite your lack of symptoms previously, or something else. So your appointment is very appropriate. Either way, it generally means your esophagus is trying to heal itself.

I don't think you have ALS. Swallowing issues when eating, which you now know have a structural basis, can often be helped by some combination of tucking your chin, avoiding plain water, drinking before, during, and after eating, and making sure you don't wolf down your food or drink.

 

[Jennie0813]

Appreciate your response. I don’t think I do either, it’s just so aggravating to google this stuff in search of solutions and have big scary letters jump out at you! Especially when you have healthy anxiety! Doing much better managing this time, but I do still wonder what the difference is when bulbar in some folks manifests with the swallowing issues and not vocal changes.

 

[lgelb]

First off, their endo doesn't show what yours did.
Second, they noticeably/clinically can't swallow as well as they used to. It's not just uncomfortable.
Re the breathing/chest pain issue that you had, that doesn't follow along with ALS in the context of your endo, either, but could accord with GERD, allergies, infections, or (one reason why you follow up this report), cancer.

 

[Jennie0813]

Thank you, this is helpful. Take care!