This has been going on for almost a year. We have had monitoring of his throat for acid reflux, and he did have some, but the rise in acid doesn’t seem to correspond with the gagging, and medication doesn’t make a difference. He has tried over-the-counter medications as well as prescriptions. He has also had an endoscopic procedure, which showed no polyps.

I would greatly appreciate any information you can provide; our doctors seem to be at a dead end.

DEAR READER: Spontaneous gagging can be a symptom of several disorders; therefore, I cannot provide a definitive answer. I believe your husband’s best chance at getting a diagnosis is to be examined and tested by a gastroenterologist (if he hasn’t done so already) or by getting another opinion from a second gastroenterologist (preferably one unaffiliated with the first) or an ear-nose-and-throat specialist.

The most likely cause is GERD. Gastroesophageal reflux disease is a common condition in which acid backwashes into the throat. Reflux, either chronic or occasional, can be the result of excess acid production; a weak or improperly functioning hiatus (the ring of muscle that connects the esophagus and stomach); hiatal hernia (in which a portion of the stomach slides into the esophagus or alongside it in the chest cavity); diet/lifestyle; etc.

Symptoms can include a burning sensation within the chest, a sour taste in the mouth, dry cough, regurgitation of food or liquids (which may result in gagging), sore throat, chest pain, difficulty swallowing (which may cause gagging) and more. People with reflux do not always experience symptoms, and for some, symptoms may appear unrelated.

Just because your husband’s gagging does not appear to be related to the acid reflux doesn’t mean that it isn’t. I suggest your husband make some moderate lifestyle changes to see whether his symptoms improve. He should exercise on a regular basis; avoid fatty, greasy and acidic foods; and consume more whole grains, fruits and vegetables. He may also wish to use over-the-counter or prescription medication daily to try to prevent symptoms.

Other possibilities include vagus-nerve impingement, esophageal spasms, smoking and achalasia.
Achalasia is rare, occurring in about one in 100,000 people, so this is not likely the problem. It causes regurgitation and difficulty swallowing, both of which can result in gagging.

Esophageal spasms are abnormal muscle contractions within the throat that typically causes pain and difficulty swallowing.

Vagus-nerve impingement can cause nausea, vomiting, gagging and more, but it is most common in people who have had sinus surgery or head injury.

Smoking is another common cause of gagging that is often overlooked. Smokers, especially heavy smokers, are damaging their lungs with the habit, and as the damage progresses, excess fluid and mucus can accumulate in the lungs and drip down the back of the throat. This situation can cause difficulty breathing, coughing, a choking sensation and gagging until the mucus can be expelled.

To provide related information, I am sending you a copy of my Health Report “Hiatal Hernia, Acid Reflux and Indigestion.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter, and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Gastroesophageal reflux disease (GERD) commonly causes heartburn and a sour taste in the mouth; however, nearly half of all sufferers experience a chronic cough with no other symptoms. If the heartburn medication works, you probably have GERD. You may wish to try using antacids, which are less expensive and have the additional benefit of adding extra calcium to your diet. If they do not work, go back to the Prilosec. My hat is off to your allergist for thinking outside the box of his specialty and doing everything he could to help you.

DEAR READER:
Gastro-esophageal reflux disease (GERD) is often due to a weakness of the hiatal sphincter in the diaphragm that separates the stomach from the lungs. This weakness can cause a hernia in which the stomach actually slips through into the esophagus. This also allows for backwash of stomach juices which can cause pain, burning, stinging and sourness.

If your Prilosec is not working, return to your gastroenterologist who can further advise you about other medications and lifestyle modifications that may be beneficial.

Since I have started this I have had no indigestion and have not had to take my Prilosec. I don’t know why or how it works but it does. Please pass this on to your readers.

DEAR READER:
Done. Like, you I have no idea why this would work but am curious to know if it works for others as well.

So readers, if you suffer from gastro-esophageal reflux disease or frequent heartburn and indigestion, please give this remedy a try and let me know what your results were. It is certainly novel, not to mention tasty, but if it works, it could also save a fair amount of money (which is important in these ever-worsening economic times). Bananas are much cheaper and healthful than are medications.

Thanks for sharing and I will be sure to print a follow-up in the future when I have received plenty of responses.

To give you related information, I am sending you a copy of my Health Report “Hiatal Hernia, Acid Reflux and Indigestion”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER: To my knowledge, Nexium is a slightly stronger medication than Prevacid. It also does not have a generic form and can be very expensive.

I recommend that you try over-the-counter medications, such as Pepcid or Zantac. If they do not work for you, you may wish to try Prilosec. This medication was once available by prescription only but was found to be relatively free of side effects. It is now available for over-the-counter sale. If you try these unsuccessfully, you may benefit from comparison shopping your area pharmacies as each one can have a different price for your medication.

Another option is Wal-Mart and Target pharmacies that offer $4 prescription programs. Cimetidine (Tagamet), Famotidine (Pepcid) and Ranitidine (Zantac) are all available through the program. Verify that they can offer the medication you need for $4 because some states have laws that require higher pricing while others still do not allow the product to be sold under the program.

These can be purchased over-the-counter, generally in packages of 10 or 12 pills for individuals with infrequent acid reflux. For people who need the medication daily, such as those with gastroesophageal reflux disease, these programs offer substantial savings.

Speak with your physician. He or she will need to give you a prescription for the medication which you then can take to the pharmacy of your choice. You can find more information regarding these programs online at www.walmart.com and www.target.com

To give you related information, I am sending you a copy of my Health Report “Hiatal Hernia, Acid Reflux and Indigestion”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.