Recurring lower-esophageal pressure, saliva and dry heaving

Summary

Since May 2025, I’ve experienced recurring episodes of intense pressure in my lower esophagus, accompanied by excessive saliva and repeated dry heaving. The pressure builds, and spitting saliva or dry heaving provides brief relief, but it quickly returns. I don’t experience typical heartburn or significant nausea.

Episodes can last 12–36 hours or longer, followed by days when I feel nearly normal. I’ve had two largely normal endoscopies and a normal-to-fast gastric emptying study. Esophageal manometry and 24-hour impedance-pH testing are scheduled for December 15–16.

I’m hoping to find someone who has experienced this specific combination of symptoms, particularly the recurring pressure and temporary relief from dry heaving.

More detailed history

I’m a 46-year-old male, physically active, and was generally healthy before these symptoms began rather suddenly in May 2025.

My symptoms tend to follow a recurring pattern:

* I can feel nearly normal for several days, eating comfortably and maintaining a good appetite.
* An uncomfortable pressure sensation develops in my lower esophagus, sometimes gradually over several hours.
* During a severe episode, the pressure becomes overwhelming. I frequently spit saliva into a cup because swallowing is the last thing I want to do.
* I may repeatedly dry heave, occasionally bringing up small amounts of clear fluid. The heaving briefly relieves the pressure, but it builds again.
* I don’t feel conventionally nauseated or sick to my stomach. It’s primarily an intense pressure sensation that makes me feel like I need to vomit, even though there’s little to bring up.
* Episodes sometimes continue overnight and can significantly disrupt my ability to eat, sleep, or function.
* Eventually, the pressure subsides, sometimes surprisingly quickly, and I can return to eating normally.

At times, these episodes have occurred roughly every five or six days. More recently, I’ve had days when the familiar pressure starts but never develops into a full episode.

Testing so far

* Two upper endoscopies: largely normal, apart from a small hiatal hernia and mild inflammation.
* Gastric emptying study: normal to somewhat fast.
* Upcoming December 15–16: high-resolution esophageal manometry and 24-hour impedance-pH monitoring to evaluate esophageal muscle function, sphincter relaxation, and acid/nonacid reflux.

I’ve also experimented with smaller, more evenly spaced meals and reducing overall daily food intake. This may help, but I haven’t established a consistent relationship between eating and the episodes. Once a severe episode begins, even prolonged fasting doesn’t reliably stop it.

My gastroenterologist also recommended a complete trial off THC to investigate whether it could be contributing. I’ve abstained since September 30, but episodes have continued.

What I’m hoping to learn from others

Has anyone experienced intense, recurring pressure specifically in the lower esophagus, accompanied by excessive saliva and dry heaving, but without significant nausea or classic heartburn?

Were you eventually diagnosed with an esophageal motility disorder, reflux hypersensitivity, nonacid reflux, or something else?

And most importantly, did you find a treatment that substantially reduced or eliminated the episodes?

I’d really appreciate hearing from anyone whose symptoms sound similar, especially if you’ve undergone esophageal manometry or impedance-pH testing.