Burping/ belching followed by back pain and chest tighten

Hello everyone,

I am seeking guidance regarding my uncle, Mr. Fakruddin (61 years old), who was treated for esophageal cancer with chemoradiation and esophagectomy with gastric pull-through surgery last year.

For the past 15 days, he has been experiencing a new pattern of symptoms mainly between 3 AM and 6 AM:

• Burping/belching starts suddenly
• Followed by chest tightness
• Then pain radiates to the upper back below the neck and sometimes lower back/rib area
• Occasionally the pain shifts toward the chest
• Symptoms occur despite sleeping with head elevation

Recent PET-CT showed:
• T6 and T12 metabolically active vertebral lesions
• Some mediastinal/right retroclavicular lymph node activity
• Rib fracture/inflammatory findings

However:
• Mediastinal lymph node biopsy showed granulomatous inflammation with NO metastasis
• TB testing was negative

Doctors are now considering whether this could be:
• severe reflux/post-esophagectomy changes,
• inflammation,
• thoracic spine-related pain,
or something else.

Has anyone here experienced similar symptoms after esophagectomy/gastric pull-through surgery — especially nighttime burping followed by chest/back pain?

Did reflux or gas ever mimic spine/chest pain for you?

Any similar experiences or suggestions would be greatly appreciated.

Thank you.