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Had Barretts esophagus. Have had reflux. Reason for burning sensation in stomach?

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Practicing since : 2000
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I have had reflux off and on for about a year. I had a web removed and scope and bioposy showed i had Barretts esophagus. I was put on Dexilant and it never went away but seem to be better. In July I had another scope and Bravo ph testing done. It showed very little acid refluxing and little inflammation. So my doctor took me off ppi meds and said eat what you would like. I did well for five weeks and all of a sudden Im having the worst burning around my lower XXXXXXX valve. It hurts so bad it feels ulcerated. The acid seems to be coming all the way up but not at all times but i can feel when the acid hits the lower part. It is worse upon bending and about two hours after i eat. I also have alot of air bubbles coming up to top of stomach and sometimes they stay there and some times they leak into my esophagus. not like a burp.. but its constant and it started when the reflux came back.They did say my valve was slightly patulous. My question is: My reflux was never this bad can just five weeks off med maybe caused my esophagus this much burning. Its only been real bad for about 10 days. Also how long does it take dexilant ppi to stop the acid? and heal the esophagus? where i can feel a difference? Im worried because it got so bad... can it reheal and settle down without major surgery even if it is a little patulous? thanks for taking the time my doctor moved and my regular dr only knows so muc in this area! would the air bubbles maybe been a hernia that just came on?
Posted Tue, 1 Oct 2013 in Digestion and Bowels
Answered by Dr. Amit Jain 11 hours later
Brief Answer:
Restart dexilant along with domperidone

Detailed Answer:
Hello! Thanks for putting your query in XXXXXXX I am a Gastroenterologist (DM).

I appreciate your concern regarding your illness. I will advise you to restart dexilant as acid suppression is most important in prevention of further progression of Barretts esophagus, along with a prokinetic agent like domperidone which will further help in reducing reflux. Dexilant starts working with in 2-3 dose. Once there is Barretts esophagus it will never heal. You have to on regular surveillance depending on the grade of dysplasia which you haven't mentioned. For example if there is no dysplasia then you have to undergo endoscopic examination with in 3 years again. Few more steps which I found very useful in my patients for prevention of reflux are:

Few more tips:
1.Avoid fatty meals
2. Don’t lie down soon after meals for at least half hour
3.Take small and frequent meals, instead of full meals at a time
4. wear loose clothes
5. If you are overweight or obese do weight reduction with dieting and exercise
6. head end elevation while sleeping

I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.
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