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Hi Doctor, For Ten Years Until About A Year Ago
Question: Hi Doctor,
For ten years until about a year ago I had suffered from GERD and hiatal hernia with acid and bile reflux shown in past gastroendoscopies. I believed my trigger was too much sugar and alcohol. After various goes at PPIs (which were not really working), a more adjusted diet and sleeping on an incline, my last check concluded in gastrititis, functional polyps which were removed and no hiatal hernia detected and I was relieved of most of the late night heartburn. Recently I did start drinking alcohol (two cocktails) and taking in more sugary items and almost immediately my heartburn symptoms were back, but now it it feels continuous and quite severe. I also suffered from intense, burning sensation in the center of my abdomen on an empty stomach. Stools are a bit soft, I have been going every day.
Now I am taking Gaviscon at night else I cannot sleep. Could you please help enlighten me about what is happening and what I can do to stop it? It is possible that I may have an ulcer, infection or a returning hiatal hernia, etc? I really don’t want a go at PPIs again as I have read research on their increased risk of stomach cancer in patients and my polyps were a result of taking PPIs long-term. Thanks.
For ten years until about a year ago I had suffered from GERD and hiatal hernia with acid and bile reflux shown in past gastroendoscopies. I believed my trigger was too much sugar and alcohol. After various goes at PPIs (which were not really working), a more adjusted diet and sleeping on an incline, my last check concluded in gastrititis, functional polyps which were removed and no hiatal hernia detected and I was relieved of most of the late night heartburn. Recently I did start drinking alcohol (two cocktails) and taking in more sugary items and almost immediately my heartburn symptoms were back, but now it it feels continuous and quite severe. I also suffered from intense, burning sensation in the center of my abdomen on an empty stomach. Stools are a bit soft, I have been going every day.
Now I am taking Gaviscon at night else I cannot sleep. Could you please help enlighten me about what is happening and what I can do to stop it? It is possible that I may have an ulcer, infection or a returning hiatal hernia, etc? I really don’t want a go at PPIs again as I have read research on their increased risk of stomach cancer in patients and my polyps were a result of taking PPIs long-term. Thanks.
Brief Answer:
Time for repeat endoscopy sir.
Detailed Answer:
Hello and thanks for choosing 'Ask A Doctor' for your query.
I've gone through your details and I appreciate your concerns.
My first and foremost suggestion is to go for a planned endoscopy. 10 years is too long a time and it's time when it should be repeated again. Some times a bacteria named H. Pylori is responsible for recurrent gastritis. A important catch in your history is that PPIs don't help you much. This usually happens when gastritis or acid peptic disorder is a result of H. Pylori infection.
Two ways are there to detect it:
Breath test
Endoscopy.
Clinically ulcers and pain due to ulcers show significant improvement on taking PPIs.
My suggestion is instead of unnecessarily taking various medicines go for a planned endoscopy. Things would be clear in 20 minutes.
Till then take over the counter Ranitidine 150mg twice daily.
It's a very safe test and in hardly 20 minutes things would be clear.
Follow up with reports of endoscopy.
Once the cause is clear your symptoms could be fully controlled by proper medication.
Hope I was helpful,
Thank you.
Time for repeat endoscopy sir.
Detailed Answer:
Hello and thanks for choosing 'Ask A Doctor' for your query.
I've gone through your details and I appreciate your concerns.
My first and foremost suggestion is to go for a planned endoscopy. 10 years is too long a time and it's time when it should be repeated again. Some times a bacteria named H. Pylori is responsible for recurrent gastritis. A important catch in your history is that PPIs don't help you much. This usually happens when gastritis or acid peptic disorder is a result of H. Pylori infection.
Two ways are there to detect it:
Breath test
Endoscopy.
Clinically ulcers and pain due to ulcers show significant improvement on taking PPIs.
My suggestion is instead of unnecessarily taking various medicines go for a planned endoscopy. Things would be clear in 20 minutes.
Till then take over the counter Ranitidine 150mg twice daily.
It's a very safe test and in hardly 20 minutes things would be clear.
Follow up with reports of endoscopy.
Once the cause is clear your symptoms could be fully controlled by proper medication.
Hope I was helpful,
Thank you.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you for your prompt reply Doctor.
I have just uploaded part of an endoscopy report, please feel free to have a look. I wanted to clarify that I have actually taken an endoscopy in April 2018. Do you still recommend that I take an endoscopy instead of a breath test?
How likely does the alcohol / sugar contribute to my sudden and severe reappearance of reflux symptoms and what diet or exercise can I use now if any?
Thank you in advance.
I have just uploaded part of an endoscopy report, please feel free to have a look. I wanted to clarify that I have actually taken an endoscopy in April 2018. Do you still recommend that I take an endoscopy instead of a breath test?
How likely does the alcohol / sugar contribute to my sudden and severe reappearance of reflux symptoms and what diet or exercise can I use now if any?
Thank you in advance.
Brief Answer:
Follow up.
Detailed Answer:
Hello again my dear patient,
No no test is required at present.All that is required is a proper lifestyle modification(sounds easy but is in practical a bit tough).
In order to relieve yourself, Diet and life style modifications need to be done.
* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Avoid alcohol intake.Complete prohibition. Period!
Alcohol converts into acetaldehyde which is highly toxic to mucosa of your gut. You can't get rid of gastritis if you won't give up alcohol.In case if you crave for it too much then initially take 2tablets of Ranitidine 300 mg with an antacid syrup containing Aluminium and Magnesium hydroxide(to form a layer of protective covering over your stomach).
* Take plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like isabgol/psyllium husk or senna. I would insist you to increase your dietary fiber intake. You can get it online on XXXXXXX Take natural isapghul fibers not the one processed by companies adding taste to it.
* Atleast regular morning walk and exercise to keep the bowel movements proper.
* If I had a patient like you I would perhaps have suggested Prodep (fluoxetine) 20 mg tablet (long term anxiolytic and a prescription drug) once daily for at least 2 months (it may take time for the action to set in). It has been seen in various researches that due to gastritis and acid peptic disorder over the time our autonomous nerves get stimulated(not controlled by brain) which cause surge in secretion of acid in gut even when a person is not feeling any anxiety.
* Take curd or yogurt on daily basis. It contains beneficial bacteria and should help.
* Stress reduction has a very important role to play. Yoga and meditation should help.
As per query regarding sugar.Sugar is the best food for any bacteria yeast or fungus.This sugar when ferments form large amount of toxic gases inside your gut causing local inflammation and depletion of good bacterial colonies in your gut.
If you crave sugar then take it in form of fruits like guava,pears,Apples etc.
Hope this answers your query.
Do feel free to follow up.
In case you have any suggestions to make my answers better do suggest them.
Do rate the answer if you close thread.
And at last just follow a good diet 6 days a week and cheat one day. Do little bit of exercise yoga etc and you would find yourself much relieved.
Wish you mountains of luck and a very happy life with fast recovery.
Thanks.
Kumar R!
Follow up.
Detailed Answer:
Hello again my dear patient,
No no test is required at present.All that is required is a proper lifestyle modification(sounds easy but is in practical a bit tough).
In order to relieve yourself, Diet and life style modifications need to be done.
* Avoid spicy food. Take small but frequent meals. Avoid long gaps between meals.
* Avoid alcohol intake.Complete prohibition. Period!
Alcohol converts into acetaldehyde which is highly toxic to mucosa of your gut. You can't get rid of gastritis if you won't give up alcohol.In case if you crave for it too much then initially take 2tablets of Ranitidine 300 mg with an antacid syrup containing Aluminium and Magnesium hydroxide(to form a layer of protective covering over your stomach).
* Take plenty of green leafy vegetables as well as other sources of dietary fibers. Take fiber supplements like isabgol/psyllium husk or senna. I would insist you to increase your dietary fiber intake. You can get it online on XXXXXXX Take natural isapghul fibers not the one processed by companies adding taste to it.
* Atleast regular morning walk and exercise to keep the bowel movements proper.
* If I had a patient like you I would perhaps have suggested Prodep (fluoxetine) 20 mg tablet (long term anxiolytic and a prescription drug) once daily for at least 2 months (it may take time for the action to set in). It has been seen in various researches that due to gastritis and acid peptic disorder over the time our autonomous nerves get stimulated(not controlled by brain) which cause surge in secretion of acid in gut even when a person is not feeling any anxiety.
* Take curd or yogurt on daily basis. It contains beneficial bacteria and should help.
* Stress reduction has a very important role to play. Yoga and meditation should help.
As per query regarding sugar.Sugar is the best food for any bacteria yeast or fungus.This sugar when ferments form large amount of toxic gases inside your gut causing local inflammation and depletion of good bacterial colonies in your gut.
If you crave sugar then take it in form of fruits like guava,pears,Apples etc.
Hope this answers your query.
Do feel free to follow up.
In case you have any suggestions to make my answers better do suggest them.
Do rate the answer if you close thread.
And at last just follow a good diet 6 days a week and cheat one day. Do little bit of exercise yoga etc and you would find yourself much relieved.
Wish you mountains of luck and a very happy life with fast recovery.
Thanks.
Kumar R!
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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