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Suggest Treatment For GERD
Question: 32 male 175 lbs. very active.
10 yr history of GERD, has been controlled 1x Prilosec. Scoped 10yrs ago and 2 years ago. My XXXXXXX doesn’t close all the way I believe.
8 months ago started getting nausea, gagging sensation when under small stresses at work (pilot) or driving. Coffee always seemed to make it worse. But got the same symptoms even after no caffeine or alcohol for 7 days. Symptoms have gotten worse. I thought it might be Flonase I take for allergies, but 5 days off, and I still have the symptoms.
Some post nasal drip, never comes out my nose, but down my throat and makes me very very uncomfortable. NEVER feels like heart burn, I feel it in my throat.
All of a sudden after a few stressful days at work, I got a case of GERD during sleep that aggravated my esophagus. It hurt, it never went away. I went to GI Dr., she suggested I double Prisolsec 2x daily and use carafate 2x daily to let my esophagus heal. Also to elevate bed post, which I did. Come back in 1 month if it still bothers you.
I have slept fine, but now I have a cough, phlegm in throat, constantly trying to clear my throat. And I still got really bad feeling of nausea and gagging driving my motorcycle around town today. Or if I bend over, I feel it in my throat. I also had chills 2 nights ago at bedtime.
1. What is the next step? Wait longer? Got back to GI to get scoped again? Should I go to ENT and rule out the post nasal drip causing these symptoms?
2. I have been very active, running never makes me feel like this, but bouncing around in a car does. How do I figure out the trigger?
I am missing work over this and would really like to get back to my normal healthy self.
10 yr history of GERD, has been controlled 1x Prilosec. Scoped 10yrs ago and 2 years ago. My XXXXXXX doesn’t close all the way I believe.
8 months ago started getting nausea, gagging sensation when under small stresses at work (pilot) or driving. Coffee always seemed to make it worse. But got the same symptoms even after no caffeine or alcohol for 7 days. Symptoms have gotten worse. I thought it might be Flonase I take for allergies, but 5 days off, and I still have the symptoms.
Some post nasal drip, never comes out my nose, but down my throat and makes me very very uncomfortable. NEVER feels like heart burn, I feel it in my throat.
All of a sudden after a few stressful days at work, I got a case of GERD during sleep that aggravated my esophagus. It hurt, it never went away. I went to GI Dr., she suggested I double Prisolsec 2x daily and use carafate 2x daily to let my esophagus heal. Also to elevate bed post, which I did. Come back in 1 month if it still bothers you.
I have slept fine, but now I have a cough, phlegm in throat, constantly trying to clear my throat. And I still got really bad feeling of nausea and gagging driving my motorcycle around town today. Or if I bend over, I feel it in my throat. I also had chills 2 nights ago at bedtime.
1. What is the next step? Wait longer? Got back to GI to get scoped again? Should I go to ENT and rule out the post nasal drip causing these symptoms?
2. I have been very active, running never makes me feel like this, but bouncing around in a car does. How do I figure out the trigger?
I am missing work over this and would really like to get back to my normal healthy self.
Brief Answer:
Need further investigations as following...
Detailed Answer:
Hi,
I am sorry for the situation you are in.
From what you are describing, I can say that GERD is the first cause of your symptoms. Sometimes, the hyperacidic stomach fluid can be aspirated to the lungs and make the pulmonar mucosa susceptible to infections. Cough, phlegm, post nasal drip, all your actual symptoms are indicative for upper respiratory tract infections.
1. The very first thing I highly recommend is to consult with ENT specialist to rule out ENT infections or other problems.
Chest X-ray, culture of sputum, spirometry (respiratory function tests) are also advised as first step to understand what is the actual condition of your lungs and ENT organs and get them treated properly.
Another upper endoscopy is advised to evaluate the damages in the esophagus and upper GI tract organs in order to determine the right treatment strategy.
2. If running in fresh air is not causing the actual symptoms, while bouncing around in a car does, make me think of a possible allergy problems that should be further evaluated through chest-Xray, spirometry and allergy testing. Discuss it further with pulmonologist/allergologist.
For the moment, I can only advise to:
- keep a good hygiene of your oral cavity
- rinse your throat with warm water and salt on daily basis
- take 1 teaspoon of olive oil, followed by 1 teaspoon of honey every day
- take anti-histaminic drug you can find as over the counter
- nasal spray can also help for post-nasal drip
- anti-septic oral lozenges are also recommended to use ( I usually advise herbal lozenges)
Hope it helped!
Dr.Klerida
Need further investigations as following...
Detailed Answer:
Hi,
I am sorry for the situation you are in.
From what you are describing, I can say that GERD is the first cause of your symptoms. Sometimes, the hyperacidic stomach fluid can be aspirated to the lungs and make the pulmonar mucosa susceptible to infections. Cough, phlegm, post nasal drip, all your actual symptoms are indicative for upper respiratory tract infections.
1. The very first thing I highly recommend is to consult with ENT specialist to rule out ENT infections or other problems.
Chest X-ray, culture of sputum, spirometry (respiratory function tests) are also advised as first step to understand what is the actual condition of your lungs and ENT organs and get them treated properly.
Another upper endoscopy is advised to evaluate the damages in the esophagus and upper GI tract organs in order to determine the right treatment strategy.
2. If running in fresh air is not causing the actual symptoms, while bouncing around in a car does, make me think of a possible allergy problems that should be further evaluated through chest-Xray, spirometry and allergy testing. Discuss it further with pulmonologist/allergologist.
For the moment, I can only advise to:
- keep a good hygiene of your oral cavity
- rinse your throat with warm water and salt on daily basis
- take 1 teaspoon of olive oil, followed by 1 teaspoon of honey every day
- take anti-histaminic drug you can find as over the counter
- nasal spray can also help for post-nasal drip
- anti-septic oral lozenges are also recommended to use ( I usually advise herbal lozenges)
Hope it helped!
Dr.Klerida
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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