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What Is Causing Mid Back Pain And Excessive Belching After Taking Zantac For Acid Reflux?

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Posted on Mon, 9 Oct 2023
Question: History of Acid Reflux since 2003, placed on Nexium 40mg. Had a ultrasonic endoscopy in XXXXXXX 2017 (looking at pancreas). At that time they said the esophagus looked fine. Dr. switched me to Zantac vs Nexium in XXXXXXX 2017. Last two months, belching and burping and noticed some mid back pain. This week had a Barium Swallow Test that was unremarkable. Also this week went to ENT who said my throat was 7 one a scale of 1-10 for being red. Your observations.
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Answered by Dr. Ramesh Kumar (43 minutes later)
Brief Answer:
a prokinetic drug should be added.

Detailed Answer:

Hello,

GERD treatment is basically divided into two parts-

1) Control over production of acid-H2 blocker like Ranitidine or PPIs like pantoprazole are given to control the production of acid in stomach.

2)Prevent reflux of acid back into esophagus and throat; For this, a prokinetic drug like Itopride or levosulpiride is usually given.They prevent the reflux of acid back into the throat (whenever the acid is refluxed back into throat it causes inflammation of pharynx and larynx as in your case).

So a prokinetic medicine should be taken in conjugation with Ranitidine or Nexium.
Itopride 50 mg would be a good choice.

Lastly, H2 blocker only prevents the excess formation of acid while PPI's like Nexium prevents the excess as well as well as control the baseline production of acid.

A sudden increase in your symptoms is due to using of H2 blocker instead of PPI.
Switch over to Nexium 40 mg twice daily with itopride 50 mg once daily and things would be much better in 21 days.

Hope I was helpful. Feel free to follow up.
Thanks.

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Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2907 Questions

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What Is Causing Mid Back Pain And Excessive Belching After Taking Zantac For Acid Reflux?

Brief Answer: a prokinetic drug should be added. Detailed Answer: Hello, GERD treatment is basically divided into two parts- 1) Control over production of acid-H2 blocker like Ranitidine or PPIs like pantoprazole are given to control the production of acid in stomach. 2)Prevent reflux of acid back into esophagus and throat; For this, a prokinetic drug like Itopride or levosulpiride is usually given.They prevent the reflux of acid back into the throat (whenever the acid is refluxed back into throat it causes inflammation of pharynx and larynx as in your case). So a prokinetic medicine should be taken in conjugation with Ranitidine or Nexium. Itopride 50 mg would be a good choice. Lastly, H2 blocker only prevents the excess formation of acid while PPI's like Nexium prevents the excess as well as well as control the baseline production of acid. A sudden increase in your symptoms is due to using of H2 blocker instead of PPI. Switch over to Nexium 40 mg twice daily with itopride 50 mg once daily and things would be much better in 21 days. Hope I was helpful. Feel free to follow up. Thanks.