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Have acid reflux, stomach pain, nausea. Taking Protonix. What is the problem?

Hi, my name is Damarica and I suffer with acid reflux very bad. At the moment, the middle part of my stomach is hurting me really bad and I am nauseous. Everything I eat or drink, it hurts when it goes down to my stomach. I ve had the upper GI and lower GI done but nothing was found. I am on protonix 40 mg once a day. My weight is up and down, not a good appetite . I just want to know what the problem can be because i am miserable.
Asked On : Tue, 27 Nov 2012
Answers:  2 Views:  600
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Gastroenterologist 's  Response
Hello, damaricadeville,
I see that you have been suffering from GERD or acid reflux problems.
You tell us that you had upper and lower GI x-rays that were reportedly
normal. That means, at least they did not see a big ulcer or narrowing
of the esophagus etc. I am not sure if you ever had an endoscopic
examination from a gastroenterologist who can take a good look at the
lining of the esophagus and , stomach and doudenum to rule out small
ulcers or signs of inflammation. He would also do a tissue sample or
a biopsy from the sophagus and stomach lining. The biopsy would also
show if you have a bacteria called Helicobacter Pylori (H.pylori) which
is associated with gastritis and ulcer.
Also, if you have not had a sonogram of the gallbladder, I suggest you
get that done. Gallstones can cause similar symptoms.
Protonix is a good PPI (Proton Pump Inhibitor) like others, and has to be
taken properly. Best time to take would be about an hour and a half before
your main meal of the day. Sometimes, you may have to take it twice
a day for relief of symptoms.
If you still don't get relief, you may have a condition called Non erosive
reflux disease (NERD) which does not respond well to PPI therapy. You
may need additional studies including stomach acidity test and also check
the contractions of the stomach (Motility).
But, I would recommend endoscopy & biopsy if you have not had one.
Wish you well.
Answered: Tue, 27 Nov 2012
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General Surgeon Dr. Grzegorz Stanko's  Response

Thank you for the query.

Such symptoms can be caused not only by acid reflux but also gallstones(the pain appears after a meal in the upper right or middle abdomen, can radiate to the back), pancreas disease, pregnancy. It is advisable for you to have abdominal ultrasound, full blood work with liver tests (AST,ALT,GGTP), amylase, bilirubin, urine analysis. amylase in urine, pregnancy test.
If no findings in this tests, abdominal CT with contrast should be performed as weight lost is symptom that should not be neglected.

Hope this will help.
Answered: Tue, 27 Nov 2012
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