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Diagnosed with GERD, sudden chest pain. EKG was normal. Lansaprozole didn't help, started Nexium. Suggest?

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General & Family Physician
Practicing since : 2007
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By way of background, I was recently diagnosed with GERD by my doctor after I had a few episodes of sudden severe chest and other pain. After that, I had two EKGs which were normal. I also had a barium swallow upper GI test which I was told was "ok". I was initially placed on Lansaprozole which did not seem to help much. A few days ago, I called my doctor's office and asked that my medication be switched. I just started Nexium yesterday.

As for my question, each time that my GERD flares up, the following few days I feel like I was punched in my gut after I eat. Sometimes it lasts for a half hour, sometime for an hour or two. Is this a lingering GERD symptom after a severe flare up or could it be an indication that there is something else going on? Along with the stomach discomfort, I usually feel a slight gagging sensation in my throat.

Finally, if I do have GERD, will Nexium allow my XXXXXXX to heal so that the acid stops causing havoc in places where it is not supposed to be?
Posted Tue, 3 Sep 2013 in GERD
Answered by Dr. Lohit K 1 hour later
Brief Answer:
GERD.Nexium with Antiemetic.Follow general measure

Detailed Answer:
Hi Thanks for using XXXXXXX

All your symptoms suggest GERD as diagnosed by doctor. I do see lot of patients with similar complaint in my clinic. Be relaxed and no need to worry.

You can follow the below mentioned for your management. My patients find good relief with these measures:

1. Proton pump inhibitors like Nexium to reduce gastric acid secretion along with an anti emetic (I prefer metoclopromide) every night 30 min before food so that the reflux is also prevented and your gastric motility will be increased.

2. If severe burning pain you can take syp. Mucaine for immediate management; but not along with Nexium. Combination reduce the action of Nexium.

3. Do regular exercises and take plenty of fluids with fiber diet. Maintain your body weight at normal range. Restrict your food before your stomach is full. Have a 30 min walk before you sleep and keep your head end raised. This will prevent gastric reflux.
You should not suddenly stop Nexium; but replace with other drugs like ranitidine BD before you stop it.

4. Get an endoscopy done to rule out any ulcer once. If ulcer is present and if you are not relieved of your symptoms with above measure then you may need to take HP Kit for H Pylori management.

Hope I answered your query. Feel free to ask any further related query and I will be free to answer them.

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